مجله فیض
سال چهاردهم شماره 4 (پیاپی 56، زمستان 1389)

Axon regeneration in adult CNS is limited by the presence of inhibitory proteins associated with myelin. Although blocking PKC activity attenuates the ability of CNS myelin to inhibit neurite outgrowth, the role as well as mechanisms underlying the remyelination inhibition in CNS are still largely unknown. Considering the role of PKC in axonal regeneration and the vulnerability of optic chiasm in multiple sclerosis (MS), we assessed the effect of PKC inhibition on remyelination of lysolecithin induced demyelinated optic chiasm. Demyelination was induced by stereotaxic intra-chiasmatic injection of 1µl lysolecithin (%1) in male mice. Intracerebroventricular daily injection of a PKC inhibitor (GO6976) was done for 14 days post-lesion. Demyelination and remyelination patterns in optic chiasm were confirmed through histological verification and electrophysiological study using Luxol fast blue staining and visual evoked potentials (VEP) recording, respectively. In lysolecithin treated animals, demyelination was mostly marked at days 3 and 7 post-lesion and an incomplete remyelination occurred at day 14 post-lesion. VEP recording showed increased P-latency at the days 3 and 7 post-lesion while it partially decreased at day 14. Following the inhibition of PKC, while the extent of demyelination and P-latency slightly decreased at the days 3 and 7 post-lesion, it recovered at day 14. VEP recording data were confirmed by histological verification. Inhibition of PKC activity could represent a potential therapeutic approach for stimulating the remyelination process in the context of multiple sclerosis.

Hippocampus is well known to be involved in learning and memory. It is proved that antioxidants improve learning and memory. Origanum vulgare L. ssp. Viridis (ORG) is a rich source of antioxidants. The aim of this study was to investigate the effect of intra-hippocampal injection of aqueous extract of ORG on spatial learning and memory.

Twenty-eight adult male Wistar rats (275-300gr) were used in this study. The animals were bilaterally canulated in dorsolateral hippocampus. One week after recovery the animals were trained (4 trails for four consecutive days) in Morris water maze (MWM). Then, the retention of spatial training was evaluated in the fifth day. Twenty minutes before the training or retrieval test, different concentrations of ORG (0.003, 0.03 and 0.3 µl/rat) or saline were injected into the hippocampus.

Repeated-measure ANOVA showd that intra-hippocampal injection of ORG significantly decreased the distance and time of reaching to hidden platform in MWM, Intra-hippocampal injection of ORG in the retrieval day did not show any significant difference in the duration of target zone and the platform proximity compared to the saline group.

The intra-hippocampal injection of Origanum aqueous extract improves the rat working memory in MWM however it doesnt affect on the consolidation of memory.

β-carboline alkaloids, such as harmane, are found in common plant-derived foodstuffs and plant-derived inhalation components of tobacco. In the present study, the involvement of dorsal hippocampus nicotinic receptor in the harmane effects on anxiety behavior has been evaluated. Mice were anesthetized with an intra-peritoneal injection of ketamine hydrochloride plus xylazine and then placed in a stereotaxic apparatus. Cannual were bilaterally implanted in the CA1 region of hippocampus. All animals were allowed to recover for 1 week before the beginning of the behavioral testing. The hole-board test was used to evaluate the anxiety-like behaviors. One-way analys was of variance so that Dunnett’s test was used to analyse data. All experiments were performed in accordance with institutional guidelines for animal care and use. Intraperitoneal injection of harmane decreased the number of head dip and locomotion (P<0.001). While bilateral intra-dorsal hippocampal injections of nicotine decreased the number of head dip (P<0.01), it had no effect on locomotor activity. Furthermore, intra-dorsal hippocampal injection of mecamylamine (nicotinic receptor antagonist) in the presence and absence of harmane had no effect on anxiety behavior and locomotion (P>0.05). harmane and nicotine not only display anxiogenic effects but also demonstrate a complex interaction. The findings also indicated that harmane induces anxiety via non-nicotinic receptors.

Nausea and vomiting are among the common complications of anesthesia and surgery with a higher incidence in laparoscopic cholecystectomy (LC). The purpose of this study was to evaluate the efficacy of pre-operative dexamethasone on the relief of postoperative nausea and vomiting following LC. This is a randomized clinical trial study. In this prospective, placebo-controlled study, 90 patients requiring laparoscopic cholecystectomy (LC) were randomly divided into two groups: the dexamethasone group (n=45) received dexamethasone (8 mg, IV) and the control group (n=45) received saline (2cc, IV) 90 minutes before the anesthesia. Signs and symptoms of nausea and vomiting were recorded every 4h for 16h in the two groups. The data were analyzed using Fishers, Chi- square and t test. A lower feeling of nausea was seen 4h and 12h post-surgery in the dexamethasone group (P=0.02, P=004), also a lower accurance of vomithng was observed 4h post-operative in the same group compared to the control group (P=0.013). The results suggest that pre-operative dexamethasone (8 mg, IV) application significantly reduces the incidence of post-operative nausea and vomiting.

Due to its high prevalence, the survey on gastric cancer survival in Iran seems too important. In the case of relative long-term survival of the cases, using standard models is not conventional. So cure models are used to estimate the proportion of the cured patients that will never experience the event of interest and also to evaluate the survival function of susceptible individuals who may experience the event and effective factors. This study was carried out to determine the five-year survival rate of gastric cancer patients who have undergone surgical treatment. Three hundred and thirty gastric cancer operated patients with a maximum 10-year survival were enrolled in the study. The patients’ life expectancy after surgery and cure fraction and their relationships with some variables were evaluated. Kaplan-Meier and Weibull Cure models were utilized for analyses. The five-year survival rate and the median life expectancy were 24% and 19.9 months, respectively. Univariate analysis using the Weibull model showed that age, existence/site of metastasis and stage of disease influenced on the probability of curing (P<0.05). On assessing the simultaneous effect of different variables the age and stage of disease proved to be effective on curing (P<0.05), but none of the variables affected the life expectancy of patients (P>0.05). Using the cure models is beneficial in situations which the population under study suggests the presence of subpopulation. The cure/immune model methodology may separeltery identify the sets of covariates related to the cured proportion and also the failure time distribution of uncured one.

Rheumatoid arthritis (RA) is one of the most prevalent autoimmune diseases in the world. Some of the researches have suggested that the serum vitamin D level may relate to disease activity. The current study was designed to identify the correlation between serum vitamin D level and the disease activity index (DAI). In this sectional study, 108 patients (diagnosed based on the American Committee of Rheumatology criteria) were enrolled. In all cases after determining the serum vitamin D level and ESR, complete joint examination were done. The normal range of vitamin D was 47.7 - 144 nm/lit. Then, the specified disease activity form (DAS-28) and visual analog scales (VAS) were filled out. The correlation between disease activity index, (based on VAS, tendered or swelled joints and ESR) and serum vitamin D was analyzed using Chi square, Mann Whitney and t-tests. Seventy nine (73.14%) out of 108 patients had normal serum vitamin D and 29 (26.86%) had low serum vitamin D level. The mean age of patients with normal and low serum vitamin D level were 52.22±11.6 and 48.48±12.51, respectively (P=0.075). The mean DAI in normal and low vitamin D patients were 3.75±1.37 and 5.19±1.56, respectively (P=0.00). The mean number of swollen joints in normal and low vitamin D patients was 1.24±1.39 and 3.65±3.3, respectively (P=0.001). The mean number of tender joints in normal and low vitamin D patients were 6.84±4.41 and 9.44±3.62, respectively (P=0.042). The mean ESR in normal and low vitamin D patients were 19.40±12.40 and 37.91±21.72, respectively (P=0.002). Moreover, the mean VAS in normal and low vitamin D patients was 23.29±19.42 and 50.68±30.78, respectively (P=0.003). The more active the RA, the less serum vitamin D level.

Escherichia coli (E. coli) is an indicator of potential human fecal contamination. Polymerase Chain Reaction (PCR) as an ideal detection method for detecting E. coli has some advantages like rapidity, high sensitivity and accuracy, easy performance, ability to run in high numbers and inexpensiveness. On the other hand, the disadvantage of PCR is possibility of its false positive results. In this study, reverse transcriptase polymerase chain reaction (RT-PCR) method was used to overcome the problem, and the results were compared to most probable number (MPN). 16srRNA forward (SF) and 16srRNA reverse (SR) primers were designed using E. coli 16srRNA sequence. After preparing different diluted samples of E. coli in distilled water, the bacteria were separated by FHLP and HAWP filters and its 16srRNA was propagated using mentioned primers. To confirm the sensitivity of the RT- PCR method compared to MPN one, samples obtained from 15 water sources in Arak city were examined. The number of bacteria in dilutions were confirmed with culture. RT-PCR data showed that FHLP compared to HAWP filters have a higher capability in separating of bacteria in different dilutions. Also there was a higher sensitivity of RT-PCR compared to RT- PCR and MPN. RT-PCR can detect the bacteria in lower dilutions of bacterial suspension. Hydrophobic filters (e.g. FHLP) compared to hydrophilic filters (e.g. HAWP) have higher capability in separating bacteria. To detect all coliform bacteria RT-PCR amplifications achieved by cells concentrated with hydrophobic filters are recommended.

Nausea and vomiting in early stages of pregnancy is a common complaint. In patients with HEG (hyperemesis gravidarum) adverse fetal outcomes, including abortion, preterm delivery, low birth weight (LBW) and maternal outcome (e.g. preeclampsia) are more common than in normal pregnancy. In this study, we evaluate the incidence of some adverse fetal and maternal complications among the patients with HEG. This study was performed on 70 patients (under 14 weeks of gestations) with HEG admitted in Yahya-Nejad hospital (Babol) as the study group and 100 cases referred to prenatal care as the control group. All the patients were followed up until the time of delivery. The incidence of preterm delivery in the HEG and control group was 9.4% and 1%, respectively, considered statistically significant (P=0.015). The incidence of abortion in the HEG and control group was 8.6% and 1%, respectively, which was significant (P=0.02). The incidence of gestational diabetes in control and HEG group was 0% and 10.9%, respectively (P=0.001). There was no significant difference between the study group and the control one in terms of the type of delivery, weight / mortality of neonates and preeclampsia. Considering the high incidence of gestational diabetes, preterm delivery, abortion and morbidity of neonates in patients with HEG, close observation of patients with HEG during the pregnancy is recommended.

The major problem in prescribing the therapeutic dose of warfarin, the most clinically used anticoagulant, is achieving its optimal International Normalized Ratio (INR). This study was designed to determine the mean dose of warfarin among the patients admitted to Kashan Heart Clinic in 2008. In this cross-sectional study, the medical documents of all patients receiving warfarin in any medical indications were studied for demographic specification, INR results, smoking, other used drugs and the underlying diseases. The warfarin dose attained (INR equal to 2.4-2.6 for 3 consecutive test results) was regarded as the optimal dose. All unqualified cases in terms of INR criteria were excluded. Statistical analysis was done using ANOVA, Pearson, Spearman and T-tests. Seventy one out of 86 patients were included in the study. The mean daily dose of warfarin was 3.97±1.38 mg. Fourty six, 13, 11 and one patient(s) received warfarin for atrial fibrillation, prosthetic valve, congestive heart failure and embolic cerebrovascular accident, respectively. While warfarin dose had an inverse relation to age (P=0.01), it had no significant relation with sex (P=0.7), underlying diseases (P>0.07), smoking (P=0.2), other used drugs (P=0.07) and the patient weight (P=0.1). The results showed that warfarin dose was higher among the patients with prosthetic valve (P=0.008). The obtained effective daily and weekly dose of warfarin i.e. 3.97±1.38 and 27.83±9.77 mg, respectively could be used as a therapeutic clue for prescribing the appropriate dose and optimum INR.

Methicillin-resistant Staphylococcus aureus (MRSA) is the main cause of hospital infection. The aim of present study was to investigate the molecular characteristics of Staphylococcus aureus (SA), to detect mecA gene, and to type SCCmec in the strains isolated from patients at Kashan Shahid Beheshti Hospital. This descriptive study was carried out on SA isolates (n=150) collected from the clinical samples at Kashan Shahid Beheshti Hospital, Iran during 2009. The identification of all tested isolates were confirmed using Gram's stain, coagulase, DNase and manitol salt agar. In addition, the genotypes of SCCmec in the MRSA isolates were determined by multiplex PCR. Eighty seven (58%) out of 150 SA isolates were confirmed as MRSA harboring mecA gene detected by PCR. Thirty four out of 87 (39.1%) were HA-MRSA and the remainig 53 (60.9%) were CA-MRSA. The multiplex PCR assay for SCCmec complex of MRSA strains (n=87) showed that 3(3.4%) samples were SCCmec type I, 12(13.8%) SCCmec type II, 8(9.2)% SCCmec type IVb, 4(4.6%) SCCmec type IVd and 3(3.4%) SCCmec type V. More than 50% of SA strains were positive for mecA gene and more than 60% of them were CA-MRSA. Moreover, SCCmec type II was the predominant strain of the identified MRSA.

Hearing loss is a sensorineural disorder occuring in 1 out of 500 births. It happens due to some genetic/environmental causes or both. More than 60% of cases are noninherited and 80% non syndromic with autosomal recessive inheritance. In the present study we investigated the frequency of mtDNA A1555G, A3243 and A7445G mutations among the patients in Fars province.

Seventy two non syndromic hearing loss subjects were studied. DNA was extracted using standard phenol-chloroform method. The screening of the mitochondrial gene mutations were performed using PCR-RFLP procedure. Finally, the possible mutations were confirmed by direct sequencing.

None of the A1555G, A3243G and A7445G mutations was detected in this study. However, destroying a MTTL1 restriction site for the investigation of A3243G mutation, revealed a G3316A with allelic variant of 1.4% in the deaf subjects.

Our data indicated that the mitochondrial A1555G, A3243 and A7445G mutations have no role in auditory deficits in patients studied.

At present, the only curative treatment for β-thalassemia major is allogenic bone marrow transplantation accompanied with considerable mortality and morbidity in class III β-thalassemia. Regarding few case reports on successful non-myeloablative stem cell transplantation in class III β-thalassemic cases, we evaluated the effectiveness of this type of allogenic stem cell transplantation, considering less toxic non-myeloablative conditioning regimen. In this prospective study in Shariati Hospital bone marrow transplantation center during 2001-3, 13 class III β-thalassemia patients (on the basis of history and physical examination and liver biopsy) were transplanted with peripheral blood and bone marrow stem cells from their HLA-identical siblings. Non-myeloablative conditioning regimen included fludarabine; busulan; antithymocyte globulin. Graft versus host disease (GVHD) prophylactic regimen was cyclosporin and metothrexate. In the case of the declining chimerism, the patients were treated with donor lymphocyte infusions (DLI). The conditioning regimen was tolerated well without any considerable toxicity in hematologic, gastrointestinal and pulmonary systems. Five (38.5%) patients had acute and 2(15.4%) had chronic GVHD. Two patients died after transplantation. While two cases had a thalassemia-free survival. Although associated with high graft failure and the recurrence of disease, non-myeloablative stem cell transplantation may be used as a curative, less toxic post-transplantation treatment for class III ß-thalassemia.

The main signs of cardiac disease (particularly the coronary disease) was chest pain and the shortness of breath. ETT is a prognostic and diagnostic tool for assessing the ischemic heart patients. The aim of present study was to determine the results of applicating ETT for patients with typical and atypical chest pain complaints referring to the Mazandaran Cardiac Center 2007.

This descriptive study was conducted on 500 patients with typical and non Typical pain referring to the heart centers of Mazandaran province. After the interview, examination and laboratory tests, attended by the researcher and cardiologist, the patients under went ETT (Exercise Tolerance Test) with Tread mill according to Bruce protocol (Bruce Protocol) in four steps.

The present study showed the positive effect of exercise test in 80(16%) of cases. The positive test results of exercise test in the cases with typical heart pain was 25 times more than the cases with atypical heart pain. 43(53.75%) of the cases with positive test were male the majority of whom were (41caseses,51.25%) in age range of 51-65 years. 12.5% of cases with positive test and also 78.6% with negative test had atypical pain.

getting serious signs and symptoms of various disease serious (especially of the typical and atypical chest pain) is among the main educational priorities for the prevention of cardiac infarction.

Foregut duplication is commonly found in the posterior mediastinum. About 10-20% of these anomalies are associated with esophageal duplication. It can occur in all parts of esophagus. Although the duplication of cervical esophagus has been previously reported, a majority of it was found in the thoracic oesophagus. Infant esophageal duplication is usually associated to respiratory distress or asymptomatic thoracic mass, casually detected in x-ray. Case Report: In this report the case was a 7 months old infant (7.5 kg) with the chief compliant of respiratory distress, fever and nutritional intolerance. Physical examination of the case showed dehydration, stridor, tachypnea, intercostal retraction and neck stiffness. Plain chest radiogram showed a dual cystic mass in the distal neck region. Neck and chest CT- scan showed cervical cystic lesion disseminated to the posterior mediastinum, probably propagated to the respiratory system. For treatment, cystic lesion attached to the esophagus was partially resected, esophagus was repaired and the remaining mucosa of the cyst was removed, then gastrostomy tube was inserted. Although the cervical esophageal duplication of cysts are rare in infant respiratory distress, they must be considered as one of differential diagnoses of the cervical masses.