نشریه دانشور پزشکی
پیاپی 90 (دی 1389)

Adenoid cystic carcinoma (ACC) andpolymorphous low grade adenocarcinoma (PLGA) originate from ductal and myoepithelial salivary gland cells. They have a similar histologic appearance, but with different clinical behavior, treatment and prognosis. CD117 is a tyrosine kinase that is expressed by melanocytes,mastocytes and germinal cells. Our knowledge about its expression inboth mentioned tumors is controversial. Evaluation of the accuracy of CD117 in histopathologic differentiation of ACC and PLGA. The study protocol was descriptive-analytical.The histopathologic records of ACC and PLGA tumors were obtained from pathology Dept., Cancer Institute and Central pathology Dept. of Imam Khomini hospital. 15 ACC and 5 PLGA were entered the study. The formalin–fixed paraffinized blocks were examined immunohistochemically for CD117 expression. The mean LI for ACC andPLGA tumors were obtained. t test was used for statistical analysis. p<0.05 was considered significant. The LI mean was 71.20 ± 27.45 and 35.37±36.43 in ACC and PLGA groups respectively. The CD117 expression was statistically significant (p= 0.031). The Cut-off point = 73 with 80% sensitivity and 53% specificity was proper. CD117 is a significant immunohistochemical marker for histopathologic differentiation of ACC from PLGA.

Breast cancer is the most common and most preventable cancer in women and early detection has the important role in reducing its morbidity and mortality, so to increase its survival time to 95%. The present study conducted to compare the effectiveness of two educational methods on knowledge, attitude and practices of Arak physicians. A semi-experimental study after randomized allocation of each 64 physician to any of two different educational methods (video and systematic review) used to compare knowledge, attitude, and practices score variation about breast cancer screening skills. Data collection carried out with structured questionnaire andentered to SPSS software. Data analyzed by t-test, paired t-test and Man-Whitney test with a significant level of 0.05. Mean of total score of knowledge, attitude and practices (KAP) showed a significant difference before and after training and the totalscore of KAP increased (p<0.05). But KAP score variation and their subscales were the same in two groups and did not show any significant difference (p>0.05). Although KAP in Arak physician is appropriate and any educational program increased their KAP level, but continuing andrepetition of educational courses seems to be necessary.

Although arsenic trioxide has been shown to be a potential drug in treatment of APL, most notably in patients with relapsed APL, the underlying mechanisms remains unclear. In this study, the cytotoxic effect of ATO on APL cancer cells was evaluated. In this basic-applied study, the human leukemia (NB4) cell line was used as a model to evaluate the cytotoxic effects of arsenic trioxide in APL cells. NB4 cells were exposed to different concentrations of ATO (0.5, 1, 2 μM) for 2, 4 and 6 days and dimethylthiazol diphenyl tetrazolium bromide (MTT) assay was applied tothem. Data obtained from this assay indicated that arsenic trioxide significantly reduced the viability of NB4 cells and inhibited cell growth in a time and dose dependent manner. Findings from the present study indicate that arsenic trioxide is highly cytotoxic to human leukemia cells, supporting its use as an effective therapeutic agent in the management of acute promyelocytic leukemia.

Regarding the prevalence of epilepsy in human society and with respect to insufficiency of used treatment, the new strategy and methods for medical treatment of epileptic patients are necessary. Ferula assa foethica (F.foethica) is an important species of medicinal plant that has been used in traditional medicine as an anticonvulsant herb. So the present study has investigated anti-convulsioneffect of F.foethica gum extract using PTZ-induced kindling method.

In the present study, 60 balb/c male mice were randomly selected and divided into 6 experimental groups (n = 10 in each group), i.e. 1. control, 2. PTZ, 3, 4 and 5. treatment groups which received the extract in 25, 50 and 100 mg/kg; i.p, respectively, and 6. positive control group which received VA (100 mg/kg) as an anticonvulsant drug. All groups were kindled by 11 period injection of PTZ(35 mg/kg; i.p.). In the 12th injection, all groups were tested for PTZ challenge dose (75 mg/kg). However, exhibited phase of seizure (0-5) were observed and noted till 30 min after PTZ injection.

Our data showed that the F. foetida gum extract has a reduction effect on seizure intensity, progression, and duration.

The attained results showed that hydro-alcoholic gum extract of F. foetida can be used in grand male seizure treatment.

In menopause period, estrogen production decreases and this leads to increases of blood lipoproteins and LP(a)and at last to increased risk of cardiovascular disease. Because physical activity is important in prevention of cardiovascular diseases, this study intended to investigate the effect of eight-week walking program on serum lipids and LP(a) and estrogen hormone concentration in nonathlete Iranian menopausal women. Twenty two healthy women (47-55 years) werethe statistical sample of this study. They were randomly divided into two groups, i.e., experimental and control. At first, anthropometric characteristics including height, weight, and body mass index (BMI) were measured and recorded. Then, blood sample was taken from anterior vein (10 ml), while they did not eat any food for12 hours. Experimentalgroup were directed to the walking program (with 60 percent of reserve heart rate for 30 minutes in first week and with 70 percent of reserve heart rate for 60 minutes in final week). Then, BM I, resting blood sample, and serum lipids and LP(a) and estrogen hormone concentration were again measured. For pre-test and post-test data comparisonbetween groups, independent t-test and Mann-Whitney U test were applied. According to results, there was a significant difference betweenserum lipids and LP(a) and BMI before and after the training in experimental group while a non-significant difference was observed in control group. Also, there was not a significant change in estrogen hormone within groups. According to these results, 8-week walking program had a beneficial effect on menopausal women’ serum lipids and LP(a) concentration and BMI.

Hepatitis C is an asymptomatic disease. The quality of life is a major concern in these patients. In this research, we compared quality of life in hepatitis c with healthy people and finally presented a structural model about it. This is an analytical study in which a total of 61 patients with confirmed hepatitis C and 78 healthy accompaniers of them were included. A questionnaire composed of Persian translation of SF-36items and Sweden QOL was used for measuring the HRQOL. Then, data were analyzed using SPSS16 and LISREAL 8.80. Total adjusted score of HRQOL (mean ± SE) was 60.77 ± 3.95 and 67.13 ± 4.80 in patients versus control group (p<0.0001). Age and ALT were 0.15 and -0.19 and had a path coefficient respectively with physical health. Age and Co disease were 0.26 and -0.36 and had a path coefficient respectively with psychological health. Physical health as a mediator accounted for 95 % of the variance and psychological health as a mediator accounted for 78 % of the variance in quality of life. This study showed that hepatitis C is responsible for great alterations in HRQOL. Every effort is to be made to provide structural models in prediction of quality of life that would play a significant role in resolving of problems.

Naloxone shows interaction with the morphine in expression of reward behaviors. L-arginine increases morphine induced conditioned place preference, whereas L-NAME decreases this process. In this project, effects of injections of L-arginine and L-NAME intra-CeA on morphine induced drug-seeking behaviorsincluding rearing, sniffing and compartment entering were investigated.

Animals (male Wistar rats weighing 200-250 g)were cannulated bilaterally by stereotaxis apparatus for the CeA coordinates and passed a recovery period lasting one week. Conditioned place preference was conducted using a five-day schedule of an unbiased procedure including three phases (pre-conditioning,conditioning, and test). Morphine was injected subcutaneously through the conditioning once a day. NO agents were intra-nucleus injected but the administration of naloxone was intraperitoneally 10 min prior to testing.

morphine (2.5-10 mg/kg s.c) induced a significant decrease in drug-seeking behaviors compared with the control group. Naloxone (0.1- 0.4 mg/kg i.p) potentiated the morphine-induced responses. When Larginine (0.3-3 μg/rat) injected intra–CeA before injection of naloxone (0.4 mg/kg) pre-testing showed a significant increase effect on the behaviors but injection of L-NAME (0.3-3 μg/rat) intra–CeA prior to Larginine (0.3 μg/rat) pre-testing blocked the response to L-arginine.

Naloxone, an opioid receptor agonist, competes with morphine in inducing the behaviors in the conditioning model and NO in the CeA shows interaction with morphine in expressing these effects. Present finding may confirm that there is an interaction between NO in the CeA and morphine in expressing the drug-seeking behaviors.

Due to the health care system's complexity, the demand for effective leadership in nursing has never been so great. The need for studies of variation in leadership styles that could assist nursing leadership in fulfilling their administrative responsibilities is emphasized. The aim of the study was to investigatethe head nurse's leadership styles and effectiveness, flexibility and adaptability of styles in self-report and reports by staff in the hospital setting in 2010.

This study used a descriptive–analytical design. The instruments used was "Leader Effectiveness Adaptability Description (LEAD-self and LEAD-other)" standard questionnaire. The questionnaire was returned by 330 including 42 head nurse and 288 staffs who were working in educational hospitals in Arak city. Theystudied a census method. Data were analyzed using SPSS (13) and descriptive-analytical statistics.

It was found out that 73/8% of head nurses were female, 88/1%married, 35/7% aged 35 to 40 years and 40/5% had a history of serving 10 to 15 years. Also, 95/8% of nurses were female, 51/4% married, 42% aged 26 to 30 years and 57/3% had served less than five years. Results indicated HNs and staffs rated "coaching" as most prevalent leadership style. Effective leadership style from the highest viewpoints of both was selected; yet high adaptability with the lowest amount and low flexibilityin "delegating" leadership style with highest amount were determined.

Effective leadership style with low adaptability and flexibility was outcome of leadership performance evaluation led by head teaching hospitals in Arak. The results of this study provide guidelines for management development programs, training, and career planning for HNs. Educating the HNs on situational leadership style is recommended. This educational program should focus on the role of leadership inmanagerial process and effectiveness.

In realm of medical ethics, four major areas namely, philosophy, medicine, theology and law must be considered. The aim of medical ethics is to resolve the ethical problems, which is due to the specific medical practice and research in biology. Analysis of ethical concepts is essential for addressing of medical ethics.To achieve this goal, understanding the fundamental principles of ethics and philosophy is basic and a fundamental step. In fact, physicians are not philosopher and sociologist of religion or not a lawyer, thus need to philosophical and religious ethic cognition. Lack of such topics on medical ethics is the important factor in writing this article. By reviewing reliable sources, the basics and philosophy of ethics were surveyed in order to answer the following questions: 1- What are the moral definitions?2- What is the origin of ethical commands? Nature, reason, society, human nature, conscience or the will of God,3- What is the concept of good and bad or good and ugly?4- Are moral sentences essay or news? In other words, moral sentences are forged or are discovered.5- What is the criterion of moral practice? Duty, results, profits and interest, praise others, pleasure, virtue?6- What are the conditions of the moral responsibility?7- What are the valuable elements of a moral action?