مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران
سال شصت و نهم شماره 1 (پیاپی 121، فروردین 1390)

Nowadays, dendritic cells (DC) are used for tumor immunotherapy as they can induce immune responses against tumor cells. In this research, we comprehensively studied the maturation stimulus addition, PHA-activated T-cell (PHA-TCM) conditioned medium, autologous monocyte-conditioned medium (MCM) and TNF-α for their ability to promote uniformly mature dendritic cells that elicit T-cell responses. Plastic adherent monocytes were cultured with granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) for five days and two days with monocyte-conditioned medium (MCM), tumor necrotizing factor-α (TNF-α) without TCM (PHA-activated T-cell conditioned medium). Phenotypic and functional analyses were carried out using anti-CD14, anti-CD80, anti-CD86, anti-CD83 monoclonal antibodies. Phagocytic activity, mixed lymphocyte reaction (MLR) and cytokine production were also evaluated. The generated dendritic cells had high expression of surface molecules i.e. CD80, CD83, CD86 and HLA-DR. Moreover, the cells had low phagocytic and high T-lymphocyte stimulating activities. Measurement of the produced cytokines showed the generation of type-1 dendritic cells (DC1) in the study. The findings indicated that more efficient maturation of dendritic cells could be achieved by the use of PHA-activated T-lymphocyte conditioned medium in the culture medium. The aforesaid supernatant can be used as a maturation factor for the production of efficient dendritic cells with the ability to be used for tumor immunotherapy. This conditioned medium can provide new strategies and evolve into more advance tools for the generation of dendritic cells in vitro for tumor immunotherapy

The effects of growth hormone (GH) on bone density in healthy adults is controversial. This study was performed to evaluate the effects of GH administration on bone density under controlled conditions in healthy adult rabbits. Twenty healthy adult New Zealand white rabbits of both sexes were included in the study. The rabbits were divided into two groups. The experiment group received human GH and the controls placebo for three months. The density of femur and humerus were measured at proximal epiphysis, mid shaft and distal epiphysis by radiography, aluminum step-wedge and appropriate software. Measurements were performed in five stages, once before and four times after the administration of GH or placebo, with 3-week intervals. The mean concentration of serum insulin-like growth factor I (IGF-I) increased significantly after GH administration (P<0.05) in the experiment group. Bone density generally increased in all regions except the distal epiphysis of femur in the test group, but significant difference were only seen in the midshaft of femur in comparison to the controls (P<0.05). In the second stage, bone density decreased slightly in all regions except distal epiphysis of femur, but it increased in the next stages. GH can increase bone density (mostly cortical bone) in adult rabbits. According to the similarities seen between growth hormone effects in rabbit and humans, this study suggests rabbits as a model for studying GH effects on bone density in acromegaly, growth hormone deficiency and even in healthy adult humans.

Resistance to beta-lactam antibiotics in clinical isolates frequently results from the production of β-lactamase enzymes. In recent years, the production of extended spectrum β-lactamases (ESBLs) and AmpC β-lactamase have greatly increased, especially in clinically isolated Escherichia coli. On the other hand, beta lactamase genes have several subfamilies and designing universal primers could be valuable in their detection. The beta-lactamase-producing E. coli which is resistant to beta-lactam antibiotics may pose a great risk to the patients. The CTX-M-1 gene is responsible for beta lactamase resistance. The purpose of this study was to find the percentage of CTX-M-1 carrying E. coli strains. A total of 500 urine samples were collected from different hospitals in Tehran, Iran during September to February 2009. The samples were cultured on EMB agar and incubated at 37 C for 24 hours. Some biochemical tests were carried out on the isolated samples. The presence of CTX-M-1 gene was determined by PCR on the isolates already identified phenotypically by disk diffusion agar and combined disks. In general, 200 out of the initial 500 samples were identified as E. coli, among which 128 (79.5%) were ESBLs producing strains. PCR used for the detection of CTX-M-1 gene, showed that 99 (77.34%) out of 128 isolates contained such gene. The results of this study showed a high percentage of β-lactamase resistant E. coli strains. This is a serious matter and would pose a public hazard and every step should be taken to avoid such hazard.

Propolis (bee glue) is a resinous substance obtained from bee hives living on various plant sources. The purpose of this study was to evaluate the effects of ethanol extract of propolis (EEP) on the experimentally induced Candidial keratitis in rabbits. The alcoholic extract of propolis was prepared by 80% ethyl alcohol. After suppressing the immune system of 24 male rabbits, experimental Candida albicans keratitis was induced in the animals under local anesthesia and sterile conditions. The animals were later divided into four groups including the control or glycerin group and a nystatin and two 500 and 1000µg/ml EEP groups. Treatment continued for 21 days and after sacrificing the animals by humane.

Atrial fibrillation is the most common but benign arrhythmia following cardiac surgery. Although this arrhythmia is often self-limited and vanishes in about 24 hours upon surgery; a number of arrhythmias might ensue among which some might be really life-threatening. A multitude of therapeutic modalities have been proposed for the prevention of this arrhythmia and one of them is posterior pericardiotomy. This method has not been fully accepted by the peers yet and more studies are needed to prove its efficacy and benefits to the patients. In this single-blind randomized clinical trial, done over a 2-year period from February 2009 to January 2011, the effects of posterior pericardiotomy were evaluated in 174 patients (87 the case and 87 the control groups) undergoing elective coronary artery bypass grafting (CABG). The case group underwent CABG with posterior pericardiotomy while the control group underwent CABG-only operation. The post-operative incidence of arrhythmia, especially atrial fibrillation, was assessed for a week using statistical methods. The prevalence of postoperative atrial fibrillations were fewer in the group undergoing CABG with posterior pericardiotomy compared with the CABG-only group (P<0.004). Posterior pericardiotomy seems to reduce the incidence of atrial fibrillation following elective CABG; therefore, its application is suggested for elective CABGs.

Reconstruction by free tissue transfer and microvascular anastomosis can provide a reliable repair for tissue defects in head and neck surgeries. During this study, we evaluated the clinical characteristics and outcomes of reconstructive surgery by the use of free flaps for defects resulting from head and neck cancers.

This quasi-experimental study included 29 patients having been diagnosed with head and neck cancers and referred to the Plastic Surgery Clinic and Cancer Institute of Imam Khomeini Hospital Complex in Tehran, Iran, for the resection of cancerous tissue. After operation, the patients were followed-up for three months and the surgical outcomes were evaluated.

The mean age of participants was 50.8 ± 15.1 yrs. Two patients (6.9%) had total and three (10.3%) had partial flap loss. The rate of total and partial flap loss in this study was less than 10%. There were no differences between groups with total and partial flap loss regarding mean age, mean operation time, and mean perioperative ischemia time. Prothrombin time (PT) and international normalized ratio (INR) were significantly different in patients with total flap loss compared with patients with successful reconstruction. The INR for the group with total loss was 2.2 and 1.2 ± 0.3 for other patients (P=0.0006). The mean ACT was 46 seconds in patients with total flap loss and 82 ± 18.9 seconds for other patients (P=0.08).

Considering its high success rate, free tissue transfer can be considered as a method for single-stage reconstruction in almost all major head and neck defects.

Sputum induction has been recently introduced as an effective and inexpensive method for obtaining high quality sputum samples in patients without spontaneous sputum. As all Iranian physicians might not be familiar with this method yet, the results of this study could be of help in this regard. During June 2010 to January 2011, all pulmonary tuberculosis (PTB) suspected patients, with clinical and/or radiological evidence in favor of PTB who had been referred to the Pulmonary Diseases department of Imam Khomeini Medical Center were enrolled in the study, if they were without spontaneous sputum. Sputum induction was performed using ultrasound nebulized hypertonic 3% sterile saline for 20 minutes. The laboratory was requested to report if the samples were of the intended quality (Polymorphonuclear Cells/Squamus Epithelial Cells≥2). The patients’ demographic data, HIV serology and chest radiological findings in favor of PTB were recorded and analyzed. In 50 patients with suspected PTB [23 men (mean age (±SD), 51.21±20.24) and 27 women (mean age (±SD) 55.40±18.00)], cough was the most common complaint. The most prevalent radiological findings were infiltration and consolidation. PPD was positive in 21 (42%) patients. Sputum induction led to obtaining proper sputum samples in 90% of the patients. Positive sputum smear and culture were seen in 13 (26%) cases. Sputum induction is a cost-effective and minimally invasive method which is associated with satisfactory results for obtaining high quality sputum samples in patients without spontaneous sputum.

Many studies have shown that periodontal pathogens are emerging as a risk factor for preterm delivery and low birth weight, but there are few studies about the relationship between other oral bacteria and pregnancy outcomes. The aim of the present study was to determine the relationship between salivary bacteria and pregnancy outcomes.

This cohort study was performed on 300 pregnant women who were recruited from the prenatal clinic of Zeynab Hospital in Tehran during 2009-2010. The patients’ demographic and pregnancy data were recorded. Using samplers, saliva samples were collected about one hour after breakfast. Microbial evaluation was performed by counting the bacteria based on their shape and the Gram reaction. The studied bacteria were composed of gram-positive and negative cocci, gram-positive and negative bacilli, spirilla, spirochetes, yeasts, fusiform bacteria and actinomycetes.

The data on the bacteriological profile and pregnancy outcome of 243 out of the 300 eligible participants of the study were completed. Five cases (2%) had intra uterine fetal death (IUFD) while 238 (98%) delivered live infants. There was a significant statistical relationship between the mean of gram-negative cocci and IUFD (P=0.04). 10 cases (4.1%) of 243, experienced adverse delivery outcomes and 233 cases (95%) had normal delivery. The adverse pregnancy outcomes had a significant relationship with the presence of spirochetes in saliva (P<0.05) but this relationship was not true for the other bacteria.

Some oral bacteria may pose a risk for premature deliveries and low birth weights.

Infections caused by opportunistic yeasts such as Candida species, Trichosporon, Rhodotorula and Saccharomyces have increased in immunocompromis-ed patients and their identification is crucial as intrinsic and acquired resistance of some yeast species to antifungal agents are on the rise. The aim of this study was to identify the organisms to the species level in order to suggest accurate and effective antifungal therapies.

In this study that carried out in Tehran, Iran in 2009, 200 patients with yeast infection were medically examined and clinical specimens were prepared for direct examination and culture on Sabouraud dextrose agar. Subsequently, the isolated yeast colonies were identified using various tests including culture on Corn Meal agar with Tween 80, CHROMagar Candida and casein agar. For the definite identification of organisms some biochemical tests were done based on carbohydrate assimilation by RapID Yeast Plus System kit, and, finally, a molecular method, PCR-RFLP, using Hpa II enzyme, was performed for the remaining unknown yeast species.

A total of 211 yeast isolates were identified in 200 patients with yeast infections. The most frequent isolated yeasts were Candida albicans, 124 (58.77%), followed by Candida parapsilosis, 36 (17.06%), Candida tropicalis, 17 (8.06%), Candida glabrata, 13 (6.16%), Candida krusei, 8 (3.79%), Candida guilliermondii, 2 (0.96%), Trichosporon, 3 (1.14%), Rhodotorula, 1 (0.47%), Saccaromyces cerevisiae, 1 (0.47%) and other yeast species, 6 (2.84%).

Nail candidiasis was the most prevalent type of yeast infection in the patients and Candida albicans was the most frequent isolated species from all clinical specimens.

Soft tissue chondroma is a rare slow-growing benign cartilage forming tumor. Tumors of this kind arise from the relative mesenchymal tissue and have tendency to occur in the fingers and toes. Due to its rarity, this tumor is likely to go undiagnosed. Histopathological examination usually reveals the correct diagnosis. Hereby, we report a case of soft tissue chondroma in a 27 year-old woman presented with a slow-growing mass in the volar aspect of her right hand. The tumor had developed over a 7-month period. The skeletal system was unremarkable on X-ray evaluation. The lesion was excised and the histopathological findings revealed a well-delineated cartilaginous neoplasm with lobular pattern.