مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران
سال هفتاد و یکم شماره 3 (پیاپی 147، خرداد 1392)

Primary culture takes place following the cell isolation from tissues. Isolation and culture of melanocytes based on their roll in the protection of body against hazardous sun rays، production of skin، cornea and hair color is really important. This study was done to set isolation، culture and proliferation of melanocytes from children foreskin and adult eyelashes، and also comparison of two types of melanocyte culture medium.

Human foreskin and eyelash samples were used for melanocyte isolation and culture. After isolation of epidermis from dermis، epidermis cell suspensions were prepared by enzymatic digestion. The isolated cells were cultured in two melanocyte selective culture media. Immunocytochemistary and reverse transcription-polymerase chain reaction (RT-PCR) assays were used for confirmation of isolated and cultured melanocytes.

Our results indicated that isolated melanocyte cultured in the selective medium without phorbol esters is better than the melanocytes cultured in selective medium cont-aining phorbol esters not only morphologically but also physiologically and from the aspect of cell adhesion. In addition، the results showed that isolated melanocyte from adult eyelashes are more dendritic than melanocytes isolated from children foreskin. Conversely، our results indicated that the number of cell passages in melanocyte isolat-ed from foreskin is more than melanocytes isolated from adult eyelashes.

Melanocytes cultured in selective medium containing convenient growth factors in absence of phorbol esters show more native physiological and adhesive properties. In addition، melanocyte isolated from younger tissues such as foreskin have better proliferative and sub-culturing properties so we suggest isolation and culture of younger tissues.

Nucleus accumbens (NAc) and prefrontal cortex (PFC) dopaminergic and glutamatergic systems are involved in regulating of locomotor activity behaviors. This study has investigated the interaction of NAc shell dopaminergic system and prelimbic glutamatergic systems in regulating locomotor activity and related parameters. The aim of this study was the effect the drugs injection interaction in the brain of male Wistar rats on locomotor activity and related parameters، in the order of this purpose، open field apparatus that automatically recorded locomotor activity was employed. Unilateral intra-cerebral injection of drugs was done. Unilateral intra-prelimbic injection of D-AP7 (N-methyl-D-aspartic acid= NMDA receptor antagonist; 0. 25، 0. 5 and 1μg/μl) did not alter locomotor activity behaviors. However، infusion of NMDA (0. 9μg/μl) in this region increased locomotor activity (P<0. 01)، whereas decreased rearing (P<0. 01) and grooming (P<0. 01) which was blocked by D-AP7 (0. 25μg/μl) (P<0. 01). Moreover، unilateral infusion of SCH23390 (dopamine D1 receptor antagonist; 0. 25، 0. 5 and 1μg/μl) into the left NAc shell did not alter locomotor activity. However، injection of SKF38393 (dopamine D1 receptor agonist; 4μg/μl) into the left NAc shell increased locomotor activity (P<0. 05) which was blocked by SCH23390 (0. 25μg/μl) (P<0. 01). Furthermore، the subthreshold dose infusion of SCH23390 (0. 25μg/μl) into the left NAc shell reduced the effect of intra- prelimbic NMDA on locomotor activity (P<0. 01). In addition، intra-NAc shell administration of the subthreshold dose of SKF38393 (1μg/μl) potentiated the middle dose (P<0. 05)، whereas decreased the higher dose of intra-left prelimbic NMDA response (P<0. 05) on locomotor activity. The results suggested a modulatory effect of the NAc shell dopaminergic system on increased locomotor activity by activating glutamate system in prelimbic.

We are in new era of knowledge and treatment of women with PCOS. We should find management modalities that can improve their life quality. Due to high prevalence of PCOS، and zinc deficiency in Iran، importance of antioxidants such as zinc on treatment and improvement of PCOS complications، and due to the disadvantages of the current treatment for the disease (i. e. OCPs)، finding an efficient alternative therapy with no or less side effects seems to be as important as some methods for changing the life style of these women. This study was performed to assess zinc levels in PCOS versus non PCOS patients to determine if zinc can be helpful in PCOS management. This is a case-control study which was performed from January 2012-2013 in 100 infertile women aged 20-45 years who were referred to Vali-e-Asr infertility clinic. Fifty patients had PCOS according to Rotterdam Criteria (case group) and 50 were infer-tile women without PCOS (control group). In both group، serum Zinc levels were deter-mined and the data was gathered using the SPSS software and analyzed by descriptive (percent، mean، standard deviation) and analytical 2، ANOVA، Mann-Whitney and Correlation). Results did not show a significant difference between case group and control group in respect to serum Zinc levels (P>0/05). Due to no difference between case group and the control one in zinc levels، it seems that zinc supplementation in PCOS patients is not necessarily useful or of clinical importance. Obviously studies with larger sample size can probably define the role of zinc in these patients.

Body dysmorphic disorder (BDD) is characterized by a preoccupation with an imagined defect in ones appearance or an exaggeration of a slight physical anomaly. Any part of the appearance may be the focuse of BDD patients. Thus preoccupation with appearance leads to significant damages of social and job functioning. The aim of this study is to determine the prevalence of BDD in patients referred to cosmetic clinic of Razi hospital.

Patients visiting cosmetic clinic of Razi hospital were selected if they agreed to participate in the study. They were evaluated by Yale brown obsessive compulsive scale modified for body dysmorphic disorder (YBOCS-BDD) as well as questionnaires containing demographic characteristics of patients including gender، educational status، marital status، history of reference to psychiatrist or psychologist، other medication، history of cosmetic surgery and rate of satisfaction of cosmetic surgery. YBOCS-BDD questionnaires then processed by educated specialist to determine BDD score of patie-nts. Demographic questionnaires، also analysed to evaluate epidemiologic properties of patients visiting cosmetic clinic of Razi hospital.

The prevalence of BDD in current sample was 33. 3%. 70. 7% of BDD patients were female while 29. 3% were male. The commonest age range was 21-50 years (82. 8%). 65. 5% were educated to level of diploma or lower، while 34. 5% had academic degrees. 51. 7% were married. 20. 7% had history of reference to psychiatrist or psycholo-gist. 17/2% had history of cosmetic surgery with satisfaction ranging from unsatisfied (20%) to relative satisfaction (80%). None were fully satisfied.

BDD had high prevalence in patients visiting cosmetic clinic of Razi skin hospital. This high rate of prevalence show the necessity of diagnosis of BDD in skin patients and it is critical for them to refer to psychiatrists or psychologists.

Athletes are usually skilled in physical aspects of sports; they are widely involved in physical conditioning، technical and tactical training. However they usually ignore the psychological and cognitive skills linked to their performance. Sport imagery is a well known fundamental skill that has a critical role in how a player performs and shows his/her competency during a real world game. On the other hand football as a complex team sport includes several skills linked to physical and psychological properties. We aimed to study the effect of cognitive imagery on elite football players through league competitions in two separate studies.

Twenty two youth players and Twenty two adult players randomly assigned to imagery and control groups. Players in intervention group received 12 weeks training program for specific cognitive imagery and general cognitive imagery. Imagery training program focused on an important component of football performance as “successful passing”. Players in control group were assigned to a waiting list with no intervention. In order to evaluate outcome variable we assessed successful passing in real compete-tions as player performance in both pre and post test occasions.

Findings of study in youth participants showed that young players in interven-tion group improved the performance of passing compared to control players (OR=1. 41، P<0. 000، CI 95%: 1. 17، 1. 69(. In contrary، Imagery performance in adult group remained unchanged in spite of an increasing trend in performance (OR=1. 07، P>0. 05، CI 95%: 0. 82، 1. 4(.

These results showed that cognitive imagery intervention can affect elite soccer players’ performance. This effect is more prominent in youth age football players.

Sympathetic complex of over-activation kidneys is one of the main causes of primary hypertension (HTN). We aimed to assess the efficacy and safety of sympathectomy using 5Fr mariner catheter ablation on patients with refractory hypertension.

In this prospective cohort study، patients who received three or more anti-hypertensive medications with 160mmHg systolic blood pressure (BP) or more were randomly included and divided into 2 groups. Cases in the first group were undergone to renal denervation and the second group was treated by previous antihypertensive medications. Both groups were followed for six month by assessing BP and adverse effects.

One hundred and seventeenth patients (54%) out of 212 screened patients were included in the first group (renal denervation) and 95 patients as the second group. The mean of BP changes in the first group was 35/15 mmHg with standard deviation of 22/11mmHg. (P<0. 001) in the second group، the mean changes of BP was not statistically significant. (5/0mmHg± 22/11، P=0. 79 for systolic BP and P=0. 96 for diastolic BP). 92% of 117 patients in the first group had a favorable BP decrease، which was defined as a 20mmHg or more decrease in BP، in comparison with 15% of 95 patients as controls (P=0. 001). There was no observed complication after denervation in the first group.

It seems that the sympathetic renal denervation can be an effective and safe method for treatment of refractory hypertensive patients indeed of routine medications although further studies with longer follow up duration and more cases are suggested for confirming this issue.

Vasoactive intestinal peptide (VIP) plays an important role in modulating coronary blood flow and heart rate. The purpose of the present study was to investigate the effect of eight weeks of low intensity aerobic exercise on plasma levels of VIP hormone، blood pressure and heart rate in healthy elderly men and women، and patients with coronary artery disease (CAD). In this study، 15 healthy women and 15 healthy men and 15 female and 15 male with CAD disease were randomly chosen as the experimental and control groups. Subjects did aerobic exercises tree days/week، for eight weeks، with the heart rate of 10010 beats per minute. Blood samples were taken from each subject in three stages، (before، immediately after and 24 hours after the 8 weeks of exercising). The results showed that there was a significant difference among plasma VIP levels in the four groups. Moreover، a significant difference was observed between the systolic blood pressure in the four groups (P=0. 01) and the systolic blood pressure in male patients and healthy women (P=0. 03) while there was no meaningful difference the systolic blood pressure in the two other groups. There was also a significant difference in the heart rate of the three rounds of sampling in the three of groups (P=0. 002) but no significant difference was observed in healthy men. According to the above results، it seems that the duration and intensity of each workout should be considered to reach the VIP stimulation threshold. It may bring about considerable changes in VIP levels.

Very preterm birth (26-32 weeks) has an important effect on infant morta-lity and disability of infancy. The aim of this study was to investigate the prevalence of very preterm delivery and early neonatal morbidity (the first 28 days after birth). In this cross-sectional retrospective study، among 4393 delivery in Arash Women''s Hospital in Tehran، 59 deliveries were very preterm that resulted in 79 very preterm neonate births. We assessed maternal risk factors and neonatal complications in women who were admitted for delivery from March 2009 to March 2010. Among 59 pregnant women، 17 (12/27%) had multiple pregnancies and 17 (12/27%) had premature rupture of fetal membranes. Caesarean section method was more common than normal vaginal delivery (46 cases- 97/77%). Women aged 18 to 35 had the highest rate of preterm delivery (45/86%). Among 79 very preterm neonates about half of them were very low birth weight، 74 neonates (93/67%) suffered from respiratory distress syndrome and 13 deaths were reported. Premature birth is a multi-factorial phenomenon. Identifying maternal risk factors and increasing knowledge about it can decrease the rate of preterm labor. The prevention of premature labor is better than cure. Further prospective studies with large number of patients and long-term follow-up are recommended for better understanding of the phenomenon.

Peptic ulcer disease is one of the most common GI disorders. Perforation has the highest mortality rate of any complication of ulcer disease، while early diagno-sis and emergency treatment save patient life. This paper reports an adolescent boy admitted to the Ziaeian University Hospital. He suffered from severe abdominal pain with dyspnea had been started since past three hours. Periumbilical pain started from past 2-3 days، gradually localized to the right lower quadrant. He had anorexia without nausea and vomiting. He was tachycardic and tachypneic، but he did not have fever. On physical examination، bowel sound was hypoactive، there was generalize tenderness، guarding and rebound tender-ness focused in the right lower quadrant and suprapubic region. Laboratory finding indicated leukocytosis. Chest X-ray showed free air under diaphragm. Once the diagno-sis has been made، the patient was given analgesia and antibiotics، resuscitated with isotonic fluid، and taken to the operating room. Laparotomy was implemented through a midline incision. There was bile secretion in the peritoneal cavity. Appendix was inflamated. Cecum and ileum were normal. A small perforation، 4mm in size was detected in first portion of duodenum. Appendectomy and omental patch repair were done. Ten days later، the patient was discharged in a good state. Serologic test for helicobacter pylori was negative. Stomach and duodenal perforation should be considered in patients with-out peptic ulcer disease، especially in children and adolescents with sudden and severe abdominal pain who are admitted to the hospital for other diseases. Because some patients present with peptic ulcer complications that are seemingly exacerbated by stressful life events.

Tubal sterilization is the permanent and effective contraception method. This can be performed at any time، but at least half are performed in conjunction with cesarean or vaginal delivery and are termed puerperal. The most complication after tubal ligation is ectopic pregnancy. Ectopic pregnancy is the leading cause of maternal death in first trimester. We present a 33 years old woman gravida5، para4، all normal vaginal delivery، presented with complaints of delayed menstrual period، pelvic pain and spotting. She underwent tubal ligation for two times. For the first time she had puerperal Pomeroy tubal sterilization after third child delivery. Intra uterine pregnancy occurred three years later. One day after vaginal delivery of fourth child، she underwent post partum tubal ligation with the Parkland method. Tubal pregnancy occurred nine months later. Physical examination identified acute abdomen. Pelvic ultrasound showed no gestational sac in uterine cavity. The sac with fetal pole was in right adnexa. Beta-HCG was 2840mIU/ml. She underwent laparotomy. Surgical management included salpingectomy with cornual resection in both sides. The surgery identified Ectopic pregnancy. Any symptoms of pregnancy in a woman after tubal ligation must be investigated; an ectopic pregnancy should be excluded. Ectopic pregnancy must be considered، in any woman with lower abdominal pain، missed period and vaginal bleed-ing. Conception after tubal sterilization can be explained by fistula formation and re-canalization of fallopian tube.