Archives of Iranian Medicine
Volume:16 Issue: 7, Jul 2013

Different reports from Middle East countries demonstrated Kaposi’s sarcoma (KS) in transplant population. This vascular malignancy occurs mostly among immunocompromised individuals. Human herpesvirus 8 (HHV-8) appears to be the causative factor for the development of this neoplasm. Transplant programs are concerned about the frequencies of HHV-8 infection either in general population or transplant patients. The current study was conducted in two phases. Firstly, we detected antibodies against HHV-8 in 790 otherwise healthy blood donors. Secondly, a total of 125 kidney allograft recipients evaluated as being seropositive for HHV-8. We utilized enzyme immunoassay (EIA) for serologic studies. Among blood donors, the male to female ratio was 1.05 (405 vs. 385) while the mean age was 38.9 ± 11.7 years. The serostatus of none of these blood donors were positive for HHV-8. Among kidney recipients, the male to female ratio was 1.9 (82 vs. 43). The mean age was 39.01 ± 14.77 years. Two (1.6%) patients were seropositive for HHV-8. The prevalence of HHV-8 infection among Iranians is likely to be low. Yet, owing to the evidence of this infection among kidney allograft recipients and its probable role in developing post- transplantation KS (PT-KS), further studies appear to be required to keep the various aspects of this infection under close surveillance.

The Stroop Color-Word Test is a classic instrument for the assessment of selective attention and inhibition control and is a highly utilized instrument in research aspects of executive functions of the brain. The purpose of the present study was a preliminary standardization of Stroop test among Iranian bilingual adolescents. In this study, 150 subjects, including three groups of adolescents (12 – 13, 14 – 15, and 16 – 17-year-olds) were randomly selected. Also, 30 subjects with attention-deficit hyperactivity disorder (ADHD) were selected for the study of differential validity. The instruments of this study were Victoria Stroop Color- Word Test and Strengths and Difficulties Questionnaire (SDQ). Correlation coeffecients by test-retest in Stroop test for reaction times of three cards and reaction time interference were 0.86, 0.86, 0.93, and 0.64; and for errors of three cards and error interference were 0.67, 0.37, 0.81, and 0.75 respectively. All of the corellations were significant. Differential validity by comparing ADHD and control group showed that there were significant differences among groups. The results of age effect in Stroop variables showed that there were significant differences between age groups in reaction time of all cards and error of the first and third cards; but sex did not show any significant effect on Stroop variables. The findings suggest that reaction time and error of almost all cards of Stroop test are reliable and also have a good differential validity to discriminate ADHD from healthy controls in Iranian bilingual adolescents. Based on our findings, age but not sex is influential on performance of Stroop test.

Hepatitis B virus (HBV) gene and protein variations have frequently been observed in chronic patients. The aims of this study were to determine the genotypes as well as the patterns of HBsAg variations in chronically-infected patients from the south-eastern part of Iran. Twenty- one chronic inactive HBV carriers from Sistan-Balouchestan Province (an area with a low prevalence of HBV complications such as cirrhosis and hepatocellular carcinoma [HCC]) were enrolled. The surface genes were amplified, sequenced, and subsequently aligned using international and national Iranian database. All strains belonged to genotype D, subgenotype D1, and subtype ayw2. Of all 39 muta tions occurred at 31 nucleotide positions, 15 (38.5%) were missense (amino acid altering) and 24 (61.5%) were silent (no amino acid changing). At the amino acid level, 15 substitutions occurred; 10 (66.67%) were distributed in different immune epitopes, five of which (33.33%) were in B cell epitopes; four (36.27%) were distributed in T helper epitopes, and one (6.67%) occurred inside CTL epitopes. A narrowly-focused immune pressure has been on the surface proteins, especially at the B cell level, led to the emergence of escape mutants in these patients that might be related to the pathogenicity of HBV chronic infection. Also, due to the negative selection imposed on HBV genome and the uniqueness of genotype D in this ethnic group, complications (cirrhosis and HCC) are lower than other published studies.

There is an increasing interest in the role of regulatory factor X1 (RFX1) and RNA-binding proteins (RBPs) during neural development. However, there are few reports about their interaction. We extracted RNA and performed reverse transcription polymerase chain reaction (RT-PCR) to identify RFX1 expression in imprinting control region (ICR) mouse tissues, analyzed RFX1 domains and motif consensus by comparing public databases on the Internet, tested the motif consensus with affinity-capture and western blotting experiments with mouse brain tissue, and predicted the binding sites of RFX1 in promoter regions of mouse RBPs genes. The expression of RFX1 was higher in embryonic brain compared to embryonic kidney, heart, and liver, and its expression level was relatively stable and higher in mouse embryonic brain than neonatal brain. RFX1 had several domains, including domain A as an activation domain, DBD as a DNA binding domain, domain B and C which played an important role in dimerization, and domain D as dimerization domain. RFX1 had three different profiles motif consensus RFX1M00281, RFX1M00280, and RFX1 (EF-C) M00626. There were 79 RFX1 binding sites at the promoters of 65 of 323 RBPs genes. RFX1 as regulatory factor will have putative important regulating role in the expression of RBPs genes during embryonic development of mouse brain.

The aim of this study was to investigate the etiology according to the age groups (adolescent, reproductive, and perimenopausal / menopausal periods) of women who were admitted with complaints of acute pelvic pain (APP). Data from 503 patients diagnosed with APP were evaluated retrospectively. The patients were divided into three groups according to their ages. The adolescent group consisted of patients who were 19 years of age and under (Group A), the reproductive age group consisted of patients who were between the ages of 20 and 44 years (Group B), and the perimenopausal / menopausal group consisted of patients who were at the age of 45 and above (Group C). The most common causes of APP among the three groups were investigated. The mean age was 29.9 ± 6.01 years. Gynecologic factors were present in 469 cases, APP was nongynecologic in nature in 24 cases, while the cause was unknown in 10 cases. The patients were evaluated in terms of APP duration, accompanying symptoms, and pain localization. There were 36 cases in the adolescent group, 361 cases in the reproductive age group, and 72 cases in the perimenopausal / menopausal group. Adnexal pathologies were the most commonly observed APP factor in all three groups. APP was most commonly observed in the reproductive period, and adnexal pathologies and infections were etiologically prominent. Early and accurate diagnosis of APP will often enable more effective and conservative treatment methods for life-threatening pathologies.Keywords:

Data available on the effect of quality (glycemic index [GI]) and quantity (glycemic load [GL]) of carbohydrates on the risk factors of cardiovascular disease (CVD) are inconsistent. The objective of this study was to examine the association between dietary GI, GL, and CVD risk factors among Tehranian adults, the participants of the Tehran Lipid and Glucose Study. This population- based cross-sectional study was conducted on 2457 subjects (46% men and 54% women), aged 19 to 84 years. Dietary GI and GL were measured using a validated 168- item semiquantitative food frequency questionnaire. Anthropometrics, blood pressure, fasting blood glucose, and lipid profiles were measured. The mean intakes of GI and GL were 68.3 and 244.8, respectively. Rice (26.6%) and bread (19.0%) were the major contributors to dietary GI and GL, respectively. Higher dietary GI and GL were associated with high intakes of carbohydrate, fiber, refined grain, fruits, simple sugar, snack, and desserts. After adjustment for lifestyle and dietary variables, a higher dietary GI was positively associated with triglycerides and high-density lipoprotein (HDL) cholesterol concentrations among obese subjects. Dietary GL was positively associated with fasting and 2-h blood glucose among nonobese subjects, after adjustment for confounders. Dietary GI and GL were associated with a few CVD risk factors, and body mass index levels may modulate these associations.

Vanadium compounds are able to reduce blood glucose in experimentally- induced diabetic rats and type 2 diabetic patients, but data about their long- term safety and efficacy in diabetic patients are scarce. Fourteen type 1 diabetic patients received oral vanadyl sulfate (50 – 100 mg TID) for a period of 30 months. Fasting blood sugar (FBS), lipid levels, hematologic, and biochemical parameters were measured before and periodically during the treatment. The daily doses of insulin decreased from 37.2 ± 5.5 to 25.8 ± 17.3 units/day and at the same time the mean FBS decreased from 238 ± 71 to 152 ± 42 mg/dL. Meanwhile, there was a decrease in plasma total cholesterol without any change in triglyceride level. No significant clinical or paraclinical side effects, with the exception for mild diarrhea at the beginning of treatment, were observed during 30 months therapy. Vanadium is effective and safe for long- term use in type 1 diabetic patients.

There are contradictory reports about the association of magnesium and attention- deficit hyperactivity disorder (ADHD). Moreover, some studies reported that magnesium is effective for treating ADHD. This is the first systematic review evaluating the effectiveness of magnesium to treat patients with ADHD. The two databases of MEDLINE/ PubMedline and Google Scholar were electronically searched using the search items and considering inclusion and exclusion criteria.Out of the 37 titles, only six studies were experimental interventional studies. However, three of these studies were without any control group. The other three studies were controlled clinical trials. Nevertheless, none of the studies was a randomized double- blind controlled clinical trial. These studies supported that magnesium is effective for treating ADHD. Magnesium monotherapy studies were not found. There is no well- controlled clinical trial investigating the efficacy and safety of magnesium for treating ADHD. In addition, the safety of magnesium in ADHD is ignored. Therefore, until further strong evidences for its efficacy and safety are provided, magnesium is not recommended for treating ADHD.

There is a lack of data regarding the incidence rate, etiology, risk factors, and natural course of thyroid disorders and their relationship with cardiovascular disease and mortality in populations undergoing nutrition transition. Therefore, we aimed to assess the natural course of thyroid disease in Tehranians, a population in nutrition transition.METHODS AND DESIGN: Between March 1997 and December 2004, 5769 individuals, aged ≥ 20 years, were selected from district No.13 of Tehran and followed up every three years. Data on risk factors for cardiovascular disease such as diabetes, hyperlipidemia, smoking, obesity, hypertension, low levels of physical activity, and dietary habits were obtained at baseline and again every three years. Cardiovascular and mortality outcomes were assessed in detail. The results of this study will provide a better recognition regarding the incidence and risk factors of thyroid disorders and their relationship with cardiovascular outcomes and mortality in a community in nutrition transition.

Anaplastic Large Cell Lymphoma (ALCL) is a subgroup of T/null cell non-Hodgkin lymphoma (NHL) in WHO classification. Lymphohistiocytic (LH) variant constitutes about 10% of all ALCLs and characterized by presence of abundant reactive histiocytes that can mask the neoplastic nature of the lesion, leading to misdiagnose as “reactive lymphadenopathy”. Here we introduce a 16-year-old female patient, diagnosed as hypocellular LH variant ALCL with unusual histologic feature including granulation tissue- like appearance. We emphasize that in young patients with unusual- looking reactive lymphadenopathy, ALCL should be considered as one of differential diagnoses. A brief review of the nature of the lesion and differential diagnoses is also included.

Hobnail hemangioma is a benign vascular lesion and intraoral of the lesions are relatively rare. Histopathologically, it shows distinctive biphasic pattern with vascular channels lined by endothelial cells showing characteristic “hobnail” cytomorphology. Since hobnail hemangioma shares similar clinical and histopathologic features with many other benign and malignant vascular tumors, accurate diagnosis is mandatory for proper treatment and prognosis. In the present study, emphasis was given to discuss the differential diagnosis and delineate the hobnail hemangioma from other vascular lesions. Further, immunohistochemical study was performed which showed strong immunopositivity for CD31 and factor VIII in all endothelial cells lining the vascular channels. CD34 was moderately immunopositive and vascular endothelial growth factor was negative.

We report our initial experience with a heart-lung transplant operation performed on a 12- year- old girl with Eisenmenger syndrome at Masih Daneshvari Teaching Hospital in Tehran, in 2009. We also outline the operative indications, anesthetic management, and postoperative complications of heart-lung transplantation. We hope that this issue on transplantation may provide an encouraging prospect for patients with end-stage cardiopulmonary disorders in Iran.

Mesenteric cysts are heterogeneous groups of lesions. Most of them are developmental cysts of lymphatic and enteric origin or cystic neoplasm such as mesothelioma or cystic teratoma. Urogenital cysts are a subcategory of developmental cysts of the mesentery. They are thought to arise from vestigial remnants of urogenital apparatus. These cysts may show evidence of mesonephric or metanephric differentiation. An 11 -year -old boy was presented with undescended testis. During preoperative work- up, an incidental cystic lesion was discovered which was attached to the ileum. Aspiration cytology of the cyst content revealed cuboidal to columnar cells; some of them were ciliated. Histologic examination showed a cyst with fibromuscular wall, lined by Mullerian type ciliated epithelium; so the diagnosis of urogenital mesenteric cyst of Mullerian type was made.Urogenital cysts are rare lesions, but they should be considered in differential diagnosis of any cystic lesion of the mesentery. Cytology could be a useful method for evaluation and revealing the nature of these cysts.