مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران
سال هفتاد و یکم شماره 5 (پیاپی 149، امرداد 1392)

Curcumin، the active ingredient of turmeric، has the ability to inhibit the carcinogenic pathways، and thus can prevent or postpone the carcinogenic process in different animal species. Retention time of curcumin is short due to the quick excretion of the body، so، the therapeutic effects of curcumin are restricted resulting in short-term retention in the plasma. Therefore، several methods are used for increasing the efficien-cy of curcumin in plasma and tissues. The present study is designed to evaluate the effects of the anti-proliferative and anti-carcinogenic of nano-curcumin in rat colon cancer. In this study which was performed in Cancer Research Center of Tehran University of Medical Sciences in 2012. Thirty rats have divided into control، curcumin and nano-curcumin groups. All animals received azoxymethane (15 mg/kg، s. c) as a carcinogen، once a week for two consecutive weeks. Animals received curcumin 0. 2% and nano-curcumin 2 weeks before azoxymethane injection up to 14 weeks after the last injection of azoxymethane in curcumin and nano-curcumin groups، respectively. At the end of experiment، the colorectal specimens from all mucosal lesions were obtained for histo-and-immunohistochemical (Ki-67 and COX-2) studies. The cytological and morphological changes of the cells in nano-curcumin group were significantly lower compared to other groups (P<0. 05). In addition، the Ki-67 and COX-2 proteins expression was lower in the nano-curcumin group in compare-son with the curcumin and control groups (P<0. 05). The results indicate that the using a suitable nanoparticle can be appropria-tely resolved the low bioavailability of curcumin. This can be an important method to use of natural products in the prevention and/or treatment of cancer.

Breast cancer is one of the most important causes of death in women. One of the various gene expression involved in breast cancer is human epidermal growth factor receptor 2 (HER2/neu) gene expression increases. Factors of dietary affect on regulation of hormone secretion and the rate of breast cancer. One of these factors is amount and type of fats in diet. Gamma-linolenic acid (GLA) and Docosah-exaenoic acid (DHA) are members of poly unsaturated fatty acids. In this study، effects of dietary GLA and DHA alone or together with paclitaxel on treatment of mice mammary carcinoma has been evaluated. Thirty female balb/c mice were divided in six groups randomly. Carcinoma-tous mass induced by tumor implantation method. Spontaneous breast adenocarcinoma of mice were used as tumor stock. The tumors of these mice were removed aseptically، dissected into 0. 5 cm3 pieces. These pieces were transplanted subcutaneously into their right flank. GLA and DHA added to the mice diet two week prior to tumor implanta-tion. At the end of intervention، tumors were removed and HER2 gene expression was measured. The weight of animal and tumor volume measured weekly. It was not significant change in the weight of animals that consumed DHA and DHA with taxol. Tumor volume in those groups that received corn oil with taxol (P<0. 01)، DHA (P<0. 05) and DHA with taxol (P<0. 001) showed significant decrease in comparison with control group. HER2 gene expression in DHA with taxol decreased significantly in comparison with control group (P<0. 05). Consumption of DHA oil with taxol causes decrease the volume of carcin-oma mass. The future studies with large number of sample is needed to support this finding.

Infertility is one of the most serious social problems. Illicit drug use can be an important cause of male factor infertility. Kerack which its use is rising up in Iran refers to a high purity street-level heroin (heroin Kerack). Heroin Kerack used in Iran is an opioid and has harmful effects on body organs. The aim of this study is to investigate the effects of Kerack used in Iran on fertility adult mice. In this study، 25 male mice were divided into five groups (control، sham and three experimental). Experimental groups of Kerack-dependent mice (received ascend-ing dose of Kerack for seven days) were divided into three categories، experimental I، II and III. Experimental I was given Kerack at a dose of 5 mg/kg، experimental II 35 mg/kg and experimental III 70 mg/kg، intraperitoneally twice a day for a period of 35 days. The sham group received normal saline and lemon juice (2. 6 µl/ml) whilst the control group just received water and food. Mice were then scarified and sperm removed from cauda epididymis were analyzed for sperm count، motility، morphology (normal/abnormal) and viability. Testes were also removed، weighed and processed for light microscopic studies. The results showed that fertility were significantly decreased in addicted mice compared with control groups (P≤0. 05). Epididymal sperm parameters and thickness of seminiferous epithelium were significantly decreased in experimental groups (dose-dependent) compared with sham and control groups (P≤0. 05). Gonadosomatic index was significantly reduced with high dose Kerack injected (70 mg/kg) in comparison with control testes (P≤0. 05). This study has shown the deleterious effects of Kerack used in addicted Iranian people on fertility for the first time. This effect is especially on epididymal sperm parameters in adult mice.

Pulseoximetry is widely used in the critical care setting، currently used to guide therapeutic interventions. Few studies have evaluated the accuracy of SPO2 (puls-eoximetry oxygen saturation) in intensive care unit after cardiac surgery. Our objective was to compare pulseoximetry with arterial oxygen saturation (SaO2) during clinical routine in such patients، and to examine the effect of mild acidosis on this relationship. In an observational prospective study 80 patients were evaluated in intensive care unit after cardiac surgery. SPO2 was recorded and compared with SaO2 obtained by blood gas analysis. One or serial arterial blood gas analyses (ABGs) were performed via a radial artery line while a reliable pulseoximeter signal was present. One hundred thirty seven samples were collected and for each blood gas analyses، SaO2 and SPO2 we recorded. O2 saturation as a marker of peripheral perfusion was measured by Pulseoxim-etry (SPO2). The mean difference between arterial oxygen saturation and pulseoximetry oxygen saturation was 0. 12%±1. 6%. A total of 137 paired readings demonstrated good correlation (r=0. 754; P<0. 0001) between changes in SPO2 and those in SaO2 in samples with normal hemoglobin. Also in forty seven samples with mild acidosis، paired readings demonstrated good correlation (r=0. 799; P<0. 0001) and the mean difference between SaO2 and SPO2 was 0. 05%±1. 5%. Data showed that in patients with stable hemodynamic and good signal quality، changes in pulseoximetry oxygen saturation reliably predict equivalent changes in arterial oxygen saturation. Mild acidosis doesn’t alter the relation between SPO2 and SaO2 to any clinically important extent. In conclusion، the pulse oximeter is useful to monitor oxygen saturation in patients with stable hemodynamic.

Recent studies have suggested that impaired fetal growth are indicators that may be present in the first trimester. The aim of this study was to investigate the relationship between crown-rump length (CRL) and pregnancy associated plasma protein-A (PAPP-A) measurements in first trimester for low birth weight (LBW).

This prospective cohort study were on 120 pregnant women in first pregnan-cy trimester، in Women''s Hospital Mirza Kochak Khan in 2011-2012. Gestational age according to crown-rump length and gestational age according to last menstrual period (LMP)، neonatal weight، small for gestational age، pregnancy associated plasma protein-A and low birth weight were recorded. Main outcome measures was weight and gestational age at birth. Statistical tests used included descriptive statistics، t-test، χ² and all tests were two-tailed and differences with P<0. 05 were considered to be statistically significant.

Our findings showed that a total of 120 cases were included CRL Z-score and log 10 (MOM PAPP-A) were positively correlated with fetal birth weight. The mean Crown-rump length Z-score was significantly can be reduced in LBW in first trimester pregnancy. (P<0. 001) Mean PAPP-A in low birth weight was (0. 4±0. 11 MOM)، but in normal weight infants was (1. 04±0. 7 MOM). (P=0. 011) also mean PAPP-A in pregnant women with SGA infants is significantly less than other pregnant women (0. 5±0. 2 versus 1. 1±0. 7) (P<0. 001).

Our data suggest that crown-rump length and maternal levels of PAPP-A measured during the first trimester are independent factors that influence fetal birth weight. But their predictive powers are not sufficiently good for them to be used alone for low birth weight screening.

One of the most common infections in neonatal period is ophthalmia neo-natorum. In this study، the bacterial agents، drug resistance and susceptibility of bacteri-al agents were studied.

In this study a total of 72 newborns with ophthalmia neonatorum admitted in Bahrami Hospital in Tehran during the years 2008-2011 were continuously enrolled in a case series، descriptive study. Demographic data، including age، sex، cause of admis-sion and culture of discharge from the eyes and its antibiogram، as well as experimental treatments and treatment outcomes were collected.

Forty four infants (61. 1%) were males and 28 (38. 9%) were females and the mean age on admission was 11. 6±7. 7 days. In 51 patients (70. 8%) the onset of ophthal-mia neonatorum was prior to admission. More than 56% of cases with ophthalmia neonatorum were associated with sepsis. On the other hand، positive blood culture was detected in 15. 3% of cases. Among 72 neonates with ophthalmia neonatorum، 26 (36. 1%) had a positive culture of the eye discharge. The most common causes of bacterial agents were Staphylococcus aureus (46. 1%) (12 of 26 cases). Other causes included streptococcus species (23%)، Pseudomonas (15. 3%)، E-coli (11. 5%) and Haemophilus influenza (3. 8%). The most frequent causes of drug resistance were Ampicillin، Penici-llin، Cefixime، and Ceftazidime (100% resistance). The most sensiti-ve antibiotics were vancomycin and imipenem (100% sensitivity). Based on the conventional treatment، clinical response to local gentamicin was approximately 60%. Sulfacetamide was associated with no clinical response in 40% of cases.

The antibiogram and clinical response to empiric treatment showed that resistance to ampicillin and some third generation of cephalosporine was 100%. Aminoglycosides’ sensitivity was more than 50% locally and systemically. Our recommendation is performing eye discharge culture before antibiotic treatment. More studies with numerous cases should be done for better definition of bacterial resistance.

The aim of this study was to minimize edema and ecchymosis following rhinoplasty through a closed drainage system to address concealed hemorrhage. This study was designed as a prospective، double blinded، randomized contr-olled study. Fifty one patients who underwent septorhinoplasty were included in this study and divided in two groups. In group A، a closed drainage system was applied in the most dependent posterior septal area following septal harvesting. Concealed bloody secretions were drained out of mouth in a vacutaner tube during three concecutive post operative days. In control group، group B، exactly the same classic rhinoplasty opera-tion by the same surgeon was done as for study group except omitting the closed drainage system. Degree of supra-tip and eyelid edema was evaluated on post operative days through photographic and software image analysis. Edema and ecchymosis rating of eyelids and ecchymosis of paranasal and cheek area done based on photographic analysis by independent plastic surgeons using a defined grading system. Eyelid ecchymosis was reduced significantly on post operative day 14 in the study group (P=0. 03). Ecchymosis of paranasal and check was reduced considerably likewise on days 7 and 14 in group A using Mann-Whitney test (P=0. 03). There was no significant deference regarding supra tip edema on post operative days. The same hold true for the eyelids edema. Significant decrement observed in eyelids ecchymosis on day 14 and para-nasal and cheek ecchymosis on postoperative days 7 and 14 in study group. There were no positive effects regarding supra tip and eyelid edema reduction using closed drainage system to evacuate concealed haemorrhage in posterior septum space. There could be different etio-pathologies for two common morbidities following rhinoplasty that should be addressed separately.

The prevalence of obesity has risen enormously over the past few decad-es. Both food intake (Appetite) and energy expenditure can influence body weight. Acylated ghrelin enhances appetite، and its plasma level is suppressed by growth horm-one. The present study، examines the effects of an intermittent exercise with progress-ive intensities on acylated ghrelin، appetite، and growth hormone in inactive male students with two levels of obesity. Eleven inactive males were allocated into two groups on the basis of their body mass index (BMI). Six subjects in group one، BMI= 31. 18±0. 92 kg/m2، and five subjects in group two، BMI= 36. 94±2. 25 kg/m2، ran on the treadmill with progressive intensities of 50، 60، 70 and 80% of VO2max for 10، 10، 5، and 2 min respectively. Blood samples were collected before the exercise (as the resting values)، after each workload (during the exercise)، and at 30، 60، and 120 min (during recovery). Plasma acylated ghrelin concentrations and hunger ratings in two groups were decreased and remained significantly lower than resting values (P=0. 008 and P=0. 002 respectively) at the end of the trial and there was no significant differences between groups. Growth hormone levels in two groups were increased and remained significant-ly higher than resting values (groups one P=0. 012، group two P=0. 005) at the end of the trial and there was no significant differences between groups. In addition، there were no significant differences between area under the curves (AUC) values over total periods for acylated ghrelin، hunger ratings، and growth hormone in two groups. These findings indicate that individuals with two levels of obesity have the same response to the different intensities of treadmill running and two hours thereafter during recovery period، which can be considered for designing a more effective weighting loss training program.

Long QT syndromes (LQT) are genetic abnormalities of ventricular repo-larization، with an estimated incidence of about one per 10000 births. It is characterized by prolongation of the QT interval in electrocardiogram (EKG) and associated with a high risk for syncope and sudden death in patients. Type of this syndrome is association with congenital deafness. Our objective was to evaluate QT interval in children with congenital deafness. For 219 patients referred to Imam Khomeini Hospital audiometric clinic in 2011، questionnaire were completed. A total of 23 congenitally deaf children were incl-uded. All patients’ examinations were done by a pediatric cardiologist. Electrocardio-gram is conducted in all children (23 patients) with sever and deep congenital deafness. Then the QT interval was measured based on Bazett’s formula. Echocardiography was also performed in these children to assess left ventricular function and the presence of mitral valve prolapse. The overall patients were two hundred and nineteen children. A total of twenty three congenitally deaf children were included and electrocardiogram was obtained. Three children had obviously prolonged QTc (0. 48±0. 02) second. The median age of them was 6. 1±5 year، the median weight was 18±11. 3 kilogram and the median of QT interval was 0. 48±0. 02 second. The QT interval obtained 0. 48±0. 02 second. In the present study we found prolonged QT in congenital deafness، thus we recommend to evaluate the electrocardio-gram of children with congenital deafness.

Malassezia Species are often commensal of the human skin and scalp that opportunistically in exist of particular predisposing factors، their proliferation increases; as، in dandruff and seborrheic dermatitis which both togather affect more than 50% of humans، the excess proliferation of yeast in scalp، leads to scalp-flaking and causes physical and mental disorder in peaple، spacially in youth that their health and hiar hygiene and beauty is more important for them. Thus، this survey has been done for rapid، easy and inexpensive method to diagnosis of abnormal proliferation and invasive condition of Malassezia yeast and can be more benefical for proper treatment. Sampling with scalpel scraping from scalp of volunteer persons that had not bathed at least two day ago were done and preparation of direct microscopic slides and staining with methylene blue were accomplished. Then، survey of morpholgic characte-ristics، yeast quantification and mycelium detection were done by direct microscopic examination. From 140 scalp samples of adult persons of both gender (male and female) with different age groups، observation of malassezia yeast in 93. 5% (131) were positive and 6. 5% (9) were negative in direct microscopic examination. Results of yeast quanti-fication in positive cases were: mild or normal flora 25. 2%، intermediate 24. 5%، severe 50. 3%. Detection of mycelium in positive cases were 22. 9% (30) (P=0. 007 df=2). Application of an accessible، easy and inexpensive method and a determi-nated pattern (yeast quantification with direct microscopic examination) to distinguish normal flora from abnormal condition (excess proliferation and mycelium production) in cases of Malassezia yeasts can be more useful to rapid diagnosis of abnormal pro-liferation and invasive condition in order to initiate a proper antifungal treatment.