مجله دانشکده پزشکی اصفهان
پیاپی 324 (هفته چهارم فروردین 1394)

Integral membrane proteins involve in a variety of valuable cellular processes including signal transduction, transport and cell-to-cell communication. Thus, due to their importance, are targeted to treatment of diseases or disorders. To achieve this goal, it is necessary to obtain adequate membrane proteins. A variety of expression systems have been used to overexpress these proteins but mammalian cells can produce membrane proteins structurally close to natural form of them and are favourable for this purpose. TOSO/FAIM3 (Fas Apoptosis Inhibitory Molecule), highly conserved membrane protein, playing important role in cell survival, immune surveillance, and homeostasis and in this study was overexpressed on HEK293T membrane. Eukaryotic expression vector pEZ-M67-TOSO was transformed into Escherichia coli top 10F’ strain to multiply. Then, the plasmid was extracted and digested with restriction enzyme Eco31I to make a linear plasmid. Subsequently, HEK-293T cells were transfected with linear plasmid and treated with hygromycin to select TOSO expressing stable cells. After three weeks, resistant colons were expanded, Chromosomal DNA and total RNA were extracted and the presence of TOSO-cDNA in HEK-293T genome and the expression level of TOSO were evaluated using polymerase chain reaction (PCR) and Real-time PCR methods, respectively. The integration of TOSO expressing cassette in HEK293T genome was confirmed. HEK-293 cells expressed 1700 mRNA TOSO molecule/cell which was in the range of protein with abundant expression. Mammalian cells represent membrane proteins in desirable form versus other expression systems. For this reason, we used HEK293T cells to overexpress transmembrane TOSO protein. In this investigation, we successfully constructed the HEK293 cell line with stable TOSO overexpression, which will facilitate further researches to characterize biophysical and biochemical structure and function of TOSO and pharmaceutical biological researches about it.

Generally, there are three kinds of urologic complications of renal transplantation including vascular, lymphatic and urologic complications; the urologic one is more common in the patients. These complications are related to several factors such as operation technique, characteristics of transplanted organs and donor and number of kidney arteries. This study aimed to determine the frequency of ureteral anastomosis complications (stenosis, urine leak and obstruction) after renal transplantation and its related factors.

In this cross-sectional study, all the kidney transplantations done during 2004-2012 in Alzahra Hospital, Isfahan, Iran, were studied. Anastomose complications such as stenosis, urine leakage and obstruction were excluded from hospital records and entered to collected data form. Finally, the data were analyzed using SPSS software.

Of 1419 cases of kidney transplantation, 630 (44.4%) were rehospitalized due to kidney problems; from them, 265 (42.1%) were during first 3 months, 251 (39.8%) during 3-6 months, 16 (2.5%) during 7-12 months and 98 (15.6) were at 12 months after the surgery or later. Of the 630 patients, 60 (4.2%) were rehospitalized due to anasthomosis complications. The kind of anathomosis complications was urethral stricture in 28 patients (46.7%), urine leak in 15 cases (25%) and urine obstruction in 17 patients (28.3%).

The incidence of ureteral anastomoses, as a complication in renal transplant, in our patients is the same as the other studies. Probably, the incidence of these complications is due to some factors such as patients’ age, number of kidney arteries and operation technique and these complications lead to rehospitalization and activities for prevention and on-time treatment is needed.

Congenital cytomegalovirus infection is less known but important cause of irreparable damages of the nerve, hearing and growth. The effect of education and certain health issues have been proved in reducing burden of the disease. In this study, the knowledge of healthcare providers in relation to congenital cytomegalovirus infection was measured. In a cross-sectional study in 2014, the knowledge, attitude, and practice behavior (KAP study) of practitioners and midwives was assessed. 341 questionnaires including question about the infection, such as prevalence, symptoms and complications, were fulfilled by the target group, gynecologists, pediatricians, general practitioners and midwives. The results were analyzed using one-way ANOVA, chi-square test, Pearson’s correlation and independent-t tests. Of 341 fulfilled questionnaires, 87 (26%) were men (40 general practitioners and 47 pediatricians) and 254 (74%) were women (60 midwives, 39 general practitioners, 55 pediatricians and 100 gynecologists) with the mean age of 39.9 ± 0.6 years. The overall knowledge score about the congenital cytomegalovirus infection was different between the specialists and general practitioners/midwives (P < 0.001). Women had more knowledge about this infection (P < 0.001). General practitioners and midwives, as the first line of health care providers to pregnant women, need more knowledge about the congenital cytomegalovirus infection.

Radial nerve damage is very debilitating complication. To restore the lost performance of radial nerve, classically, transferring of flexor carpi radialis and ulnaris tendons is used to restore the extension of the fingers and palmaris longus tendon transfer is used for thumb extension. The aim of this study was comparing the using of flexor carpi radialis tendon to classic method in patients with radial nerve damage. In a clinical trial study, 48 patients with radial nerve damage during 2004-2013 were selected and randomly divided in two groups. In the first group, tendon of flexor carpi radialis was used for the thumb and other fingers and in the second group, palmaris longus tendon and flexor carpi radialis tendons were used to restore the extension of the thumb and fingers, respectively. All the patients were followed 18 weeks after operation and results of surgery, including extension range of thumb and fingers and strength of hand, were compared between the two groups. Range of extension of thumb and fingers in 37.5% of first group and 16.7% of second group was above 500 and no statistically difference between the two groups was seen (P = 0.44). Strength of thumb and fingers in 25% of first group and 12.5% of second group was equal to safe hand and no statistically difference between the two groups was seen (P = 0.68). According to results of this study, transferring of one flexor tendon for extension of thumb and fingers is effective as well as transferring of two tendons. As a result, intervention and invasion in transferring one tendon is lower than the transferring of two tendons.

Recent studies have shown that anesthetic drugs can cause postoperative shivering. The incidence of postanesthetic shivering varies between 5 and 65% and patients report it as one of the leading causes of discomfort after operation. It may also induce a variety of physiological consequences such as increased O2 consumption and cardiac output. The effect of alfentanil, sufentanil and ketamine on prevention or decrease of postanesthetic shivering is not still clear. This study was performed to find out a suitable alternative for pethidine in prevention of postanesthetic shivering. In this randomized double-blind prospective study, 160 patients were classified into five equal groups according to drugs used for prevention of postoperative shivering after general anesthesia. Alfentanil, sufentanil, ketamine and pethidine groups received the drugs 30 minutes before the end of surgery and were compared with placebo (control group). The primary outcome measures were the incidence and severity of postoperative shivering. The five groups were were not different regarding age, gender, height, weight and the physical status class based on the American Society of Anesthesiologists score. In recovery room, postoperative shivering was seen in 18 patients, 2 in ketamine, 2 in pethidine, 4 in alfentanil, 3 in sufentanil and 7 in placebo group. Fisher’s exact test showed no statistically difference between the groups (P = 0.34). Intravenous infusion of alfentanil, sufentanil and ketamine 30 minutes before the end of surgery effectively reduced the occurrence and severity of postoperative shivering after the general anesthesia, without significant side effects but not as well as pethidine.