فهرست مطالب

Archives of Iranian Medicine
Volume:18 Issue: 6, Jun 2015

  • تاریخ انتشار: 1394/04/05
  • تعداد عناوین: 15
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  • Mohsen Emadedin, Maede Ghorbani Liastani, Roghayeh Fazeli, Fatemeh Mohseni, Reza Moghadasali, Soura Mardpour, Seyyedeh Esmat Hosseini, Maryam Niknejadi, Fatemeh Moeininia, Aslan Aghahossein Fanni, Reza Baghban Eslaminejhad, Ahmad Vosough Dizaji, Narges Labibzadeh, Ali Mirazimi Bafghi Page 336
    Background
    Osteoarthritis (OA) is a debilitating disease that typically affects a large number of the middle-aged and elderly population. Current treatment strategies have had limited success in these patients. This study aims to investigate the safety of treatment with autologous bone marrow (BM)-derived mesenchymal stem cells (MSCs) transplanted in patients with OA of the knee, ankle, or hip.
    Methods
    We enrolled 18 patients with different joint involvements (knee, ankle, or hip OA) and one was lost to follow-up. BM samples were taken from the patients, after which BM-derived MSCs were isolated and cultured. Each patient received one MSC injection. Patients were followed with clinical examinations, MRI and laboratory tests at 2, 6, 12, and 30 months post-transplantation.
    Results
    We observed no severe adverse events such as pulmonary embolism, death, or systemic complications. A limited number of patients had very minor localized adverse effects such as rash and erythema. There were no changes in liver function, hematology, or biochemistry analyses before and after cell therapy. There was no evidence of tumor or neoplastic changes in the patients during the 30-month follow-up period. All patients exhibited therapeutic benefits such as increased walking distance, decreased visual analog scale (VAS), and total Western Ontario and McMaster Universities OA Index (WOMAC) scores which were confirmed by MRI.
    Conclusions
    Our study has shown that injection of MSCs in different OA affected joints is safe and therapeutically beneficial. However, further studies are needed with larger sample sizes and longer follow-up periods to confirm these findings.
    Keywords: Ankle osteoarthritis, autologous mesenchymal stem cell transplantation, hip osteoarthritis, knee osteoarthritis, safety
  • Ramezan Ali Ataee, Reza Golmohammadi, Gholam Hossein Alishiri, Reza Mirnejad, Ali Najafi, Davood Esmaeili, Nematollah Jonaidi, Jafari Page 345
    Background
    It has been recognized that infectious agents, such as different bacteria and viruses, may play a role in the developing of rheumatoid arthritis (RA). Recently, the mycoplasma species has been implicated in the pathogenesis of RA.
    Aim
    The aim of this study was to design a multiplex PCR for rapid and simultaneous detection of Mycoplasma pneumoniae, Mycoplasma hominis, and Mycoplasma arthritidis in the synovial fluid of patients with rheumatoid arthritis (RA).
    Methods
    A total of 131 synovial fluid (SF) samples from patients with RA were assayed. Mycoplasma pneumoniae (ATCC: 29342), M. hominis (native strain), and the synthetic complete genome of M. arthritidis mitogen (MAM) superantigen were used as controls. All SF samples were subjected to DNA extraction separately and multiplex PCR was performed. The PCR products were confirmed by sequencing.
    Results
    The designed multiplex PCR was able to detect M. pneumoniae, M. hominis, and M. arthritidis in the SF of patients with RA with a frequency of 30 (22.9%), 23 (17.5%) and 13 (9.9%), respectively.
    Conclusion
    In this study, the overall detection of the Mycoplasma species in RA patients was 53.4%; thus, we recommend the application of multiplex PCR assays when searching for a specific anti mycoplasma treatment for RA patients.
    Keywords: Multiplex PCR, Mycoplasma arthritidis, Mycoplasma hominis, Mycoplasma pneumoniae, Rheumatoid arthritis, synovial fluid
  • Masoud Karimi, Googheri, Hamid Daneshvar, Mehdi Khaleghinia, Reza Bidaki, Mohammad Kazemi Arababadi Page 351
    CONTEXT: The stimulator of interferon genes (STING) induces the activation of interferon regulatory factor 3 (IRF3) in response to intracellular viral double-stranded (ds) DNA. The aim of this study was to evaluate mRNA levels of STING and its downstream transcription factor, IRF3, in the isolated peripheral blood mononuclear cells (PBMCs) of patients with chronic HBV (CHB) infection.
    Methods
    This study was performed on 60 healthy controls and 60 CHB patients. The mRNA levels of STING and IRF3 were determined using Real-Time polymerase chain reaction (PCR) techniques. The SPSS software version 18 was used to analyze raw data.
    Results
    The results revealed that mRNA levels of STING were significantly decreased in CHB patients in comparison to healthy controls (P = 0.013). Our results also revealed that expression levels of IRF3 were not different between CHB patients and healthy controls (P = 0.828).
    Conclusions
    In the present study, we found that CHB patients were unable to express appropriate levels of STING. Thus, it may result in impairment of HBV-DNA recognition and subsequently disruption of immune responses. These results suggest a plausible mechanism which may partially define the fact that immune responses are impaired in CHB patients.
    Keywords: Chronic HBV infection, IRF3, STING
  • Nurhan DoĞ, An, Dilek Toprak Page 355
    Background
    Suicide is among the top 20 leading causes of death globally in all age groups and it is still a significant social and public health problem.
    Methods
    Data on suicide deaths in 1987–2011 were extracted from the Turkish Statistical Institute mortality dataset based on ICD-9 and ICD-10 codes. The temporal trend in age-standardized suicide rates was tested for age, gender and methods using Joinpoint Regression Analysis.
    Results
    The average of age-standardized suicide rates of the period 1987–2011 were 3.08 per 100,000 people, 3.95 for male and 2.21 for female. Significant increases were observed in males in all age groups, but no significant changes were observed in females over the age of 45. The most common methods of suicide among people who live in Turkey were hanging, poisoning, firearms and jumping.
    Conclusion
    High-risk groups could benefit from targeted strategies of suicide prevention. To understand the important influences on suicide risk in different age groups, future studies must investigate the experiences of older and younger individuals separately.
    Keywords: Joinpoint regression analysis, mortality data, suicide, suicide methods, trend
  • Ali Akbar Moghadamnia, Saeid Hakiminia, Mahmoud Baradaran, Sohrab Kazemi, Manouchehr Ashrafpour Page 362
    Introduction
    Diabetes mellitus (DM) is associated with memory and learning deficits. Evidence has been provided that vitamin D is involved in brain function. The aim of the present study was to determine the potential effect of vitamin D on acquisition and retention of memory and learning in streptozotocin (STZ)-induced diabetic mice.
    Methods
    Experiments were performed in four groups of mice (each group; n = 7). Male mice were induced to diabetes by single dose (60 mg/kg, i.p.) injection of freshly prepared STZ dissolved in cold normal saline. Treatment with vitamin D (5µg/kg daily, i.p. dissolved in tween80) was begun at three days after diabetes induction. Passive avoidance (PA) learning method was used four weeks later. Retrieval test was carried out 24 h after training.
    Results
    Our results demonstrate significant impairment in acquisition and retrieval processes of PA learning in STZ- induced diabetic mice. Treatment with vitamin D improved learning and memory compared to the control group, both in acquisition and retrieval stages and reversed learning deficits in diabetic mice. In acquisition test, there were significant differences in the initial latency among the DM+Vit. D treated and control groups (P < 0.05). There was a significant difference in step-through latency between diabetic group treated with vitamin D compared to diabetic non-treated groups (P < 0.05).
    Conclusion
    It is possible that the effects of Vitamin D on cognitive deficits in STZ-induced diabetic mice could be mediated through calcium homeostasis modulation. These findings suggest a potential role for vitamin D in the treatment of diabetes-associated cognition deficits. The positive effect of vitamin D on the avoidance task may be attributed to its neuronal protective roles metabolic regulating roles of prolonged vitamin D administration.
    Keywords: Diabetes, learning, memory, streptozotocin, STZ, vitamin D
  • Khodamorad Jamshidi, Farid Najd Mazhar, Davod Jafari Page 367
    Background
    Chondromyxoid fibroma is a rare benign primary bone tumor of cartilaginous origin, which most commonly involves the metaphyseal bone of proximal tibia and distal femur. The purpose of the study is to report our experience with diagnosis and surgical management of Chondromyxoid fibroma in the pelvic region.
    Methods
    Eight consecutive patients with a final diagnosis of pelvic Chondromyxoid fibroma were treated from 2001 to 2010. We considered the presentations and outcome for surgical complications and local recurrence after extended curettage and allogenic corticocancellous bone grafting.
    Results
    Three patients were female and five were male. The median follow up period was 72 (30–126) months. The mean age of cases was 31.9 (20–41) years. Five patients had left side involvement and in the remaining three, the right side was involved. Four involved periacetabulum, two involved the ilium and the remaining two cases were ischiopubic. The mean Musculoskeletal Tumor Society Score was 94.1%. The major complications were recurrence in one case and herniation after pubic rami resection in another case.
    Conclusion
    Chondromyxoid fibroma should be distinguished from chondrosarcoma. Management recommendation includes extensive curettage and corticocancellous bone grafting. We also advocate use of fibular strut allograft for reconstruction of pubic rami after its resection to prevent hernia in cases with pubic rami involvement.
    Keywords: Chondromyxoid fibroma, complication, fibular graft, pelvic tumor
  • Ali Akbar Esmailiejah, Mohammadreza Abbasian, Salman Azarsina, Farshad Safdari, Mahasti Amoui, Samaneh Hosseinzadeh Page 371
    Background
    Limited recent studies have demonstrated that 99mTc-UBI scan can be a helpful method in precise diagnosis of infection. In the current study, we aimed to investigate the diagnostic efficacy of 99mTc-UBI scan in detection of musculoskeletal infections.
    Methods
    Fifty patients with suspected musculoskeletal infections (painful THA, TKA, implant and nonunion) were enrolled in this study. After injection of 99mTc-Ubiquicidin 29-41, up to 30 minutes, dynamic imaging was performed every 1 minute. Whole body anterior and posterior images were acquired at 60 and 120 min (5 min/frame). A polygonal region of interest (ROI) was drawn manually around the area of increased accumulation of tracer (lesion) and anatomically similar area on the contralateral side (background) and the lesion to background ratio (LBR) was calculated. Then, patients underwent surgical procedures to assess infection by tissue sampling and histopathologic studies as gold standard. The receiver operating characteristics (ROC) analysis was performed to find a cut-off value for LBR and determining the diagnostic efficacy of UBI scan in musculoskeletal infections.
    Results
    Histopathologic studies revealed infection in 38 patients. The mean LBR was significantly higher in infected patients (2.05 ± 0.41 vs. 1.52 ± 0.22; P < 0.001). ROC analysis showed that a cut-off point of 1.74 for LBR will have 94.7% sensitivity, 83.3% specificity and 92% accuracy for diagnosis of musculoskeletal infections.
    Conclusion
    UBI scan is a useful diagnostic tool for evaluation of patients with suspected musculoskeletal infection. However, UBI imaging has some limitations which result in some incorrect diagnoses. It is important to interpret the results of the scan with regard to the clinical findings.
    Keywords: Infection, musculoskeletal system, ubiquicidine
  • Roya Rafati, Razieh Jalal, Ahmad Asoodeh, Maryam M. Matin Page 376
    The aim of this study was to investigate whether the rs12255372 (TCF7L2) and D76N (PDX-1) polymorphisms are associated with type 2 diabetes mellitus (T2DM) in Mashhad, northeast Iran. A hundred twenty seven patients with T2DM and 71 non-diabetic controls in Mashhad were genotyped by PCR-RFLP and ARMS-PCR methods. Single nucleotide polymorphisms (SNPs) were confirmed by sequencing in some samples and allelic and genotypic frequencies were then analyzed in each group. The T-allele of the SNP rs12255372 of TCF7L2 (OR = 2.70, 95% CI = 1.12–6.49, P = 0.027) and the A-allele of PDX-1 D76N (OR = 3.93, 95% CI = 1.60–7.68, P = 0.002) were significantly associated with an increased risk of T2DM. The rs12255372 SNP of TCF7L2 and D76N of PDX-1 genes may confer susceptibility to T2DM in the population living in Mashhad.
    Keywords: D76N_rs12255372_PDX_1_TCF7L2_Type 2 diabetes mellitus
  • Ana, Maria Singeap, Carol Stanciu, Camelia Cojocariu, Catalin Sfarti, Anca Trifan Page 379
    Since its introduction to clinical practice in 2001, small-bowel capsule endoscopy (SBCE) has become an important investigation procedure in many small bowel pathologies, including both suspected and known Crohn’s disease (CD). SBCE has higher diagnostic yield than other radiologic and endoscopic modalities used in evaluation of patients with suspected CD. In addition, SBCE has proved useful, in a non-invasive and safe manner, as a monitoring method for evaluating the severity and extent of lesions, postoperative recurrence, and mucosal healing in patients with known CD. Monitoring of colonic inflammation in patients with ulcerative colitis (UC) using second-generation of colon capsule endoscopy (CCE-2) has also been reported. Besides its advantages, CE also has several limitations such as the inability to obtain biopsies and lack of therapeutic capabilities, hopefully to be overcome in the near future by advances in modern technologies.
    Keywords: capsule endoscopy, Crohn's disease, inflammatory bowel disease, ulcerative colitis
  • Mousa Talebi, Bakhshayesh, Fatemeh Samiee, Rad, Hossein Zohrenia, Ali Zargar Page 384
    Acute esophageal necrosis is a rare cause of upper gastrointestinal bleeding, usually caused by hypo perfusion. In this report, we present a 34-year-old male patient suffering from acute esophageal necrosis presenting as hematemesis in a patient with Diabetic ketoacidosis. Diabetic ketoacidosis is rarely reported as a cause of acute esophageal necrosis and it is vital to diagnose it in a patient with Diabetic Ketoacidosis as a potential cause of mortality.
    Keywords: Acute esophageal necrosis, black esophagus, diabetic ketoacidosis
  • Rao Xu, Tie, Mei Shi, Shou, Jun Liu, Xin, Lu Wang Page 386
    A 30-day-old neonate was brought to our hospital due to testicular neoplasm in the right scrotum. Scrotal ultrasonography revealed a mixed cystic and solid mass in the testis. Analysis of testicular tumor markers was negative. Scrotal exploration was performed. A red nodular tumor was removed from the testis by surgery. Histological examination of the specimen showed it to be hemangiolymphangioma (HLA).
    Keywords: Hemangiolymphangioma (HLA), neonate, testis, ultrasound
  • Ji, Chun Zhao Page 389
    Patient, a 59-year-old male coming from an undeveloped area of Sichuan Province, China, was admitted because of chest pain for one month. Compute tomography angiography showed descending aorta pseudoaneurysm at the level of the 6th thoracic vertebra (T6). History of bone tuberculosis and tuberculosis DNA test had confirmed diagnosis of tuberculosis. Interventional surgery was performed 3 days after admission. A covered stent (Medtronic TF 3030C200EE) was deployed slowly and accurately. Digital subtraction angiography showed that the pseudoaneurysm was isolated successfully and completely. The chest pain syndrome was relieved considerably. On the day after surgery, the patient was discharged. Fourteen months later, a recent CT revealed that the stent was in the right place and fluent and no infective clue was detected. The patient did not have any discomfort. Interventional therapy for infective pseudoaneurysm still has long promising prognosis. At the same time, anti-infection therapy is also essential.
    Keywords: Infective pseudoaneurysm, interventional therapy, undeveloped area
  • Hadi Mirfazaelian, Maryam Nikzad, Yahya Daneshbod Page 391
  • Mohammad Hossein Azizi, Touraj Nayernouri, Moslem Bahadori Page 393
    The history of early attempts of blood transfusion in Iran traces back to the 1940s; however, around three decades later in 1974, the Iranian National Blood Transfusion Service (Sazeman-e Melli-e Enteqal-e Khun-e Iran) was founded by the outstanding hematologist, Professor Fereydoun Ala. The main goals of this centralized organization were to collect blood from healthy voluntary donors, to screen the donated blood and to provide various safe blood products based on scientific and ethical standards. In due course, a new era of blood transfusion service in Iran had begun to such a degree that after more than four decades of its activity, it is now considered the best-developed blood service in the eastern Mediterranean region. Here, a brief historical account of the early blood transfusion efforts and the establishment of the modern Iranian National Blood Transfusion Service in Iran is discussed in addition to the life and career of its founder and first director, Professor Fereydoun Ala.
  • Erdim Sertoglu Page 401