A. R. Dehpour, PharmD, PhD
A. Javadian, MD
Vol 51, No 11 (2013)
One of the main members of the large aggregating proteoglycans (PGs) family is versican which is able to bind to hyaluronate. Versican is a chondroitin sulfate proteoglycan and is a key ingredient of the extracellular matrix. Due to its widespread expression in the body, versican is involved in cell adhesion, proliferation and migration. Induced expression of versican is often observed in tissues such as breast, brain, ovary, gastrointestinal tract, prostate, and melanoma. In addition, versican has important role in development. For example, versican conducts the embryonic cell migration which is essential in the formation of the heart and outlining the path for neural crest cell migration. Several studies in the past decade up to now have shown that versican produced by mononuclear cells has an important role in wound healing and blood vessel formation and suggested that it promotes tumorigenesis and angiogenesis. In this mini-review, we summarise and discuss the role of versican in healthy and pathological tissues and suggest the possible function of transcription factors and signalling pathway in regulation of versican.
The Overtraining Syndrome (OTS) is a physically debilitating medical condition that results in athletes being totally compromised in their capacity to perform and compete. Many physiological systems are affected by the process of overtraining and the development of the OTS which results from it; but one system in particular, the immune, is highly susceptible to degradation resulting in a reduction in overall health and physical performance. The aim of this paper is to review; 1) the evidence-based proactive steps and actions to take to greatly reduce the risk of development of an infection or a compromised immune system in athletes; and 2) the course of action for clinicians to take when they are dealing with an athlete displaying overt signs of an infection and, or inflammation. Evidenced reported here within support that it is essential for clinicians to take practical preventative and management steps - actions with athletes (involved in intensive exercise training) in order to help preserve and maintain a healthy and robust immune system if they are going to perform optimally.
Laryngopharyngeal reflux (LPR) is a variant of gastroesophageal reflux disease (GERD) in which the stomach contents go up into the pharynx and then down into the larynx. LPR causes a wide spectrum of manifestations mainly related to the upper and the lower respiratory system such as laryngitis, asthma, chronic obstructive pulmonary disease, cough, hoarseness, postnasal drip disease, sinusitis, otitis media, recurrent pneumonia, laryngeal cancer and etc. The object of this study was to examine the effect of N-acetyl Cysteine (NAC) with and without Omeprazole on laryngitis and LPR. Ninety patients with laryngitis or its symptoms were referred and randomly assigned into three groups. The first group was treated by Omeprazole and NAC. The second group was treated by Omeprazole and placebo and the last group was treated by NAC and placebo. Duration of treatment was 3 months and all patients were evaluated at the beginning of study, one month and three month after treatment of sign and symptoms, based on reflux symptom index (RSI) and reflex finding score (RFS). Based on the results of this study, despite therapeutic efficacy of all treatment protocols, the RSI before and after 3 months treatment had significant difference in (NAS+ Omeprazole) and (Omeprazole+ placebo) group (P<0.001 in the first group, P<0.001 in the second group and P=0.35 in the third group). Whereas RFS before and after 3 month treatment had significant difference in all groups. (P<0.001 in each group in comparison with itself) but this results had not significant difference after 1 month treatment. Our results showed that the combination therapy with Omeprazole and NAC treatment had the most effect on both subjective and objective questionnaire at least after 3 months treatment. Based on the results of the present study, it seems that the use objective tools are more accurate than subjective tools in evaluation of therapeutic effects in patients with GERD-related laryngitis.
To evaluate results of concurrent functional endoscopic sinus surgery (FESS) and nasal plastic surgery in terms of safety, efficacy and patient satisfaction, and compare them with the results of single procedures. We conducted a prospective case control study in three groups of patients with chronic sinusitis and nasal deformity; 25 cases had concurrent FESS and rhinoplasty, 25 controls had FESS, and 25 controls had rhinoplasty alone. The patients preoperative and postoperative sino-nasal outcome test (SNOT22) and also patients' satisfaction using the visual analogue scale were evaluated after one year. There were no significant differences between aesthetic indexes of concurrent surgery and control groups. Also, we found no significant inter-group difference between SNOT22 scores. There was no major complication in the studied patients. Conducting nasal plastic surgery and FESS concurrently can be a feasible surgery with functional and aesthetic results comparable to those with individual FESS or rhinoplasty.
Two main forms of COPD (Chronic Obstructive Pulmonary Disease) refer to a group of lung diseases that block airflow and cause a huge degree of human suffering. A new method for identifying and estimating the severity of COPD from three-dimensional (3-D) pulmonary X-ray CT images would be helpful for evaluation of treatment effects and early diagnosing is presented in this paper. This method has five main steps. Firstly, corresponding positions of lungs in inspiration and expiration are found based on anatomical structures. Secondly, lung regions are segmented from the CT images by active contours. Next, the left and right lungs are separated using a sequence of morphological operations. Then, parenchyma variations of three main cuts which selected by a feed-forward neural network are found based on the inspiratory and expiratory states. Finally, a pattern classifier is used to decide about the disease and its severity. Twenty patients with air-trapping problems and twelve normal adults were enrolled in this study. Based on the results, a mathematical model was developed to relate variations of lung volumes to severity of disease. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the accuracy of our method for right regions were %81.6, %80.5, %87.5, %72.5 and %81.3 respectively. And these parameters for left regions were %90, %83.3, %90, %83.3 and %87.5 respectively. The proposed method may assist radiologists in detection of Asthma and COPD as a computer aided diagnosis (CAD) system.
To prevent post cholecystectomy infection, the most common microorganisms causing it and their antibacterial susceptibility pattern should be determined. Therefore, the aim of the present study was to determine the exact incidence and nature of the microbial flora in the bile of the patients with cholelithiasis and chronic cholecystitis as well as their antibiotic sensitivity pattern. In this study, a total of 132 samples from the patients were tested for bacterial strains using the appropriate methods for testing them. The isolated bacteria were subsequently subjected to antibacterial susceptibility test using Kirby-Bauer method. The data were analyzed using Frequency, Chi-square and t-test. Fifty of 132 (37.87%) studied patients were positive for bacteria. The most common isolated organisms were Escherichia coli (13; 26%), Enterobacteriaceae (9; 18%), and Salmonella typhi (7; 14%). The most effective antibiotics were sequentially Amikacin, Ceftriaxone, and Clindamycin. Isolating bacteria and determining their sensitivity to different antibiotics may be help physicians take prophylactic measures against postoperative infection of cholelithiasis and chronic cholecystitis.
The aim of this study was to determine the sleep quality and level of depression among Iranian migraineurs. Among 380 cases that were selected by simple random selection from those who attended Outpatient Neurology Clinic of Imam Khomeini Hospital, 332 patients participated in this cross-sectional study. After an inclusive examination by a neurologist, the participants were asked to fill valid and reliable Persian versions of Pittsburg Sleep Questionnaire (PSQI) and Beck Depression Inventory (BDI). They also requested to score headache severity by means of a visual analogue scale graded from 1-10. According to frequency of attacks, patients were divided into three groups: with 1-4 migraine days per month, 5-7 migraine days in a month and more than 7 migraine days per month. Mean age of participants was 36.3±10.1 years and mean headache severity score was 6.0±1.9. The PSQI total score and headache severity score were highest among patients with frequent attacks. Mean BDI, PSQI and headache severity scores significantly differ between male and female participants. There was significant positive correlation between BDI and PSQI scores (r=0.5, P<0.001) also there was a positive correlation between headache severity score and PSQI score (r=0.6, P<0.001). Decreased sleep quality with other co-morbidities such as depression in migraineurs cases should be considered.
To determine the association between polymorphism of UGT1A1 gene and idiopathic hyperbilirubinemia in Iranian neonates. Fifty neonates with idiopathic hyperbilirubinemia and Serum total bilirubin (STB) more that 15mg/dl and 50 neonates with idiopathic hyperbilirubinemia and Serum total bilirubin (STB) less than 15mg/dl enrolled in this study. Thymine-adenine (TA) repeats in the promoter region of UGT1A1 gene investigated by means of polymerase- chain reaction (PCR) DNA sequencing. Demographic characteristics did not differ significantly between groups while STB was higher in case group (17.5±1.9 vs. 10.4±1.8, p value<0.001). Among one hundred neonates evaluated in this study, TA6/6, TA6/7 and TA7/7 genotypes found in 52%, 42% and 6%, totally. TA6/7 and TA7/7 genotypes observed in case group more than the control group (P<0.001). STB levels were significantly higher in cases with TA6/7 and TA7/7 genotype pattern (P<0.001). Heterozygous and variant homozygous genotypes of the promoter region of UGT1A1 gene in healthy Iranian neonates with idiopathic hyperbilirubinemia should be considered.
Skin disorders comprise more than 35% of all occupationally related diseases. 90-95% of work-related dermatoses are contact dermatitis. Effects of occupational dermatitis in the lives of workers are substantial. To plan any preventive program we need basic statistics of the problem, that we had no reliable one which includes a lot of industries in Iran. Therefore we decided to determine occupational contact dermatitis, and it's subtypes prevalence in various jobs. The objective of this study is determination of occupational contact dermatitis, and it's subtypes prevalence and comparison among various jobs. In this cross -sectional study, we examined 3061 workers of various industries during 2007-2012 and recognized contact dermatitis cases. Irritant and allergic cases were separated according to clinical judgment of physician and patch test using European standard series. We found 271 (prevalence=8.8%) occupational contact dermatitis cases which 247 (91.1%) were irritant, and the rest were allergic. The highest prevalence was in washing powder production and then glaze and paint workers, mechanists and chemical workers were located. There is a great variability for occupational contact dermatitis in various industries and between different countries. These statistics changes during the time by changing in number of workers and their characteristics, variation in material and process and glove use situation. So every country must have a national data bank of occupational contact dermatitis, which must be updated after a period of time.
Due to the epidemiological alteration in distribution of Candida species as well as significant increasing trend of either intrinsic or acquired in resistance of some of these fungi, the precise identification of Candida species is necessary for effective antifungal therapy and also for prevention of nosocomial infections. PCR-RFLP method is indicated to be a reliable, rapid and simple technique which is able to differentiate the Candida species. In the present study, we applied this method to evaluate the distribution of Candida species in patients affected with cutaneous candidiasis in the Guilan province. 896 clinical cutaneous samples were collected from different parts of skin and nail of suspected patients referred to clinical centers all over the Guilan province during 24 months. Samples were examined directly with 15% KOH and cultured on fungal specific media. Genomic DNA was extracted and the restriction enzyme Msp1 was applied for polymorphism analysis. Totally, 47 yeast strains were successfully isolated from different clinical samples and identified by conventional as well as PCR-RFLP methods. The results indicated that Candida albicans (36.17%) was the most frequent species followed by C. parapsilosis (25.53%), C. tropicalis (19.14%), C. guilliermondii (14.89%), C. famata (2.12%) and C. krusei (2.12%). Female finger nails were the most common location to be affected by Candida species. In conclusion, PCR-RFLP method was successfully used for recognition of clinical Candida species within the Guilan province and obtained results revealed C. albicans as the predominant causative agent of cutaneous candidiasis. However, distribution of other Candida species did not completely consist with the reported distribution of Candida species in other parts of Iran with different climate to the Guilan province.
Incontinentia Pigmenti (IP) is a rare X-linked dominant disorder with skin, eye, central nervous system (CNS) and tooth abnormalities. According to the reported cases, it is estimated that there have been nearly 900-1200 affected individuals. In this article, the literature is reviewed and a case of IP with characteristic skin lesions and optic atrophy is presented.
A 25-year old man presented with chronic low back pain for about 5 years due to mild congenital lumbar kyphosis (L1-L3 25° with congenital posterior wedge vertebra L2). Preoperative neurologic examination was normal. After posterior spinal fusion and instrumentation with moderate curve correction, the patient gradually developed the symptoms and signs of cauda equina syndrome due to intraoperative L2-3 disc herniation. After 5 days the patient underwent posterior decompression surgery and on the latest follow up visit at 2 years later, nearly all the motor power was recovered but the patient complained of occasional urinary incontinence and residual right leg paresthesia. In surgical treatment of congenital kyphosis, much attention should be paid to the presence of contemporaneous asymptomatic disc herniation.
Intestinal tuberculosis is an uncommon presentation of tuberculosis (TB) and has clinicopathological similarities with Crohn's disease. In regions where TB is endemic clinicians must aware of this condition and fully evaluate their patients when Crohn's disease is diagnosed. We recommend all pathologic specimens be evaluate effectively for TB.Smear, culture and PCR for Mycobacterium.tuberculosis from samples aside the pathological reviews help for better diagnosis. Here we present a case of intestinal tuberculosis which initially diagnosed as Crohn's disease but after starting immunosuppressive agents he presented with disseminated tuberculosis.
Gelatin sponge, oxidized cellulose and microfibrillar collagen are used to achieve hemostasis during neurosurgical procedures. Hemostatic agents may produce clinically symptomatic, radiologically apparent mass lesions. The differential diagnosis should include the foreign body along with recurrent tumor. We present a case of intracranial hemostatic agents found in a 56-year-old male patient seven years after undergoing a craniotomy for a left posterior parietal convexity meningioma. Preoperative magnetic resonance imaging (MRI) suggested the presence of a recurrent tumor. We emphasize that although it is rare, a granuloma due to a foreign body reaction can result in a false image of tumor recurrence.
Hypothalamic hamartoma (HH) is a rare intracranial lesion that usually presents with classic triad of central precocious puberty, gelastic epilepsy, and developmental delay. Herein, a 14-year old boy is presented in whom the diagnosis of HH was made by magnetic resonance imaging. While he did not have any complain of precocious puberty, he surprisingly suffered from delay in puberty. The definite diagnosis of HH can only be made by appropriate imaging, in a case with atypical feature of delay in puberty and in the absence of gelastic epilepsy. To our best knowledge, this is the first case of HH who is presented with delay in puberty as of first manifestation.
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