Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 5 2017 07 11 282 289 EN Soheila Sarmadi Department of Pathology, Women Hospital, Tehran University of Medical Sciences, Tehran, Iran. Narges Izadi-Mood Department of Pathology, Women Hospital, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Movarei Department of Pathology, Women Hospital, Tehran University of Medical Sciences, Tehran, Iran. Salma Sefidbakht Department of Pathology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran. Kambiz Sotoudeh Department of Pathology, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran. Eesa Jahanzad Department of Pathology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran ,Iran. 2016 02 25 2017 01 30 Tumor angiogenesis is one of the most important factors in tumor progression. In this study, the angiogenesis of cervical squamous cell carcinoma (SCC) and its association with prognostic factors was assessed by using CD34 immunostaining marker. The microvessel density in 40 patients with cervical SCC was studied in three areas of the tumor; stromal and peripheral tumor area (combined) central stromal tumor area and peripheral tumor area and the relationship of microvascular density and survival was also evaluated. The count of CD34 is correlated with younger age, the presence of perineural invasion and metastasis to lymph nodes. High peripheral tumor angiogenesis is also correlated with lower disease-free tumor survival. According to the findings of the present study, CD34 expression, especially in peripheral tumor areas, can be used as a prognostic marker in cervical SCC. https://acta.tums.ac.ir/index.php/acta/article/view/5468 https://acta.tums.ac.ir/index.php/acta/article/download/5468/4933

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 5 2017 07 11 340 343 EN Kamran Balighi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Arghavan Azizpour Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ali Sadeghinia Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Vahide Saeidi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 20 2016 09 27 Paraneoplastic pemphigus (PNP) is an autoimmune bullous disease associated with underlying neoplasms, both malignant and benign. The most constant clinical presentation of PNP is the presence of intractable stomatitis. Herein we present a 25-year-old male with a 3-month history of refractory stomatitis especially involving the lips and widespread vesiculobullous eruption on his trunk and extremities. The diagnosis of PNP was confirmed based on histological and serological results. Investigation for the underlying neoplasm revealed a retroperitoneal tumorous mass which was biopsied and diagnosed as the inflammatory myofibroblastic tumor (IMT). The tumor was surgically excised, and different treatment regimens were used to treat the mucocutaneous lesions. Skin lesions responded favorably to treatment, but oral stomatitis still persists which is the case in most PNP patients. This combination of PNP and IMT has rarely been reported in the literature. Treatment started with corticosteroid and rituximab then tumor excised. https://acta.tums.ac.ir/index.php/acta/article/view/5011 https://acta.tums.ac.ir/index.php/acta/article/download/5011/4941

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 5 2017 07 11 352 353 EN Mirhojjat Khorasanizadeh Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Eskian Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Nima Rezaei Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. 2016 04 01 2017 01 03 https://acta.tums.ac.ir/index.php/acta/article/view/5532 https://acta.tums.ac.ir/index.php/acta/article/download/5532/4944

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 5 2017 07 11 290 296 EN Majid Mossahebi-Mohammadi Department of Hematology and Blood Banking, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Amir Atashi Department of Hematology and Blood Banking, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. AND Stem Cell and Tissue Engineering Research Center, Shahroud University of Medical Sciences, Shahroud, Iran. Saeid Kaviani Department of Hematology and Blood Banking, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Masoud Soleimani Department of Hematology and Blood Banking, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. 2017 01 21 2017 02 21 Hematopoietic stem cells (HSCs) were characterized by self-renewal and multilineage potential. Umbilical cord blood-derived (UCB) as an alternative source of HSCs is widely used especially in children for stem cells transplant (SCT). The main limitation in using UCB for transplantation especially in adults is low cell dose. To overcome this limitation besides using double dose UCB, ex vivo expansion is the most important way to increase cell number for transplantation. HSCs are mainly isolated using CD133 or CD34. CD133, as the most primitive marker, shows important physiological role in maintenance and expansion of HSCs. SALL4 plays crucial role in the development and maintaining the pluripotency and self-renewal ability of embryonic stem cells (ESCs) as well as HSCs. Moreover, SALL4 act as a regulator of HSCs expansion, normal hematopoiesis, and hematological malignancies. In the present study, CD133+ cells positively selected and ex vivo expanded in SALL-4 and GFP-transduced group. CD133 expression assessed using flow cytometry at day 0, 7 and 10. Moreover, multilineage differentiation and proliferation potential of expanded cells in both groups evaluated using colony forming unit (CFU) assay, and cells count assay. Karyotyping analysis was performed to assess any chromosomal instability after 7 days of expansion. Obtained results demonstrated that SALL-4 transduced cells showed significant increase in cell number compared to control group. Moreover, immunophenotyping results showed higher expression level of CD133 at day 7 and 10 following expansion in SALL-4 transduced (62 % and 42%) compared to control group (51% and 20.6%). Our results illustrated that SALL4 could act as a positive factor for the expansion of CD133+ derived UCB cells besides maintaining self-renewal and differentiation ability of expanded cell without any numerical and structural chromosomal aberrations. https://acta.tums.ac.ir/index.php/acta/article/view/6161 https://acta.tums.ac.ir/index.php/acta/article/download/6161/4934

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 5 2017 07 11 344 347 EN Hamid Attaran Legal Medicine Research Center, Legal Medicine Organization, Mashhad, Iran. 2016 04 08 2016 10 21 Methamphetamine is one of the most common abused drugs, so its various effects on different body organs should be familiar to all physicians. Regarding its gastrointestinal sequels, there are few reports of ischemic colitis induced by its vasoconstrictive effects. This is the first report of isolated small intestinal infarction resulting in death following methamphetamine toxicity. A 40-year-old woman with a past history of medical treatment for obesity referred to hospital with severe chest and back pain, perspiration, nausea, agitation, high blood pressure, bradycardia and subsequent lethargy and vasomotor instability. Cardiac evaluations were normal, and a toxicologic urinalysis revealed methamphetamine. Later, abdominal pain predominated, and ultrasonography revealed signs of bowel infarction. She did not consent to surgery and succumbed afterward. At autopsy gangrene and perforation of distal ileum were found. The cause of death was determined as intestinal gangrene following methamphetamine toxicity. Methamphetamine has anorectic effects and so is used in some "diet pills"; Consumers may not even know they are using methamphetamine. Hence in cases of either known MA abuse or those using unknown weight reduction drugs presenting with gastrointestinal complaints or abdominal pain, intestinal ischemia should be kept in mind and if plausible, intervened promptly. https://acta.tums.ac.ir/index.php/acta/article/view/5564 https://acta.tums.ac.ir/index.php/acta/article/download/5564/4942

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 5 2017 07 11 297 303 EN Arezou Ebrahimi Department of Biology, Faculty of Sciences, Islamic Azad University, Damghan Branch, Damghan, Iran. AND Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran. Abasalt Hosseinzadeh Colagar Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran. Mohammad Karimian Department of Biology, Faculty of Sciences, Islamic Azad University, Damghan Branch, Damghan, Iran. 2016 08 04 2017 01 29 Methionine synthase (MTR) is one of the key enzymes of folate pathway, which play a key role in the construction, repair, and methylation of DNA. In this study, an association of MTR A2756G gene transition with prostate cancer in men populations of Kashan-Iran was investigated by a case-control study and an in silico analysis. The 200 samples including 100 patients with prostate cancer, as case group and 100 healthy men, as control group included in this study. MTR-A2756G genotyping was performed by PCR-RFLP technique. Some in silico tools used to evaluate the effects of A2756G transition on the structure and function of MTR. Results showed that the AG genotype (OR: 2.4014, 95% CI: 1.3216-4.3636, P=0.0040), and GG genotype (OR: 3.6324, 95% CI: 1.2629-10.4475, P=0.0167) and G allele (OR: 2.0120, 95% CI: 1.3098-3.0905, P=0.0014) were associated with prostate cancer. In silico analysis showed that polymorphisms of the enzyme protein might change properties of MTR such as relative mutability and flexibility, which leads to alteration of stability and function of the enzyme. Based on the results, an MTR-A2756G polymorphism which changes activity and stability of the methionine synthase associated with prostate cancer in men. It is a preliminary study and is presenting data for future comprehensive study for making a clinical conclusion that this gene transition is a biomarker for susceptibility to prostate cancer. https://acta.tums.ac.ir/index.php/acta/article/view/5801 https://acta.tums.ac.ir/index.php/acta/article/download/5801/4935

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 5 2017 07 11 348 351 EN Hamid Mohammadi Kojidi Department of Forensic Medicine, School of Medicine, Razi Teaching Hospital, Guilan University of Medical Sciences, Rasht, Iran. Morteza Rahbar Taramsari Department of Forensic Medicine, School of Medicine, Razi Teaching Hospital, Guilan University of Medical Sciences, Rasht, Iran. Alireza Badsar Department of Forensic Medicine, School of Medicine, Razi Teaching Hospital, Guilan University of Medical Sciences, Rasht, Iran. Mirsaeed Attarchi Department of Forensic Medicine, Inflammatory Lung Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran. 2016 02 22 2016 10 10 A 51-year-old man committed suicide by swallowing the contents of a fire extinguisher. A few hours after his suicide attempt, he was referred to the medical center for poisoning. At the time of admission, the patient was conscious with stable vital signs. The patient complained of burning lips and mouth, mentioning diarrhea. Initial treatments included gastric lavage with activated charcoal, while paraclinical measures were requested. The patient had undergone hypernatremia (Na: 152 mEq/l) and metabolic alkalosis. Treatment focused on the adjustment of sodium level and alkalosis. On the first day of hospitalization, the patient experienced recurrent episodes of tonic-clonic seizure along with the loss of consciousness. On the third day of hospitalization, the patient developed respiratory arrest followed by cardiac arrest and death. https://acta.tums.ac.ir/index.php/acta/article/view/5462 https://acta.tums.ac.ir/index.php/acta/article/download/5462/4943

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 5 2017 07 11 304 310 EN Asie Sadeghi Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran. Maani Beigy Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran. Samira Alizadeh Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hossein Mazloom Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Sanaz Vakili Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2016 08 22 2017 04 23 The purpose of this study was to determine the effect of vestibular rehabilitation therapy program on the sensory organization of deaf children with bilateral vestibular dysfunction. This cross-sectional and analytic study was conducted on 24 students between the age of 7 and 12 years (6 girls and 18 boys) with the profound sensorineural hearing loss (PTA>90 dB). They were assessed through the balance subtest in Bruininks-Oseretsky test of motor proficiency (BOTMP). For children which the total score of the balance subtest was 3 standard deviation lower than their peers with typical development, vestibular function testing was completed pre-intervention. Posturography Sensory organization testing (SOT) was completed pre- and post-intervention with SPS (Synapsys, Marseille, France). Children with bilateral vestibular impairment were randomly assigned to either the exercise or control group. Exercise intervention consisted of compensatory training, emphasizing enhancement of visual and somatosensory function, and balance training. The exercise group entered in vestibular rehabilitation therapy program for 8 weeks. The children initially participating in the control group were provided the exercise intervention following the post-test. Based on the results there was significant difference in condition 5 and 6, areas of limits of stability (LOS), vestibular ratio and global score in posturography at the end of the intervention, but there was no significant difference in the control group in posturography (P<0.05). The results indicated that testing of vestibular, and postural control function, as well as intervention for deficiencies identified, should be included in deaf children rehabilitation program. https://acta.tums.ac.ir/index.php/acta/article/view/5829 https://acta.tums.ac.ir/index.php/acta/article/download/5829/5016

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 11 2018 01 02 730 732 EN Fezzeh Elyasinia Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Hassan Emami Razavi Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Alireza Hosseini Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Firoozeh Abolhasanizade Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Reza Matloub Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Behnam Behboudi Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farham Ahmadi Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2016 12 05 2017 04 15 Complications of hiatal hernia are potentially lethal, and surgical intervention is necessary. This matter is more important in cases that have ambiguous symptoms and are diagnosed with a delay. Such patients may experience life-threatening course and events. Accordingly, in this report, a 23-year-old male patient with unusual findings is presented. A 23-year-old male patient with acute dyspnea and fever was admitted in infectious disease ward with diagnosis of empyema according to chest radiography and CT-scan findings (Figures 1 and 2). On physical examinations the right lung sounds were normal, and the left lung sounds could not be heard. Then a gastrography was performed because of suspicion to hiatal hernia based on physical examination findings showing the presence of stomach in the thorax (Figure 3). In the surgery, the stomach and the transverse colon were released and reputed in the abdomen (Figure 4). The diaphragm was primarily repaired due to small defect, and the patient was discharged after 4-5 days with good general conditions. This case had a learning note that in the case of acute dyspnea with a positive history of stab wound to the chest, hiatal hernia should be considered as an important diagnosis and in these cases performing a gastrography would help physicians to make true and certain diagnosis and therapeutic decision. https://acta.tums.ac.ir/index.php/acta/article/view/5807 https://acta.tums.ac.ir/index.php/acta/article/download/5807/5019

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 11 2018 01 02 690 695 EN Samira Joorabbaf Motlagh Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Maryam Shabany Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Khosro Sadeghniiat Haghighi Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran. Alireza Nikbakht Nasrabadi Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Seyed Hassan Emami Razavi Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. 2016 09 30 2017 04 15 One of the important reasons for accidents is sleepiness.With this description, the sleep disorders are associated with health and mortality, and not only affect the person but also the family and the whole society. Aim of this study was assessing of relationship between Sleep Quality, Obstructive sleep Apnea and Sleepiness during day with related factors in professional drivers. This was a cross-sectional study measuring correlation between sleep quality questionnaire (Pittsburgh Sleep Quality Index or PSQI), Epworth Sleepiness Scale (ESS) and Stop Bang questionnaire (STOP BANG).the appropriate sample size to achieve a 95% confidence level was 943 people. The study population was chosen among qualified drivers using a convenience sampling method that took place over 12 months duration. Exclusion criterion consisted of the presence of a physical or mental disability. Data analyzed by software SPSS, version 15. In this study, all drivers were men with mean of age 36±9/5 year (minimum 22 year and maximum 72 year), 799 (84.7%) were married, 535 (56.7%) had high school education. Also, 96.4 % of drivers had undesirable sleep quality, 25.8% obstructive sleep apnea and 6.8% abnormal sleepiness during day. Multiple linear regression test showed, Score of STOP-Bang was correlated with smoking (OR (β)=0/2, P=0.006) and history of hurt disease (OR (β)=0.95, P=0.003), shift work (OR (β)=0.19, P=0.006) more probability. Moreover, PSQI was statistically significant with shift work (OR (β)=0.44, P=0.02), smoking (OR (β)=0.98, P=0.001), history of pulmonary disease (OR (β)=3.58, P=0.009) more probability , and ESS was statistically significant with smoking (OR (β)=0.64, P=0.007) and history of pulmonary disease(OR (β)=2.82, P=0.006), shift work (OR (β)=0.59, P=0.008) more probability. In our study, according to the results, it should be planning to reduce the driving time in day and night and also it are recommended short breaks during driving. It is suggested the more widespread and prospective studies, as well as informing the drivers about the benefits of proper sleep and annual checkup drivers of health. https://acta.tums.ac.ir/index.php/acta/article/view/5919 https://acta.tums.ac.ir/index.php/acta/article/download/5919/5017

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 11 2018 01 02 696 704 EN Roya Sattarzadeh Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Anahita Tavoosi Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Saadat Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Leila Derakhshan Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Bakhtyar Khosravi Department of Pediatrics, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Babak Geraiely Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2016 09 25 2017 05 14 Accurate measurement of Mitral Valve Area (MVA) is essential to determining the Mitral Stenosis (MS) severity and to achieving the best management strategies for this disease. The goal of the present study is to compare mitral valve area (MVA) measurement by Continuity Equation (CE) and Pressure Half-Time (PHT) methods with that of 2D-Planimetry (PL) in patients with moderate to severe mitral stenosis (MS). This comparison also was performed in subgroups of patients with significant Aortic Insufficiency (AI), Mitral Regurgitation (MR) and Atrial Fibrillation (AF). We studied 70 patients with moderate to severe MS who were referred to echocardiography clinic. MVA was determined by PL, CE and PHT methods. The agreement and correlations between MVA’s obtained from various methods were determined by kappa index, Bland-Altman analysis, and linear regression analysis. The mean values for MVA calculated by CE was 0.81 cm (±0.27) and showed good correlation with those calculated by PL (0.95 cm, ±0.26 ) in whole population (r=0.771, P<0.001) and MR subgroup (r=0.763, P<0.001) and normal sinus rhythm and normal valve subgroups (r=0.858, P<0.001 and r=0.867, P<0.001, respectively). But CE methods didn’t show any correlation in AF and AI subgroups. MVA measured by PHT had a good correlation with that measured by PL in whole population (r=0.770, P<0.001) and also in NSR (r=0.814, P<0.001) and normal valve subgroup (r=0.781, P<0.001). Subgroup with significant AI and those with significant MR showed moderate correlation (r=0.625, P=0.017 and r=0.595, P=0.041, respectively). Bland Altman Analysis showed that CE would estimate MVA smaller in comparison with PL in the whole population and all subgroups and PHT would estimate MVA larger in comparison with PL in the whole population and all subgroups. The mean bias for CE and PHT are 0.14 cm and -0.06 cm respectively. In patients with moderate to severe mitral stenosis, in the absence of concomitant AF, AI or MR, the accuracy of CE or PHT method in measuring MVA is nearly equal. But in the presence of significant AI or MR, PHT method is obviously superior to CE and in the presence of AF neither have sufficient accuracy. https://acta.tums.ac.ir/index.php/acta/article/view/5895 https://acta.tums.ac.ir/index.php/acta/article/download/5895/5010

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 11 2018 01 02 705 711 EN Robabeh Abedini Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Amin Matinfar Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Pardis Sasani Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Anahita Salehi Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Te