Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 9 2017 10 30 539 549 EN Newshan Behrangi Faculty of Basic Sciences and Advanced Technologies in Biology, University of Sciences and Culture, Tehran, Iran. Nabiyollah Namvar Pasteur Institute, Production and Research Complex, Karaj, Iran. Mitra Ataei National Institute of Genetic Engineering and Biotechnology, Tehran, Iran. Sakineh Dizaji Pasteur Institute, Production and Research Complex, Karaj, Iran. Golshid Javdani Pasteur Institute, Production and Research Complex, Karaj, Iran. Mahommad Hossein Sanati National Institute of Genetic Engineering and Biotechnology, Tehran, Iran. 2016 09 26 2017 04 15 Matrix metalloproteinase-9 (GELB) as a member of gelatinases plays key role in the destruction of blood-brain barrier (BBB), T cells migration into the CNS, and demyelination induction. Considering remyelination induction in response to tart cherry extract and pure p-coumaric acid ingestion via tracking MMP9 gene expression in the cuprizone mouse model. Firstly, predicting the chemical interaction between p-coumaric acid and MMP9 protein was conducted through PASS and Swiss dock web services. Next, the content of p-coumaric acid in the tart cherry extract was analyzed by HPLC. Later, mice (male, female) were categorized into two groups: standard, cuprizone. After the demyelination period, mice classified into four groups: standard, natural chow, tart cherry extract, p-coumaric acid. Finally, brains were extracted from the skull, and MMP9 gene expression was evaluated by real time RT-PCR. Bioinformatics analysis displayed p-coumaric acid has potent inhibitory effect on MMP9 gene expression (Pa=0.818) with estimated ΔG (kcal/mol) -8.10. In addition, during the demyelination period, MMP9 expression was increased significantly in the male group that is related to myelin destruction. However, MMP9 was declined throughout remyelination in both male and female. It’s remarkable that pure p-coumaric acid and tart cherry extract ingestion could decrease the gene expression ratio more than natural chow. According to the results, it’s deduced the male mouse is more appropriate gender for demyelination induction via cuprizone. In addition, tart cherry extract and pure p-coumaric acid ingestion could decrease MMP9 gene expression level considerably during remyelination. https://acta.tums.ac.ir/index.php/acta/article/view/5896 https://acta.tums.ac.ir/index.php/acta/article/download/5896/4984

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 9 2017 10 30 585 590 EN Samaneh Abbasi Department of Stem Cell Research, Sarem Women’s Hospital, Tehran, Iran. Mehrdad Noruzinia Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Oranous Bashti Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Mohammad Ahmadvand Department of Hematology, Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Salehi Chaleshtori Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Leila Mahootipou Department of Stem Cell Research, Sarem Women’s Hospital, Tehran, Iran. 2016 07 07 2016 10 31 Mucopolysaccharidosis VI (MPS-VI) is an infrequent autosomal recessive disorder caused by mutations in ARSB gene and deficiency in lysosomal enzyyme ARSB activities subsequently. This enzyme is essential for the breaking of glycosaminoglycans (GAGs) such as dermatan sulfate and chondroitin sulfate. ARSB dysfunction results in imperfect breakdown of GAGs and their accumulation in urine. Mutations in ARSB gene are the main players in MPS-VI disease and its clinical consequences. Most reported mutations are point mutations but there are some other examples in literature. Here we report a novel missense mutation in ARSB gene that is inherited as an autosomal recessive mode and probably explain the clinical status of the proband. This mutation replaces the threonine 92 by proline and alters ARSB structure. This is the most feasible scenario for clinical condition we described here. This novel mutation should be remarked for PND and PGD to improve the health and management of such families. https://acta.tums.ac.ir/index.php/acta/article/view/5759 https://acta.tums.ac.ir/index.php/acta/article/download/5759/4991

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 9 2017 10 30 602 603 EN Fatemeh Tabatabaei Department of Gynecologic Laparoscopic Surgeries, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Obstetrics and Gynecology, Shafa Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. Zahra Tavoli Department of Obstetrics and Gynecology, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2016 08 23 2017 05 15 No Abstract https://acta.tums.ac.ir/index.php/acta/article/view/5834 https://acta.tums.ac.ir/index.php/acta/article/download/5834/4995

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 9 2017 10 30 550 555 EN Kian Khodadad Department of Internal Medicine, Dalhousie University, Cape Breton Cancer Centre, Sydney, Canada. Shirin Karimi Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Esfahani-Monfared Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Adnan Khosravi Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Bizhan Bandarchi-Chamkhaleh Department of Molecular Pathology, Princess Margaret Hospital, University of Toronto, Toronto, Canada. 2016 08 10 2017 04 17 Minichromosome maintenance complex component 6 (MCM-6) is one of the six proteins of the MCM family, which are involved in the initiation of DNA replication, represents a marker of proliferating cells. The goal of this study was to evaluate the prognostic relevance of the neoplastic cell proliferation rate in patients with Hodgkin's lymphoma (HL). We evaluated the formalin-fixed paraffin-embedded lymph node biopsy specimens from 55 patients by using monoclonal antibody against MCM-6 and compared these findings with clinical data and treatment outcome. Median of MCM-6 expression was 85% (range: 35%-99%). In multivariate analysis, MCM-6 expression, B symptoms, and age were not statistically significant predictor for relapse in contrary to response (P=.001) and stage of disease (P=.048). Patients with lower MCM-6 expression rates showed higher relapse rate and lower disease-free survival (DFS). Meanwhile, patients with MCM-6 expression less than 85% showed shorter DFS (P=.031). We hypothesize that in group of patients with lower MCM-6 expression rate, a larger proportion of proliferating malignant cells are arrested in the very early phase of mitosis, in comparison to the group of patients with higher MCM-6 expression, and this could imply a shorter and probably higher relapse rate in the former group. https://acta.tums.ac.ir/index.php/acta/article/view/5810 https://acta.tums.ac.ir/index.php/acta/article/download/5810/4985

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 9 2017 10 30 591 593 EN Rana Rafiei Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Hojat Eftekhari Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Siamak Granmayeh Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Nahid Nickhah Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran. Behnam Rafiee Department of Pathology, NYU Winthrop Hospital, Mineola, NY, USA. 2015 11 26 2016 03 04 Extramammary Paget’s disease is an uncommon intraepithelial adenocarcinoma in genital and perianal regions. Genital wart is the most common sexually transmitted disease caused by human papilloma viruses and vulval lichen sclerosus is chronic pruritic dermatitis in genital area which could be able to change to invasive squamous cell carcinoma. We report a patient who had simultaneous lichen sclerosus, genital wart and extramammary Paget’s disease of the vulva. We could not find any significant association between them in literature. https://acta.tums.ac.ir/index.php/acta/article/view/5199 https://acta.tums.ac.ir/index.php/acta/article/download/5199/4992

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 9 2017 10 30 556 562 EN Mojtaba Malek Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. Rokhsareh Aghili Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. Ameneh Ebrahim Valojerdi Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. Mohammad Ebrahim Khamseh Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. 2016 08 30 2017 04 15 This sub-analysis of the Iran-AFECT study was to determine the baseline characteristics are predicting the likelihood of attainment of HbA1c goal and changing in HbA1c after initiation of basal insulin glargine in insulin naïve people with type 2 diabetes not adequately controlled with oral glucose-lowering drugs. Iran-AFECT was a 24-week, prospective, multicenter, observational study of people with type 2 diabetes initiated or switched to insulin glargine. In this sub-analysis, we included all insulin naïve people. Glycemic response was defined as HbA1c≤7.0% and/or change in HbA1c at week 24. Data on 433 participants were included. The mean HbA1c was 8.9%±0.9% at baseline which decreased to 7.6%±1.2% (P<0.001). By week 24, 36% of the participants reached HbA1c≤7.0%. In univariate analysis, the strongest association was for the baseline HbA1c (r2=0.32, P<0.001). In multivariate analysis, predictors of change in HbA1c were baseline HbA1c (r2=0.29, P<0.001), and dosing of glargine (r2=0.01, P=0.02). The baseline HbA1c was accounting for 88% of explainable variances in HbA1c. The best cut-off predicting glycemic response for baseline HbA1c was 8.5%. Among factors predicting response to initiating basal insulin therapy with insulin glargine, baseline HbA1c is the strongest predictor explaining most of the variances in HbA1c change. https://acta.tums.ac.ir/index.php/acta/article/view/5852 https://acta.tums.ac.ir/index.php/acta/article/download/5852/4986

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 9 2017 10 30 594 596 EN Hojat Eftekhari Department of Dermatology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Kaveh Gharaei Nejad Department of Dermatology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Seyyede Zeinab Azimi Department of Dermatology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Rana Rafiei Department of Dermatology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Alireza Mesbah Razi Clinico-Pathology Laboratory, Rasht, Iran. 2016 06 15 2017 03 21 Bowen's disease (BD) is an epidermal in-situ squamous cell carcinoma (SCC). Most Human Papilloma Viruses (HPV)-positive lesions in Bowen's disease are localized to the genital region or distal extremities (periungual sites) in which HPV type-16 is frequently detected. Patient was a 64-year-old construction worker for whom we detected 2 erythematous psoriasiform reticular scaly plaques on peri-umbilical and medial knee. Biopsy established the diagnosis of Bowen's disease and polymerase chain reaction assay showed HPV-6, -18 co-infection. Patient was referred for surgical excision. https://acta.tums.ac.ir/index.php/acta/article/view/5714 https://acta.tums.ac.ir/index.php/acta/article/download/5714/4993

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 9 2017 10 30 563 567 EN Sepideh Rezaei-Adl Department of Biology, School of Sciences, Islamic Azad University, Tehran, Iran. Arash Ghahroudi Tali Department of Biology, School of Sciences, Islamic Azad University, Tehran, Iran. Moloud Payab Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Pourmand Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2017 03 13 2017 03 15 Stress urinary incontinence is a common medical problem among women. The urethral closure complex and/or the supportive mechanisms are responsible for incontinence in the majority of patients. Several surgical procedures with different degrees of invasiveness and outcomes have been reported to treat the problem. Although most of these procedures are reasonably effective, a general trend towards the study of natural and biocompatible tissues is emerging over popular synthetic materials. Here we report our experience of autologous adipose-derived stem cells transplantation into the periurethral region as a new method of stress urinary incontinence treatment. Ten women with symptoms of stress urinary incontinence were treated by injections of autologous adipose-derived stem cells into the periurethral region via transurethral and transvaginal approach under urethroscopic observation. This report presents the short-term outcome of the patients. The outcome measured by pad test results, ICIQ-SF scores, and Qmax. The mean age of the participants was 45.8±8.7 years. Urinary incontinence significantly decreased through the first two, 6 and 24 weeks after the injection therapy. The difference was significant in pad test results (P<0.001) and ICIQ-SF scores (P<0.001), especially comparing results between 2 and 6 weeks and among 6 and 24 weeks, but not for 2 and 6 weeks compared to each other. Surprisingly, Qmax showed improvement after the study period (means 32.6 vs. 35.7; P=0.002). This study showed that injection of the autologous adipose-derived stem cells to the periurethral region is a safe, yet short-term effective treatment option for stress urinary incontinence. Further studies with longer follow up are needed to confirm its long term efficacy. https://acta.tums.ac.ir/index.php/acta/article/view/6295 https://acta.tums.ac.ir/index.php/acta/article/download/6295/4947

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 6 2017 08 19 411 413 EN Raheleh Aliabadi Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Hassan Riahi Beni Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Jila Nadjafi East Surrey Associate Hospital for Brighton University, London, Uk. Morteza Hassanzade Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Mehrnaz Tabrizi Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Mohsen Nasiri Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Gandom Sedehi Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Ali Pourmojarab Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. 2015 10 28 2016 04 17 Streptokinase is a fibrinolytic agent that enhances plasmin activation and is used in selected patients with acute ST elevation myocardial infarction (STEMI). Similar to the other thrombolytics, a common side effect is bleeding, especially from venous puncture sites. Here, we present a case of acute anterior wall STEMI complicated by large spontaneous iliopsoas hematoma after streptokinase administration. With conservative management, the course of the disease was uneventful, and the patient was discharged with no symptom and no clinically important sequel. https://acta.tums.ac.ir/index.php/acta/article/view/5087 https://acta.tums.ac.ir/index.php/acta/article/download/5087/4955

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 6 2017 08 19 375 380 EN Abbas Darjani Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Nahid Nickhah Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Mohammad Hassan Hedayati Emami Department of Internal Medicine, Endocrinology and Metabolism Research Center, Guilan University of Medical Sciences, Rasht, Iran. Narges Alizadeh Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Rana Rafiei Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Hojat Eftekhari Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Kaveh Gharaei Nejad Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. 2016 04 07 2017 02 01 Pemphigus vulgaris is a chronic autoimmune disease and glucocorticoids are one of the main treatments. Our study investigates the prevalence and associated factors of glucocorticoid-induced diabetes mellitus in these patients under different glucocorticoid regimens. 36 patients with first diagnosed Pemphigus vulgaris based on pathological and direct immunofluorescence findings who had received different glucocorticoid regimens (1-2 mg/kg oral or 1-2 mg/kg oral with 1g methylprednisolone pulse daily for 3 consecutive days with or without azathioprine) were evaluated during 2014-2016. Our study found that 22.2% of patients had impaired fasting glucose and incidence of corticosteroid-induced diabetes mellitus was 22.2% with no difference between oral and pulse therapy of corticosteroid. The first day after pulse therapy 19 patients of 21 had post bolus hyperglycemia that 36% of them became diabetic after 8 weeks. None of the variables, including age, BMI, HbA1c, LDL, HDL, TG, cholesterol, family history and blood pressure were associated with diabetes. Pretreatment FBS was the factor that would increase the likelihood of glucocorticoid-induced diabetes mellitus, 42.2% of patients with pretreatment FBS 100-126 developed diabetes in comparison with 17.2% in normal pretreatment FBS. Although the group who received azathioprine was associated with increased incidence of diabetes, the overall corticosteroid dose in this group was significantly higher than the other group (P=0.012), and controversy with other studies could be because of difference in corticosteroid dosage and small number of patients. The incidence of diabetes was not different between the group with glucocorticoid pulses and oral prednisolone without pulse therapy. Higher pretreatment FBS can be related to increased incidence of diabetes, but results from this study due to small number of patients are preliminary and multicenter studies are needed. https://acta.tums.ac.ir/index.php/acta/article/view/5561 https://acta.tums.ac.ir/index.php/acta/article/download/5561/4948

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 6 2017 08 19 381 388 EN Ata Pourabbasi Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Tehrani-Doost Department of Psychiatry, Rouzbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Soqra Ebrahimi Qavam Department of Educational Psychology, Faculty of Psychology and Education, Allameh Tabataba’ee University, Tehran, Iran. Jalal Farzami Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran, Iran. Bagher Larijani Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2017 01 31 2017 02 07 Diabetes in children and adolescents is a chronic condition with an expanding trend in the community. Several studies have shown cognitive dysfunctions are the most important side effects of diabetes among individuals of younger ages. Due to cultural differences and their impact on cognitive issues, the authors decided to assess the cognitive functions of Iranian children and adolescents with diabetes. Cognitive functions including memory, attention and executive functions were evaluated in 62 diabetic children and adolescents and healthy peers using CANTAB cognitive tests. Other data such as demographic, school performance and medical information were collected by questionnaires. Except in the case of few variables in RVP, SSP and SST, no significant difference exists between diabetic children and the control group in terms of different cognitive domains. But cognitive variables, especially in PRM, SWM and SOC test, has been shown to be deteriorated with increasing HbA1C values in serum levels. Diabetes has no impact on the cognitive functioning of children provided by maintaining a glycemic control. It is proposed that the adoption of appropriate parenting styles and family and social support can prevent cognitive changes in children with diabetes. https://acta.tums.ac.ir/index.php/acta/article/view/6197 https://acta.tums.ac.ir/index.php/acta/article/download/6197/4949

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 6 2017 08 19 389 394 EN Niloofar Shekoohi Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Hassan Javanbakht Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Marjan Sohrabi Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Mahnaz Zarei Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Hamed Mohammadi Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Mahmoud Djalali Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. 2016 05 20 2017 02 01 Smoking may modify the appetite, and consequently affect nutrient intake and serum micronutrients. The effect of smoking on vitamin B12 status has been considered in several studies. The research proposed that organic nitrites, nitro oxide, cyanides, and isocyanides of cigarette smoke interfere with vitamin B12 metabolism, and convert it to inactive forms. This research was carried out to determine the serum level of active and inactive forms of vitamin B12 in male smokers in comparison with male nonsmokers. This is a case-control study, in which the participants were 85 male smokers and 85 male nonsmokers. The serum levels of total and active form of vitamin B12 were measured. Dietary intake was recorded by a quantitative food frequency questionnaire and one-day 24-