Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 6 2018 06 23 355 359 EN Ali Dehghani Fard Department of Hematology, School of Medicine, Tarbiat Modares University, Tehran, Iran. Saeid Kaviani Department of Hematology, School of Medicine, Tarbiat Modares University, Tehran, Iran. Mehrdad Noruzinia Department of Genetics, School of Medicine, Tarbiat Modares University, Tehran, Iran. Masoud Soleimani Department of Hematology, School of Medicine, Tarbiat Modares University, Tehran, Iran. Abbas Hajifathali Department of Hematology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2016 06 21 2016 07 17 Multiple myeloma (MM) is clonal B-cell malignancy characterized by the progressive proliferation of malignant plasma cells and accumulation of monoclonal immunoglobulin (M-spike) in blood and urine. Pomalidomide is an immunomodulatory agent which has potentially suppressed myeloma cell progression, especially in drug-resistant cases. As epigenetic modifications have an important role in gene regulation and because of the revealing role of DNA-Methyltransferase 1 (DNMT1) overexpression in myeloma pathogenesis, in this study DNMT1, 3a and 3b genes expression of U266 myeloma cell line treated with pomalidomide have been evaluated. In this study after treatment of U266 cells with 1 μM pomalidomide for 48 hours, total RNA extraction and cDNA synthesis was performed. Gene expression of DNMT1, 3a and 3b has been evaluated using real time PCR technique. The result of this study show that pomalidomide can downregulate the expression of DNMT1, 3a, and 3b in 48 hours of treatment as 0.049, 0.058 and 0.055, respectively as comparing with untreated control (P<0.05). Based on these results we conclude that pomalidomide has desired effect on epigenetic modification by downregulation of DNMTs genes expression and has been considered as an effective drug for inhibition of myeloma proliferation. https://acta.tums.ac.ir/index.php/acta/article/view/5726 https://acta.tums.ac.ir/index.php/acta/article/download/5726/5103

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 6 2018 06 23 419 420 EN Man Amanat NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. AND Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mona Salehi NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. AND 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. 2017 10 13 2017 12 19 No Abstract https://acta.tums.ac.ir/index.php/acta/article/view/6772 https://acta.tums.ac.ir/index.php/acta/article/download/6772/5121

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 6 2018 06 23 405 409 EN Mansour Moghimi Department of Pathology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mahmood Kazeminasab Student Research Committee, Shahid Sadoughi Univerity of Medical Scineces, Yazd, Iran. Mohammad Reza Vahidi Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mojtaba Meybodian Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mojtaba Babaei Zarch School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mostafa Babai Resident of Radiology, School of Medicine, Ahvaz Jundishapour Univerity of Medical Scineces, Ahvaz, Iran. 2016 11 03 2017 05 05 Laryngeal chondrosarcoma is a rare tumor that involves head and neck region such as larynx in rare cases. This malignant tumor usually grows quite slowly. The patient may experience symptoms for several years before a diagnosis is made. The diagnosis is achieved by clinical, radiological and pathological features. Management is basically surgical. Prognosis is generally good, depending basically on histologic grade. Herein, we report a case of laryngeal chondrosarcoma presented with hoarseness. Spiral CT scan demonstrated an expansile mass with calcification originating from cricoid cartilage. The patient underwent surgery for open excisional biopsy, and postoperative histopathologic evaluations confirmed "laryngeal chondrosarcoma" as definite diagnosis. The patient denied total laryngectomy for complete removal of the tumor. Six months follow up showed no more growth. https://acta.tums.ac.ir/index.php/acta/article/view/5989 https://acta.tums.ac.ir/index.php/acta/article/download/5989/5113

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 6 2018 06 23 410 414 EN Mohammadreza Maghsoudi Department of Emergency, Tehran University of Medical Sciences, Tehran, Iran. Behzad Babapour Department of Internal Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran. Bita Shahbazzadegan Department of Social Determinants, Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran. Saghi Maghsoudi Department of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2017 03 13 2017 04 17 Cerebral venous thrombosis is an uncommon disorder in children however it can be associated with serious clinical consequences. As it is a rare condition without any specific clinical presentation, it is usually undiagnosed. Clinical manifestation of cerebral thrombosis in children is relatively different from adult because of age-related differences in the vascular and neurologic systems. We present a case of a twenty days boy with a history of one-week lethargy and poor feeding and grand mal seizure. He had hypernatremia and severe dehydration. Non-contrast CT scan of the brain revealed superior sagittal and both transverse and sigmoid sinus thrombosis. The patient was treated in neonatal ICU with a favorable clinical response. We also present a fourteen days girl who presented with three days of fever, poor feeding, tachycardia, respiratory distress, and grand mal seizure. She had hypernatremia and severe dehydration. Non-contrast CT scan of the brain revealed superior sagittal sinus thrombosis and right temporal lobe infarction. She was also treated in neonatal ICU with noticeable improvement in symptoms. These cases demonstrate the importance of dehydration in neonatal and clinical suspicion of cerebral venous thrombosis (CVT). We present these two cases to enhance the awareness of clinical practitioners. CVT is an unusual and serious condition in neonates and due to its nonspecific clinical presentation often remains unrecognized. Early neuroimaging, including transfontanel doppler ultra-sonography, and non-contrast CT scan in all neonates with neonatal seizures will improve detection. https://acta.tums.ac.ir/index.php/acta/article/view/6300 https://acta.tums.ac.ir/index.php/acta/article/download/6300/5115

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 6 2018 06 23 360 365 EN Farnaz Malekmarzban Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Toxicology and Pharmacology, Poisoning Research Center, Tehran University of Medical Sciences, Tehran, Iran. Vahideh Montazeri Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Toxicology and Pharmacology, Poisoning Research Center, Tehran University of Medical Sciences, Tehran, Iran. Maryam Majdzadeh Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Toxicology and Pharmacology, Poisoning Research Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Nasser Ostad Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Toxicology and Pharmacology, Poisoning Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2017 07 23 2017 12 23 It is established that cancer stem cells (CSCs) have potential in tumor formation, progression, and metastasis in different types of solid tumors. Additionally, recent studies have demonstrated that Genistein consumption is correlated with lowered cancer rate and metastasis decrease. In this study, we premised that Genistein could be an influential agent targeting breast cancer stem cell-like cells. In this survey, CD44+/CD24-cells (cancer stem cell-like cells) were isolated from MDA-MB-231 cells by magnet-activated cell sorting (MACS). The effect of various concentrations of Genistein on the cell proliferation and viability in MDA-MB-231 CD44+/CD24-cells tested in comparison to their parental cells utilizing MTT assay, invasion assay. The results of this study show that Genistein could inhibit invasion in MDA-MB-231 cells. Also, we observed that Genistein could be efficient for invasion inhibition in CD44+/CD24-cells. Considering the finding that Genistein could have desired effects on MDA-MB-231 as well as CD44+/CD24-cells, we demonstrated that Genistein could be an influential agent for treating malignant and invasive breast tumors. https://acta.tums.ac.ir/index.php/acta/article/view/6610 https://acta.tums.ac.ir/index.php/acta/article/download/6610/5122

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 6 2018 06 23 415 418 EN Aritz Gil-Ongay Department of Cardiology, University Hospital Marqués de Valdecilla, Santander, Spain. María Elena Arnáiz-García Department of Cardiovascular Surgery, University Hospital of Salamanca, Salamanca, Spain. Cristina Blanco-Castillo Department of Cardiovascular Surgery, University Hospital Marqués de Valdecilla, Santander, Spain. Ivana Pulitani Department of Cardiovascular Surgery, University Hospital Marqués de Valdecilla, Santander, Spain. José María González-Santos Department of Cardiovascular Surgery, University Hospital of Salamanca, Salamanca, Spain. Ana María Arnáiz-García Department of Internal Medicine and Infectious Diseases, University Hospital Marqués de Valdecilla, Santander, Spain. 2017 01 11 2017 04 18 We present the case of how a massive proximal deep vein thrombosis result of an unknown recurrence of a previously colonic malignancy treated, classically known Trousseau´s Syndrome, can mimic symptoms of severe peripheral arterial disease in a patient affected of peripheral chronic arterial disease surgically treated. Trousseau´s Syndrome is commonly associated with serious and chronic diseases and a variety of paraneoplastic thromboembolic disorders. Thrombotic episodes may precede the diagnosis of cancer and be the potential marker for an unknown and occult malignancy. We highlight the key points of the Trousseau´Syndrome and those paraneoplastic vasculopathies related that can mimic a vascular disease or complication. https://acta.tums.ac.ir/index.php/acta/article/view/6133 https://acta.tums.ac.ir/index.php/acta/article/download/6133/5117

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 6 2018 06 23 366 371 EN Anahita Nosrati Department of Pathology, Gastrointestinal Cancer Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran. Zhila Torabizadeh Department of Pathology, Gut and Liver Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran. Mahboobeh Majlesi Department of Pathology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran. 2017 08 02 2017 12 18  Breast cancer is the most frequent malignancy among women worldwide including Iranian women. The different markers have already been investigated for predicting invasion and metastases which one of the most tempting ones is Chemokines. In fact, one of the well-known mediators in the breast cancer metastases is stromal cell-derived factor-1 (SDF-1) CXCR4 chemokine. The CXCR4 chemokine receptor is a G-protein-coupled receptor that selectively binds to SFD-1 (also known as CXCL12). It is obvious that this chemokine receptor plays a critical role in some biologic processes. Nevertheless, there is not enough study to confirm the CXCR4 clinical importance and also its exact prognostic worth in the breast cancer. We carried out this diagnostic study. Immunohistochemically on 70 paraffin blocks of invasive ductal breast carcinoma and adjacent normal tissue simultaneously to assess the expression of CXCR4. The correlation between the presence and intensity of expression of this marker with various clinicopathological factors including age, tumor size, lymph node involvement, stage, and grade are evaluated in all patients. Among the 70 cases, 64 cancer specimens (91.4%) showed CXCR4 expression. It is found out that there is a significant difference between the expression of CXCR4 and the histological grade and lymph node metastasis (P<0.001), but no correlation with other clinicopathologic parameters, such as age, tumor size, and the stage is identified. By considering the CXCR4 intensity, we came across a significant difference between the high expression and the size, stage, histological grade and lymph node metastasis (P<0.001). Breast cancer is the most common i Imam Hospital, affiliated with Tehran University of Medical Sciences; a total of 195 female patients with breast cancer met the inclusion criteria. All of the patients had a complete blood count with leukocyte differential performed before chemotherapy. Medical records including pathology reports were also available. Data for all patients were collected prior to any surgical intervention. Exclusion criteria included clinical evidence of active infection, presence of hematological disorders, acute as well as chronic inflammatory or autoimmune diseases, or prior steroid therapy. Higher platelet count was significantly associated with the higher stage. The stage was not associated with the hemoglobin level. There was no association between the tumor size and age of patients with NLR. There was a significant relationship between NLR and IDC. There was a significant relationship between IDC and NLRs of less than 8.1 and greater than 3.3. There was a significant relationship between NLR and vascular invasion. There was no association between NLR and estrogen receptor and HER2. There was no significant relationship between the PLR and the cancer stage. In this study, NLR showed a significant relation with the disease staging. As the NLR increases the stage increases as well. Therefore, this ratio may be helpful in the preoperative evaluation of patients with breast cancer. https://acta.tums.ac.ir/index.php/acta/article/view/5704 https://acta.tums.ac.ir/index.php/acta/article/download/5704/4921

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 268 271 EN Bahram Mofid Department of Clinical Oncology, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zeinab Shankayi Department of Medical Physics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Kambiz Novin Department of Clinical Oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sadegh Dehghani Department of Medical Physics, Tehran University of Medical Sciences, Tehran, Iran. Morteza Shankayi Department of Mechanic, School of Engineering, Tarbiat Modares University, Tehran, Iran. Hamidreza Haghighatkhah Department of Radiology, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. S. Mohammad Firoozabadi Department of Medical Physics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. 2015 10 04 2016 09 05 Electrochemotherapy (ECT) is a new local treatment method for solid and superficial tumors. During this new technique, patients experience an unpleasant sensation and slight edema. Most unpleasant and painful is mainly attributed to muscle contractions provoked by high amplitude and low repetition frequency pulses. Recently, we showed that electrochemotherapy using low voltage and higher repetition frequency (LVHF ECT) is an effective tool for inhibiting tumor growth and inducing cell permeabilization. Low voltage high-frequency electrochemotherapy was developed and optimized in vitro and in vivo which and can be used in the clinic. In the present study, we report a case of cervical lymph node metastasis of breast cancer treated by the technique. In our case, LVHF ECT was successful in reducing the size and palliating the symptoms of cervical lymph node metastasis in clinical conditions, whereas other approaches were inefficient. Our electrochemotherapy technique shows good clinical results. However, more studies on this new method are necessary to prove that LVHF ECT can be considered as a standard treatment modality. https://acta.tums.ac.ir/index.php/acta/article/view/4259 https://acta.tums.ac.ir/index.php/acta/article/download/4259/4932

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 233 240 EN Mehrnaz Rasooli-Nejad Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Maryam Khazaee-Pool Department of Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran. Ladan Abbasian Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Zahra Bayat Jozani Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Sara Ahsani-Nasab Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Banafsheh Moradmand Badie Discipline of Public Health, School of Medicine, Flinders University, Flinders, South Australia. Afsaneh Pargar Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Esmaeeli Djavid Academic Member of Academic Center for Education, Culture and Research, Tehran, Iran. 2015 10 25 2016 03 04 There are limited documents about HIV patients switched to second-line antiretroviral therapy (ART) in resource-limited countries. We aimed to assess the efficacy of second-line ART for HIV patients following first-line ART failure. This was a cohort study of HIV/AIDS patients with first-line ART treatment failure switched to second-line ART between January 2004 and March 2014, who followed for at least 12 months after switching. Fifty of studied patients (85%) were treated with regimens containing lopinavir/ritonavir (Kaletra) and nine of them (15%) treated with other regimes. Seven patients were experienced opportunistic infections in accordance with stage III and IV WHO classification. In this way, 11.8% of patients had aclinicalfailure, and 37 of them (62%) had immunological responses. Weight gain was evident in these patients, and there was a significant correlation between theincrease in CD4 and weight gain (P=0.007). Only 13 patients achieved HIV viral load testing that 6 of them had avirological response after 12 months on second-line ART. No significant associations were found between virological or immunological response and gender, age, and lopinavir/ritonavir regimens (P>0.05).With counselling and supporting in those failing first-line ART, inessential switching to more costly second-line ART can be prevented in the majority of patients. However, patients' need to second-line ART drugs has increased, for which national ART programmes and regular follow-up should be organized. The high cost of these drugs and limited access to viral load testing are main barriers to proper management of patients switched to second-line ART regimens. https://acta.tums.ac.ir/index.php/acta/article/view/5060 https://acta.tums.ac.ir/index.php/acta/article/download/5060/4922

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 272 276 EN Anju Bansal Department of Pathology, National Institute of Pathology (ICMR), Safdarjang Hospital Campus, New Delhi, India. Manveen Kaur Department of Pathology, National Institute of Pathology (ICMR), Safdarjang Hospital Campus, New Delhi, India. Varsha Dalal Department of Pathology, National Institute of Pathology (ICMR), Safdarjang Hospital Campus, New Delhi, India. 2015 10 13 2016 05 01 Sarcomas account for less than 1% of all primary breast malignancies, pleomorphic sarcoma of the breast being even rarer. We present two cases of pleomorphic sarcoma of the breast in a 35-year-old and a 43-year-old female. An extensive review of the available literature with evaluation of the etiology, changing terminologies and histopathologic features of pleomorphic sarcoma of the breast are discussed. The prognostic factors and treatment modalities have also been reviewed. https://acta.tums.ac.ir/index.php/acta/article/view/4970 https://acta.tums.ac.ir/index.php/acta/article/download/4970/4929

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 241 248 EN Fatemeh Pouya Department of Anatomy, Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran. AND Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran. Seyed Hassan Eftekhar-Vaghefi Department of Anatomy, Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran. Parvin Salehinejad Department of Anatomy, Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran. AND Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran. 2016 02 09 2017 01 30 The human body dimensions are affected by ecological, biological, geographical, racial, sex, and age factors. Craniofacial measurements can be considered to be one of the important tools for determination of the morphological characteristics of the head and face. In this study, which was conducted on Persian adolescents living in Kerman/Iran, different forms of head and face were determined for using in various aspects of medicine. The study was conducted on 732 participants including 366 males and 366 females in the age of 18-20-year-old. In addition to the height and weight of the participants, cephalofacial sizes of them were measured and then cephalic, facial, and brain indices were calculated. Among the cephalofacial sizes, cranial length and breadth, cranial circumference, prosopic length and prosopic breadth were significantly greater in males compared to females (P<0.005). Also, volume and weight of brain were significantly greater in male comparing to female participants (P<0.005). The predominant type of head was meso-cephal, and the predominant type of face was meso-prosopic in both sexes.  https://acta.tums.ac.ir/index.php/acta/article/view/5421 https://acta.tums.ac.ir/index.php/acta/article/download/5421/4923

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 277 279 EN Mohammad Ali Mohagheghi Department of Surgical Oncology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Ramesh Omranipur Department of Surgical Oncology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Fereshteh Ensani Department of Pathology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Alireza Ghannadan Department of Pathology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Shahriar Shahriaran Department of Radiology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Farhad Samiee Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Sedighi Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 12 2016 07 02 We present here a 32-year-old male with advanced lately diagnosed, right sided retroperitoneal mass, which had been already treated due to progressive muco-cutaneous lesions clinically consistent with psoriasis, during recent four years. The advanced retroperitoneal mass resected surgically and reported as hyaline-vascular castleman disease with a dense focus of coarse calcification, on histopathology. Association of psoriasis and castlman disease is discussed in this case report.  https://acta.tums.ac.ir/index.php/acta/article/view/4951 https://acta.tums.ac.ir/index.php/acta/article/download/4951/4930

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 249 253 EN Gholamreza Pourmand Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Shahram Gooran Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Reza Hossieni Department of Urology, Sina Hospital, Urology Research Center, Tehran University o