1 2588-722X Hamadan University of Medical Sciences 337 Other Clinical Specialties Study of BIO (6-Bromoindirubin-3?-Oxim) Effect on Growth and Bone Differentiation of Rat Marrow-Derived Mesenchymal Stem Cells Eslaminejad Mohammadreza Salami Farimah Mehranjani Malek Soleimani Abnoosi Mohammad Hosein 1 3 2009 15 4 5 13 24 11 2015 24 11 2015 Introduction & Objective: According to some study, wnt signaling pathway is among those molecular pathways that involve in cellular proliferation and bone differentiation. On the other hand, investigations have indicated that 6-bromoindirubin-3´-oxim (BIO) is able to activate this pathway. In the present study, effect of BIO on in vitro proliferation and bone differentiation of mesenchymal stem cell (MSC) was considered. Materials & Methods: In this experimental study, rat marrow-derived MSCs was used. Initially, a range of BIO concentration was examined in terms of their effect on MSC viability using MTT assay. The concentrations with no toxic effect on cell viability including 0.01, 0.1, 1 and 1.5 µM were then selected and added into either MSC proliferation or bone differentiation culture medium. To determine the BIO effect on MSC proliferation, population doubling number (PDN) was calculated and to quantify the BIO effect on MSC bone differentiation, expression level of the bone specific genes and the amount of culture mineralization was measured. In these experiments, culture without BIO was considered as control. Results: PDN results indicated that the cell population at cultures with 0.1 and 1 µM BIO was doubled in number significantly more than the other cultures (P<0.05). Differentiation experiment indicated the negative effect of BIO on MSC bone differentiation. At all BIO-treated cultures, the expression level of osteocalcin and alkaline phosphatase genes as well as the amount of culture mineralization appeared to be significantly lower than those in control cultures (P<0.05). Conclusion: It seems that BIO enhances MSC proliferation in culture while inhibits the in vitro bone differentiation.
338 Other Clinical Specialties Expression of Two Survivin Variants in Different Developmental Stages of Mouse Ovaries Mazoochi Tahereh Salehnia Mojdeh Khamechian Tahereh 1 3 2009 15 4 14 20 24 11 2015 24 11 2015 Introduction & Objective: Survivin is one of the new characterized members of the inhibitor of apoptosis proteins that shows widespread expression in embryonic and tumoric tissues. The aim of this study was to evaluate the expression of Survivin variants in different stages of follicular development in mouse ovary. Materials & Methods: This experimental study was carried out on immature female mice (NMRI). Preantral, large preantral and antral follicles were mechanically isolated from ovaries from 12, 16 and 21-day old mice respectively. Total RNA from all above mentioned groups was extracted and cDNA synthesis was done using oligo dt primers and M-MuLV enzyme. PCR amplification of the cDNA samples was done using specific Survivin primers. The semi-quantitative expression of Survivin mRNA in cDNA samples were compared with that of β2m as an internal control, using post-hoc LSD test. Results: Data showed the expression of two Survivin variants (140, 40) in different stages of follicles. The maximum expression of Survivin140 was observed in the preantral follicles and decreased towards antral stage (P<0.05). The level of Survivin 40 did not change significantly in three stages of follicles. The third variant, Survivin 121 mRNA was not expressed in any of follicular stages examined here. Conclusion: Since the highest level of apoptosis is detected in antral follicles, the lowest levels of Survivin140 mRNA in this stage might be related to a possible role in follicular atresia. Further studies at protein level are needed to confirm this role for Survivin 140 in ovarian follicles. 339 Other Clinical Specialties Effect of Simvastatin on Renal Fibrosis after Unilateral Ureteral Obstruction in Rat Khayat Nouri Mir Hadi Gharamaleky Mehrdad Mousavi Ghafoor 1 3 2009 15 4 21 27 24 11 2015 24 11 2015 Introduction & Objective: Comparative reductase inhibitors, such as simvastatin increase HDL-cholestrol and decrease serum triglyceride and cholesterol. It is widely recognized that statins have organ protective nature and most effective for organ damage progressing. Obstructive uropathy can be used to indicate any obstruction to urinary flow which causes a developing of hydronephrosis, tubular atrophy and associated renal impairment. The aim of this study was evaluation of the simvastatin effect on renal fibrosis after unilateral ureteral obstruction in rat.Materials & Methods: In this experimental study, 50 adult male Sprague-Dawley rats were subjected to unilateral ureteral obstruction (UUO) and randomly divided into five groups (ten rats in each group) as follows: (1) control group (2) UUO (3) UUO/SIM (4) Sham-operated (5) Sham/SIM. Control animals received orally drug solvent by gavage for 15 days (started one day before operation). Unilateral ureteral obstruction was performed in groups 2 and 3 and sham operations were performed in groups 4 and 5. In group 2 animals received drug solvent and in group 3 animals received simvastatin (2 mg/kg/twice daily) for 15 days (started one day before operation). Rats were sacrificed either at day 14 for histopathological evaluation with H;E, masson-trichrome and PAS technique. Results: In this investigation histopathologic evaluation approved that in UUO group, renal interstitial fibrosis, tubular epithelial necrosis, hemorrhage, interstitial infiltration of mononuclear cells, tubular atrophy, glumerular tufts expanding, periglomerular sclerosis, subcapsular fibrosis, glomerulosclerosis and peritubular capillaries edema were observed. But in simvastatin treated animals this histopatologic lesions and fibrosis significantly (p<0.05) decreased. There was no difference between control and sham groups.Conclusion: In this investigation our results showed that ureteral obstruction increased renal fibrosis and caused sever deterioration in renal tissue but simvastatin administration improved renal fibrosis. It needs to be more investigation for approving of organ protective action of simvastatin in human renal disorders. 341 Other Clinical Specialties Comparison of Preemptive Intramuscular and Intravenous Ephedrine for Reduction of Spinal Anesthesia Induced Hypotension during Cesarean Section Manochehrian Nahid Nikoseresht Mahshid Seif Rabie Mohammad Ali 1 3 2009 15 4 28 33 25 11 2015 25 11 2015 Introduction & Objective: Spinal anesthesia offers many advantages for cesarean section delivery. But one of its disadvantages is higher incidence of hypotension. Comparison of preemptive intramuscular and intravenous ephedrine for reduction of spinal anesthesia induced hypotension during cesarean section was the aim of this study. Materials & Methods: This study was a randomized double blind clinical trial. 76 women candidate for elective cesarean section & A.S.A (class I,II) after obtaining an informed patients consent were randomly divided in four groups. Group IM50: 10 minutes before spinal anesthesia , 50 mg ephedrine IM and immediately after spinal anesthesia 2 ml N/S Iv were injected. Group IV20: 10 minutes before spinal anesthesia, 1ml N/S IM and immediately after spinal anesthesia 20 mg ephedrine IV were injected. Group IV10: 10 minutes before spinal anesthesia, 1ml N/S IM and immediately after spinal anesthesia 10 mg ephedrine IV were injected. Group P: 10 minutes before spinal anesthesia, 1ml N/S IM and immediately after spinal anesthesia 2 ml N/S IV were injected (Placebo). In all patients blood pressure and heart rate were measured by Reishter manometer and pulse oximetry device (oxypleth 520 A). after infusion of 500 ml ringer IV, spinal anesthesia was performed in sitting position , using needle number 25 gauge , at L3-L4 or L4-L5 level with 1.5 ml hyperbaric lidocaine 5%. Blood pressure and pulse rate were measured every minute for five minutes, also every 5 minutes and after 20 minutes every 10 minutes. Hypotension was defined as decreased blood pressure greather than 25% of baseline blood pressure or systolic blood pressure lower than 90 mmHg , which was treated with 10 mg IV ephedrine . Time and dose of therapeutic ephedrine was recorded. Results: By considering age and baseline blood pressure and heart rate, all patients were similar. Mean systolic blood pressure (SBP) and mean arterial blood pressure (MAP) in IV20 group were higher than placebo group (P<0.05). Incidence of hypotension and mean dose of rescue ephedrine were also significantly lower in IM50 and IV20 groups. Conclusion: Prophylactic ephedrine 20 mg IV or 50 mg IM, were effective in preventing hypotension during cesarean section under spinal anesthesia. 342 Other Clinical Specialties Comparison of Digital and Analogue Behind the Ear Hearing Aids Effectiveness in Treatment of Tinnitus in Elderly Patients of Otolaryngology Centers in Hamadan (2006-2007) Imami Faranak Farahani Farhad Behnood Fathollah Goodarzi Mohammad Taghi 1 3 2009 15 4 34 38 25 11 2015 25 11 2015 Introduction & Objective: Tinnitus is one of the most common otologic complaints. This study was designed for evaluation of different kinds of hearing aids effectiveness in treatment of tinnitus in elderly patients in Hamadan. Materials & Methods: In this clinical trial study 27 referral patients with complaint of tinnitus and hearing loss to otolaryngology clinics in Hamadan during 2006-7 were evaluated. All patients evaluated by PTA, SRT, SDS and Tinnitus matching tests. Persons with more than 40db SNHL and SDS above 60% were referred for hearing aid fitting. In each case behind the ear analogue type of hearing aid were fitted for 3-month course and then it was changed to the digital type for another 3 months. At the end of each course tinnitus evaluation were done and the effect of hearing aids on SDS were reevaluated. Subjective patient satisfaction and the degree of tinnitus diminution were evaluated by designed questionnaire. Results: From 27 cases17 were female and 10male and the mean of SDS and severity of hearing loss were 77.5% and 60db respectively. Moderately to severe hearing loss (35%) and downward sloping pattern (63%) were the most frequent types of hearing loss and audiogram patterns. Complete recovery of tinnitus were achieved in 55.6% of digital and 33.3% of analogue hearing aids users and the difference between them were significant(p=0.02). Digital and analogue hearing aids performance were satisfactory in 70.4% and 33.3% of the patients respectively and the difference between them were significant too (p< 0,001). Diminution of tinnitus intensity in digital group were more than analogue one (p=0.03) and improvement of SDS before and after fitting of digital hearing aid were better than analogue group) p<0.001). Conclusion: Digital hearing aids can improve communication abilities and subsiding tinnitus in elderly patients. 344 Other Clinical Specialties Correlation between Joint Erosion and Clinical and Laboratory Findings in Rheumatoid Arthritis Basiri Zahra Biranvand Mandana Nadi Ebrahim Gholyaf Mahmood Samet Mohammad 1 3 2009 15 4 39 43 25 11 2015 25 11 2015 Introduction & Objective: Rheumatoid Arthritis (RA) is a chronic progressive inflammatory disease of the articular joint that results in significant pain, stiffness and swelling and leads to destruction. The clinical findings and biomarkers application can allow clinicians to quality the effects of aggressive treatment during the first stage of the disease in order to prevent joint destruction and disability. The purpose of this study was to determine the correlation between joint erosion and clinical and laboratory findings. Materials & Methods: In this cross sectional study 266 patients with RA referred to Mobasher Kashani hospital in Hamadan were evaluated. The data of clinical and laboratory findings and X ray results were collected and analyzed by chi square test. Results: The study showed that the painful joint, number of painful joint and swelling joint had a significant correlation with erosion (P=0.05, P=0.057, P=0.013 respectively). The morning stiffness, fatigue and rheumatoid nodule had a significant correlation with joint erosion (P=0.001 , P=0.00 , P=0.04 respectively). However the number of joint swelling, elevated ESR, positive CRP and positive RF didn’t have significant correlation with joint erosion (P=0.18 , P=0.108 , P=0.66 , P=0.32 respectively). Conclusions: We conclude that for a better diagnosis of joint erosion both clinical and paraclinical findings should be considered. 345 Other Clinical Specialties Hostility, Type A Personality and Coronary Heart Disease Heidari Pahlavian Ahmad Gharakhani Mohsen Mahjub Hosein 1 3 2009 15 4 44 47 25 11 2015 25 11 2015 Introduction & Objective: In modern medicine, researches in behavioural sciences have described link between psychosocial characteristic, specific personality traits, and development of coronary artery disease. The aim of present study was to investigate the relationship between " hostility" and "type A" personality with acute myocardial infarction. Materials & Methods: In this case-control study 102 patients suffering from acute myocardial infarction and 162 no patents individuals after matching by age, gender, education level, marital status and occupation were studied and compared with regard psychological conditions by type A Najarian questionnaire and SCL – 90 – R. Results: Our study found evidence in support of the hypothesis that hostility may predict heart disease more than type A personality.Conclusion: Our study has some practical meaning for prediction and prevention of CHD. This finding suggests that mental health providers should continue to look at the effectiveness of providing psychological intervention for those individuals with high hostility levels. 347 Other Clinical Specialties Evaluation of Hearing Status in Children with Meningitis in Hospitals of Hamadan during 1996-2006 Behnoud Fathollah Farahani Farhad Goodarzi Mohammad Taghi 1 3 2009 15 4 48 52 26 11 2015 26 11 2015 Introduction & Objective: Meningogenic hearing loss remains the most common cause of acquired postnatal childhood sensorineural hearing loss. Hearing loss occurs in 6-37% after meningitis. The object of this study was evaluation of frequency of post meningitic hearing loss in the patients who hospitalized in the hospitals of Hamadan during 1996-2006. Also we attended to conclude that routine screening of these patients and detection the cases that need to early treatment was advocated. Materials & Methods: This cross-sectional descriptive study was conducted on 65 children. All of them with diagnosis of bacterial meningitis were hospitalized during 1996-2006. They were tested by P.T.A. and then data were analyzed with spss/10th version. Results: Prevalence of hearing loss in meningitic patients was 53.8% that did not show meaningful statistical difference in aspect of age & sex. Hearing loss in all of the cases were sensorineural, that 82.8% were bilateral and 17.2% were unilateral. About 76.1% of hearing loss cases were in frequencies of 4000, 6000, 8000 HZ and 74.6% of hearing loss cases had hearing threshold between 20-50 db. Conclusion: Analysis of our data showed that meningitis lead to bilateral sensorineural hearing loss, often with hearing threshold about 20-50 db and in high frequencies. Routine screening of postmeningitic children for sensorineural hearing loss is advocated 348 Other Clinical Specialties Early Diagnosis and Treatment of Penetrating Cardiac Trauma Through Minithoracotomy : Report of 4 Cases Eskandarlou Mahdi Moieni Abbas 1 3 2009 15 4 53 57 26 11 2015 26 11 2015 Introduction: Nowadays penetrating cardiac trauma has increased and is one of the important causes of mortality in patients with sharp chest trauma. Frequently death occurs in prehospital era. Routine approach for diagnosis of those patients who are referred alive to the hospital are clinical and paraclinical findings so due to take a long time, they can be life threatening. With early diagnosis and treatment, improvement up to 70 – 80% is predicted. Case Report: In this report 4 patients with stab wound to the chest and heart are presented that were referred to Mobasher hospital in 2005 and 2006. There seen several non specific signs and symptoms suggestive to cardiac injury in two and clinical presentation were infavor to cardiac injury in another ones. With careful clinical examination specially about anatomical location of the chest penetrating trauma and evaluation of tract of sharp object in the chest wall and proximity to the heart, early surgical exploration through minithoracotomy was done and they treated after diagnosis of cardiac rupture. Conclusion: It seems in patients with penetrating chest trauma, if finger examination of tract of the wound revealed direct penetration to the pleural cavity and had proximity to the heart, there is no need further work up and in clinically unstable patient, exploratory anterior minithracotomy through intercostal space 4th or 5th and in stable patient , thoracoscopy or minithoracotomy is recommended. 349 Other Clinical Specialties A Case Report of Closed Injury of Flexor Digitorum Profundus and Superficialis Tendons of Ring Finger Shariatzadeh Hooman Jafari Davood Taheri Hamid Najd Mazhar Farid Pahlevan Sabagh Alireza 1 3 2009 15 4 58 60 26 11 2015 26 11 2015 Introduction: The usual causes of flexor tendon injuries in hand are penetrating wounds. Closed injury and avulsion of flexor tendon are rare and mostly occur as avulsion of flexor digitorum profundus tendon of ring finger from its bony insertion at distal phalanx. Closed avulsion of flexor digitorum superficialis is even rarer. The rarest is closed and simultaneous avulsion of both flexors in the same finger and only about ten cases are reported in the literature. Case Report: Patient was a healthy 27-year-old right handed male shopkeeper. He fell down during his work ten days before referring to the hospital. After this event he was unable to flex his left fourth finger through interphalangeal joints. There was no injury to the skin of his hand. With the impression of closed rupture of both flexors of ring finger he underwent operation and repair of the flexor profundus tendon. Conclusion: Closed injury of both flexor tendons should be considered in differential diagnosis in similar situations even though they are rare.