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Introduction: Basal cell carcinoma is the most common malignancy in humans. A number of treatment modalities are available. We performed this study in order to determine the efficacy of Mohs micrographic surgery in treatment of basal cell carcinoma.
Materials and Methods: This retrospective descriptive study was performed on 194 basal cell carcinoma (in 175 patients) were treated in Isfahan Al-Zahra Hospital from september 1999 to March 2003 with Mohs micrographic surgery. Data were obtained from patient's files and were analized by SPSS software.
Results: Of the 175 patients (with 194 basal cell carcinomas), 110 (62.85%) paticnls were male and 65 patients (37.14%) were females. The mean age of patients was 58±12.38 years. The majority of tumors were located on face and scalp. 180 of tumors were primary and 14 were recurrences. 17% of tumors were larger than 2cm. Recurrences of the tumor occured in 3 patients. The cosmetic results were excellent and good in 81%. The incidence of recurrnce rate was 0.9%.
Conclusion: Kecurrence rate is low when basal cell carcinomas treated with micrographic surgery so this treatment modality (when indicated) is also strongly recommended in Iran for the treatment of basal cell carcinoma.

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Introduction: Previous studies indicated that children, who acquired conversation concept, produce adjectives better than other mental retarded.
Other studies showed that Down syndrome children have lower linguistic abilities than other mental retarded children. The main goal of this research was to study the effects of Down syndrome on production of semantic skills.
Materials and' Methods: This analytic cross-sectional study was conducted on girls who studied in exceptional primary schools of Semnan city.
Samples were chosen systenlaticaly. At first, 38 Down syndrome girls, who were monolingual and with no sign of sensory and motor deficits, were selected.
Then, 37 mental retarded girls (non-Down syndrome), that mental retardation had no specific ethiology, were matched on date of birth, educational level, failuer in previous classes, parent's job and education. These 75 pupils participated in operative tests and those who were able to comprehend the concept of conversation were examined by Raven Colourd Progressive Matrices. At final stage, 30 educable girls were participated in production test.
Results: Our findings showed that:
1. The production of nominal and superlative adjectives were equivalent between two groups, but Down syndromes had lower ability in production of comparatives;
2. The simplisity of adjectives were as fallow: nominal> comparative> superlative, and big-small> tall-short> thick-thief> wide-narrow.
3. There were few samples able to produce superlatives.
Conclusion: This investigation revealed that girls suffering from Down syndrome have lower ability on production of semantic skills.

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Introduction: In diabetes mellitus the increase of AgII (Angiotensin II), IGF-1(insulin like growth factor-1) and growth hormone induce kidney lesions especially changes in content and thickness of GBM and widening and fusion of podocyte pedicles. In this research for the first time the combination of Losartan (AT1 receptor blocker) and Octreotide (Somatostatin analogue) were used in order to prevent glomerular epithelial lesions.
Materials & Methods: In this experimental study 15 male rats (2 months age) were uninephrectomised from left flank and divided in 5 groups (3 per group). 7 days later diabetes was induced in 2th, 3th, 4th and 5th group by Alloxan (120mg/kg) subcutaneously. 5 days after diabetes induction, the third group received Losartan (5mg/kg/day) orally, 4th group Octretide (10 ŭg/day) subcutaneously and 5th group both two drugs with the mentioned doses for 8 weeks. The 2th group was served as diabetic non treatment group. Kidneys of all groups were fixed by perfusion technique. After second fixation of 1 mm3 cortex parts in Osmium Tetroxide, they were processed in TAAB812 resin for embedding. Thin sections (600 nm thickness) were prepared and investigated by transmission electron microscope qualitatively.
Results: Losartan inhibited fusion and thickening of podocyte pedicles but in some cases couldn,t maintain the 3 layer form of GBM. Octreotide had little effect on inhibition of fusion and thickening of podocyte pedicles and no effect in 3 layer form maintaining of GBM. Combined therapy inhibited fusion and thickening of podocyte pedicles and maintained 3 layer form of GBM but in some cases the lamina rara near endothelium was not seen.
Conclusion: Octreotide have little effect on prevention of glomerular epithelium lesions. However Losartan could prevent glomerular epithelium lesions well, but combined drug therapy showed better results comparing Losartan.

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Introduction: It is well recognized that hearing is critical to speech and language development, communication, and learning. Otoacoustic emission (OAE) is an efficient and sensitive method to identify subjects at risk for auditory impairment. Infants who require admission to neonatal intensive care unit are reported to be at 10-20 times greater risk for hearing impairment. The porpuse of this study was to investigate the incidence of hearing impairment in neonates screened by OAE. Materials and Methods: In a cross-sectional study, 148 newborns having risk factors for hearing impairment reffering to Taleghani hospital of Arak and Aboozar hospital of Ahwaz were evaluated. All clients had normal otoscopic findings. Transient evoked (TEOAE) and distortion-product otoacoustic emissions (DPOAEs) were measured in both ears. If the results of otoacoustic emissions were not normal, these tests were repeated one month later. Patients who did not pass the second stage were reffered for comprehensive auditory evaluations. Data analysis was performed using Kolmogrov-Smirnov and t-tests. Results: 41 and 28 cases could not pass the examining test at the first TEOAE and DPOAE examination, respectively. Also, 23 and 16 cases did not pass the examining test at the second TEOAE and DPOAE evaluations, respectively. These participants underwent auditory brainstem response evaluation and 11 of them had abnormal responses. In 5 cases of confirmed ones, hearing impairment was due to aminoglycoside side effects. Conclusion: OAE hearing screening of at-risk newborns is a clinically beneficial approach to early detection of hearing impairment. Regarding the high prevalence of hearing loss in our subjects (7.43%), prevention of its complications is highly recommended in this population.

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Introduction: Allium Sativum (garlic) is used widely in the world, especially in Iran. This plant is used in cooking foods as an odorant. In Iran it is believed that it is useful for gastrointestinal disorders. So in this study the effect of Allium Sativum extract on acid and pepsin secretion in rat is investigated. Materials and Methods: This experimental study is performed on two groups of rats (12 in each group: control group and allium sativum group). After anesthesia with nesdonal (50 mg/kg, ip), rats had gone under surgical tracheotomy, laparatomy and gasterodeodenostomy. In garlic group Allium Sativum extract (100mg/kg) was introduced into the stomach by gasterodeodenostomy canula. In order to stimulation of acid and pepsin secretion, Pentagastrin was used (25mcg/kg, ip). Stomach secretion was washed out and acid was measured using titerimetery and pepsin using Anson method. Data was analyzed using t-test. Results: Allium Sativum caused a meaningful increase in acid and pepsin secretion in garlic group comparing to control group (p<0.001). Pentagastrin also increased acid and pepsin secretion in control group (p<0.001). Conclusion: Using garlic in nutritional regimen causes an increase in acid and pepsin secretion in those using this plant.

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Introduction: Cecal volvulus is an emergency surgical acute abdomen. In this condition cecum, ileum terminal and ascending colon becomes twisted on its mesenteric anticlock wise direction rotation ranging 180-360 degrees. The cecal volvulus is caused by a lack of fixation of cecum to retroperitoneum. The usual presentation consists of severe colicky abdominal pain with asymmetric abdominal distension. In this article two cases of cecal volvulus are presented. Cases: The first case was a 74 year old female which presented with sudden abdominal pain & asymmetrical severe distension following 3 days constipation. After Plain abdominal x-ray and abdominal CT scan, right hemicolectomy was performed. The second case was a 70 year old female who following 4 days constipation was presented with abdominal pain and distension. Supine and erect abdominal x-ray showed colon hyperaeration and multiple air-fluid levels. The gangrenous colon was resected and colostomy was done. Conclusion: Despite other causes of intestinal obstruction or sigmoid volvulus which can sometimes be treated medically, the treatment of cecal volvolus is always surgery and consisted of cecum and ascending colon resection.

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Background: Leukemia is a malignant and progressive disease. Over-expression of inhibitors of apoptosis proteins (IAPs), such as survivin and its anti-apoptotic variants, including sur-ΔEx3, is the main cause of resistance to apoptotic effects of chemotherapy drugs. In the present study, the effects of CBX on apoptosis and expression level of survivin and sur-ΔEx3 and K562 cells (experimental model of chronic myeloid leukemia) were investigated. Materials and Methods: In this experimental study, human K562 cells were cultured and exposed to CBX. Trypan blue exclusion test was used to evaluate growth inhibitory and viability effects of the drug. Fluorescent microscopy (acridine orange/ ethidium bromide double staining) and DNA electrophoresis were applied to the study of apoptosis. The expression level of survivin and sur-ΔEx3 was studied by semiquantative RT- PCR. Results: The results showed that after the 48 h treatment of K562 cells with 150 µM CBX, significant growth inhibitory and apoptotic effects (up to 50%) were induced. In addition, after 2-4 h of treatment with CBX (150 µM), down-regulation of survivin and sur-∆Ex3 were observed. However, the expression level of survivin and sur-ΔEx3 increased to the level of control cells with longer treatment times (6-12 h). Conclusion: Noticing the apoptotic and down-regulatory effects of CBX on survivin and sur-∆Ex3 expression, this drug can be used as a potential candidate for further studies on CML treatment, especially for inhibition of drug resistance in leukemia cells.

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Background: To date, several drugs have been proposed for the treatment of acute promyelocytic leukemia (APL) however, none of them has resulted in complete remission. Therefore, many efforts are in progress to find new drugs with the capability of inducing apoptosis. Recently, anti-carcinogenic effects have been reported for a drug named carbenoxolone (CBX) on several cell lines. In the present study, the effects of CBX on NB4 cell line, as an experimental model of APL, were examined. Materials and Methods: In this trial, NB4 cell line was cultured and treated with different concentrations of CBX (50-250µM) in various time intervals (12-48 hours). Trypan blue exclusion test was used to evaluate growth inhibitory and viability effects of the drug on NB4 cell line. Fluorescent microscopy (acridine orange/ethidium bromide double-staining) and agarose gel electrophoresis DNA were used to study apoptosis. Results: CBX induced growth inhibition of NB4 cells so that growth inhibition rates of NB4 cells, after the 48 hour of treatment with 50, 100, 150, 200, and 250 µM CBX were 32.65, 47.52, 60.73, 68.91, and 74.33%, respectively. Furthermore, the results of DNA fragmentation and fluorescent microscopy assays indicated that apoptosis is a major mode of cell death after treatment of NB4 cells with above concentrations of CBX. Conclusion: Noticing the growth inhibitory and apoptotic effects of CBX on human promyelocytic leukemia NB4 cells, it can be considered as a potential candidate for further studies on APL treatment.

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Background: Nucleostemin plays a critical role in controlling proliferation and self-renewal of stem cells and cancer cells. Thus, inhibition of nucleostemin expression could be a potent therapeutic approach in cancer treatment. In the present study, the effects of nucleostemin gene silencing in K562 cell line were studied. Materials and Methods: In this experimental study, after transfecting NS-specific siRNA into K562 cells, changes in nucleostemin gene expression pattern were determined by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Trypan blue exclusion test, MTT assay, and fluorescent microscopy were used to evaluate the growth inhibition and apoptosis of K562 cells, respectively. Flow-cytometery was utilized for evaluating the effects of nucleostemin gene silencing on cell cycle. Results: The results showed the high expression of nucleostemin gene in K562 cells. NS-siRNA transfection into K562 cells at 200 nM inhibited the nucleostemin mRNA level up to 55% after 48 hours when compared to corresponding control cells. Forty eight hours after transfection, the cell growth decreased up to 33.7%. In addition, the silencing of nucleostemin induced G1 cell cycle arrest. Furthermore, fluorescent microscopy assays indicated that apoptosis occurred 48 hours after silencing nucleostemin gene expression. Conclusion: Noticing the potent growth inhibitory and apoptotic effects of nucleostemin siRNA in human myeloid leukemia K562 cells, silencing this gene can be a potential target for inhibiting K562 cells as the stem cell model of chronic myeloid leukemia.

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Background: Since researchers were able to produce dendritic cells (DCs) from peripheral blood monocytes, many scientists have been in search of discovering the best way of producing dendritic cells and optimizing the DCs maturation processes in vitro to treat some diseases. The aim of this study was to investigate the maturation of DCs for tumor immunotherapy. Materials and Methods: In this experimental study, DCs were produced in two stages. In the first stage, monocyte cells were converted to immature DCs by GM-CSF and IL-4. In the second stage, immature DCs were made mature in the presence of human umbilical vein endothelial cells and PHA -activated T lymphocytes conditioned media and maturation factors. Results: The produced DCs with appropriate phenotype, phagocytosis ability, and proliferation of T lymphocytes stimulation traits could secrete high levels of cytokines. Conclusion: Endothelial cells and T lymphocytes conditioned media can produce Th1 and DC1 in vitro. Therefore, DCs produced through this method are suitable for immunotherapy treatment applications and cancer treatment through treatment cells.

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Background: There are various factors effective in the appearance of metastasis that have been surveyed and recognized in different studies. However, the appearance of metastasis by determination of these factors cannot be predicted. One of the models used for the analysis of recurrent data and consideration of heterogeneity between patients is frailty model. Materials and Methods: In this survival study, 133 women with breast cancer were treated in Fayazbakhsh Hospital, Tehran, during 2005-2007. All patients were followed until April 2011. Frailty model was employed for the analysis of data and gamma frailty distribution was assumed with the average one and Ө variance. All statistical methods were run in R software. Results: Disease-free survival rates for 3 and 5 years were 0.78 and 0.72, respectively. During the follow-up period, the risk of metastasis was estimated to be 43%. Two factors were identified as the prognostic factors in the appearance of metastasis: tumor malignancy grade and the number of positive lymph nodes. Frailty variance was 4.27 (P=0.001). Conclusion: The significant variance of frailty component in the model indicates that patients who have identical explanatory variables face different levels of risk experiencing metastasis. Also, specific characteristics of the patients are important in the incidence of metastasis.

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Background: In recent years, changes in the composition of Iranian population into aged population have increased the need for more information about the quality of life (QOL) of this group. Proper planning for this age group for increasing their quality of life depends on the identification of factors associated with QOL. The aim of the current study was to assess the quality of life and its relationship with the quality of diet in elderly people aged 60 years and more living in the urban areas of Markazi province. Materials and Methods: This cross-sectional study was carried out on 165 elderly people in the urban areas of Markazi Province in 2010. Data obtained via general and QOL (SF-36) questionnaires and three 24-hour recalls on food. The quality of diet was measured using Healthy Eating index. Results: The means of total SF-36, physical and mental components scores were 55.66, 51.32 and 57.30, respectively. Additionally, the average overall healthy eating index score was 82.83. The results showed that the total, physical, and mental components of SF-36 scores in the elderly were positively associated with the healthy eating index but not significantly (P=0.2). QOL and diet scores were significantly associated with age, sex, education, previous employment, income, leisure activities, exercise, insurance, smoking, present disease, and drug consumption (P<0.05). Conclusion: The results showed that the QOL in the elderly was not related to their quality of diet.

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  Background: Due to the lack of efficient anti-HIV vaccine, anti-HIV pharmaceuticals play an important role in controlling HIV infection. Also significant rise in drug resistance and drug toxicity has caused increased interest in finding new anti-HIV agents. In this study, a nano-sized version of lamivudine based on PEGylated chitosan was synthesized.

  Materials and Methods: In this research, nanoparticles of chitosan were efficiently PEGylated for increasing their stability in water and then the anti-HIV drug, lamivudine, was loaded on these PEGylated nanoparticles. After purification and lyophilization of new synthesized nanoparticle, the raw materials and final product were sampled and FTIR, HNMR and CHN analyses were done.

  Results: Results of HNMR spectroscopy showed that chitosan nanoparticle was successfully PEGylated. HNMR data confirmed FTIR results and indicated that lamivudine was conjugated on chitosan nanoparticle. In addition, CHN analysis data also confirmed both HNMR and FTIR data, and demonstrated that a high yield of chitosan nanoparticle PEGylation (approximately 97%) was done and illustrated a high capacity of lamivudine conjugation on nano-sized PEGylated chitosan (30% _W/W chitosan).

  Conclusion: In this study, lamivudine drug was successfully synthesized, based on PEGylated chitosan nanoparticle.

 

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Background: Schizophrenia is a widespread neurodegenerative disorder, which affects approximately 1% of the world population. It is a multifactorial and a highly heritable disease to which genetic factors contribute up to approximately 80%. Nowadays, multitude of genes have been discovered that relate to this disorder mostly by affecting the performance and levels of neurotransmitters in neural systems. Since PAI-1 is a considerable gene in the performance of neural systems, the present study dealt with the relationship between -675 4G/5G polymorphism in PAI-1 gene and schizophrenia among Iranian patients.

Materials and  Methods: This case-control study was carried out on 106 blood samples collected from individuals suffering from schizophrenia and 122 healthy controls. DNA was extracted from the samples and the frequency of the polymorphisms was analyzed using ARMS-PCR method. Finally, the products were detected on 2% agarose gel electrophoresis.

Results: The analysis of the data for -675 4G/5G polymorphism showed that 17.9% of the patients and 1.6% of the controls were mutant homozygous and 65.1% of the patients and 45.9% of controls were heterozygous. Also, 17% of the patients and 52.5% of the controls were normal homozygous.

Conclusion: There was a significant relationship between PAI-1 4G/5G polymorphism and the incidence of schizophrenia. To the best of our knowledge, this is the first study in Iran that assesses the frequency of the polymorphism among Iranian patients. However, further studies with more samples are necessary.

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Background: Multiple sclerosis (MS) is a chronic progressive  disease  of the central nervous system with signs and symptoms such as fatigue and balance that are disable. The purpose of this study was to assess the effect of training which instructions focus of attention on postural sway of multiple sclerosis patients.

Materials and Methods: The present quasi-experimental study used a pretest-posttest design. The subjects with the age of 27-42, expanded disability status scale 1-4 and were purposefully and voluntarily selected and randomly allocated to the experimental and control groups. Training program for groups was carried out in 3 weeks, five sessions per week, and each session lasted about one hour. Berg Balance Scale was used to measure balance. The data was analyzed by using analysis of independent and dependent sample t-test at a significance level of p≤0.05.

Results: The results showed that significant improvements observed in balance (p≤0.05). Also significant differences observed between  post hoc scores in the experimental and control groups (p≥0.05).

Conclusion: According to research findings, the exercise walking program on textured surface resulted in considerable improvements in balance in multiple sclerosis. Also, the respective specialists can use these exercies as a complementary treatment along with the drug therapy for patiens with multiple sclerosis.

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Background: Birthweight less than 2500 grams is the major indicators of neonatal and infant health. The studies on animals show that copper and zinc deficiency in pregnancy is associated with fetal growth and congenital abnormalities. Therefore, our study was conducted to evaluate the role of these two elements on human embryos.

 Materials and Methods: In this descriptive study, cord blood of all infants born in Nik-Nafs Maternity of Rafsanjan was Collected for 1 year. Then, serum was separated and saved. In total, 64 samples including 9 infants with congenital anomalies, 21 infants with a weight equal to or less than 2500 grams and 34 healthy infants were selected randomly as control group. The level of copper and zinc in cord boold was measured by the spectrophotometric method and data analysis was carried out by SPSS 17 software and statistical methods involving Chi-square, T-test and analysis of variance.

Results: No significant relation was shown between the levels of copper and zinc withbirth weight and congenital abnormalities. Also, there was not any significant correlation between these two teo elements and some pregnancy risk factors such as type of delivery, premature rupture of membrane, placental decolman, placental previa, preeclampsia, gravidity, height, head circumference and Apgar scores.

 Conclusion: The findings indicate that the levels of copper and zinc in cord blood are not associated with incidence of low birth weight, congenital malformations and pregnancy risk factors.

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Background: Childbirth is a stressful event that requires a mental adjustment. Optimism is one of the important determinants of psychological adjustment which is a combination of interest and positive attitude. The purpose of this study was to determine the effect of optimism training during pregnancy on attitude and intentions to choose the mode of delivery in nulliparous women.

Materials and Methods: In this clinical trial , 64 primipar pregnant women with normal pregnancies, 34-30 weeks, without indication for cesarean section referring to the health centers in Mashhad in 2014 were selected and were randomly divided into two groups , A (trained) and B (no training). Optimism training during 5 session of the 60-minute, with the group participation of participants and active exercises was conducted. Data were analyzed with using the software SPSS and statistical tests including variance analysis, Fischer exact test, willcoxon, Square-Chi and paired t-test.

Results: Average attitude score towards c/s delivery in the study group, before and after training has a significant difference (p<0.001). Average attitude score towards natural childbirth was significantly higher in intervention group compared to the control group (p<0.002). Frequency of intentions to choose the mode of delivery in the study group, before and after training has a significant difference (p<0.033).

Conclusion: Reults showed that optimism training in creating a positive attitude towards natural childbirth and thus reducing the rate of elective c/s delivery is effective.

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Background: Nuclear radiation emission by radionuclides causes the diseases, such as cancer or genetic anomalies. Therefore, the study of radioactivity in soil and food as well as calculating the risk of cancer seems essential for foods consumption.

Materials and Methods: In this research, nine different varieties of beans containing the grain of beans, areal part and their soil cultivated were collected. The specific activity of ²²⁶Ra, ²³²Th, ⁴⁰K and ¹³⁷Cs was determined for each sample employing gamma ray spectrometry method using high purity germanium detector with 30% relative efficiency.

Results: The absorbed dose rate in the air in one meter above the ground surface varied from 77.23 to 112.78 in nGy/h. The annual effective dose rate absorbed by adult person from the beans consumption in Iran is in the range of 122.14 to 905.86 in μSv/y. The cancer risk for the different varieties of beans varied from of 1.87 × 10^-5 to 1.59 ×10^-4 which is less than acceptable value as 10^-3.

Conclusion: The specific activities of radionuclides in soils samples are more than average of world wide range. The absorbed dose rate from bean consumption for the most of Varieties is more than of world average. Cancer risk resulted from bean consumption is less than acceptable value and consumption of bean has no risk for population health.

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Background: Inflammatory bowel disease (IBD) includes two basic categories ulcerative colitis (UC) and Crohn's disease (CD) that the etiology of which remains unclear. Tumor necrosis factor alpha (TNFα) promoter polymorphisms are a good candidate for susceptibility to IBD as there is a significant relationship between them. The main aim of this study was to assess TNFα gene polymorphisms with IBD susceptibility at positions -1031in Iranian patients.

Materials and Methods: In this case-control study, were studied 101 patients with IBD (86 ulcerative colitis, 15 Crohn's disease) and 100 healthy controls were studied. PCR-RFLP (Polymerase Chain Reaction-Restriction Fragment Length Polymorphism) was used for determining of genotyping. In following, allele frequency and genotype distribution of polymorphism T> C in TNFα gene between the case and control groups were typed.

Results: The frequency of genotype TT, TC and CC among patients was 64.4%, 28.7% and 6.9% and in control group was 63%, 29% and 8%, respectively. Also, allele frequency T-1031 of TNFα gene in IBD patients was high, while there is no statistical significant(p>0.05).

Conclusion: There was no significant correlation between TNFα gene polymorphisms and susceptibility to IBD at position -1031. Our results showed that TNFα gene polymorphisms cannot be considered as a potential prognostic marker cause of IBD in Iranian population.