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Background: Noticing the fact that graft survival rate of kidney transplantation from live donors is more than deceased donors, this study was conducted to determine the relationship between the graft survival rate of renal transplantation and the donor source in patients transplanted from March 1999 to March 2009 in Namazi Hospital Transplantation Center of Shiraz. Materials and Methods: In this retrospective cohort study which was designed to determine the relationship between graft survival of kidney transplantation and the donor source (related live donor, unrelated live donor, and deceased donor) in 1356 patients who were transplanted in Shiraz Transplant Center, Namazi Hospital. Kaplan-Meier method was used to determine the survival rate, log-rank test was used to compare survival curves and Cox regression model was used for ruling out the intervening factors. Results: Five-year graft survival rates of renal transplantation from related, unrelated, and deceased donors were 92.4, 92.6 and 82.1%, respectively. Also, a significant relationship was seen between donor source and survival rate of the renal allograft (P>0.001). Conclusion: The findings of this study transplanted patients with kidneys from living donors (related or unrelated) have a higher graft survival rate compared with deceased donors.

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Background: One of the main complications associated with arteriovenous fistula in hemodialysis patients is the median nerve ischemic neuropathy in the wrist. This study was conducted to examine the effect of arteriovenous fistula on the development of carpal tunnel syndrome. Materials and Methods: This cross-sectional study was conducted on 37 hemodialysis patients at Shahid Mohammadi Hospital of Bandar Abbas in 2007-2008. All of the patients had either a distal or a proximal arteriovenous fistula in one hand. Nerve conduction velocity and median nerve distal sensory and motor latency were applied to the diagnosis of carpal tunnel syndrome. The limb with fistula (the case) was compared to the one without it. Data were analyzed through independent t-test and Pearson product correlation. Results: Overall, 17 patients had proximal and the rest had distal fistulas. Fistulas aging more than one year were seen in 15 patients and 22 patients had fistulas less than one year old. Carpal tunnel syndrome had developed in 25 wrists with fistula (17 motor and 8 sensory cases) and 27 wrists without fistula. A significant difference was observed in the median nerve distal sensory latency between the wrists with fistula and those without it. There was not a significant difference between the variables. In addition, there was a significant difference between the age of the fistulas and the incidence of carpal tunnel syndrome. Conclusion: The rate of the development of carpal tunnel syndrome in wrists with or without fistula is the same. Also, the site of the fistula does not have any effects on the incidence of the median nerve ischemic neuropathy.

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Background: Noticing the practical significance of stem cells, this study was conducted to culture and screen bone marrow mesenchymal stem cells derived from Raf and Hilline chicken strains and investigate the effect of age and race on the morphology and differentiation of the generated cells. Materials and Methods: In this fundamental study, bone marrow cells from 3 to 25 day-old Raf and Hiline chicken strains were cultured in low glucose DMEM, 10% BFS. Then third passage bone marrow cells of the two strains were compared in terms of morphology, differentiation to bone, cartilage, and adiposity. Data were analyzed through SPSS software. Results: In culturing Raf chicken derived bone marrow cells, in contrast to Hiline chicken strain, colonization took place and they almost had a better fibroblastic morphology. The results indicated higher yields of differentiation to bone, cartilage, and adipose tissues in Raf chicken derived bone marrow cells than Hiline chicken. These differences were statistically significant. Also, 15 days was the most suitable age for screening the mesenchymal stem cells of chicken. Conclusion: Screening and proliferation of mesenchymal stem cells from 15-day old Raf chicken bone marrow cells are good resources for differentiation and purification of chicken bone marrow mesenchymal stem cells.

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Background: Hyaluronidase A is an antigenic protein that is secreted by Streptococcus pyogenes. Nowadays, streptococcal infections are diagnosed by tracking down anti-hyaluronidase A antibodies. In this study, the attempt was made to generate recombinant hyaluronidase A in E. coli. Materials and Methods: In this experimental study, through designing specific primers and polymerase chain reaction (PCR), hyaluronidase A gene was amplified and after purification, it was sub-cloned in plasmid expression vector pET32a. Then pET32a-hylA was transferred to E. coli BL21-DE3-plySs. Protein generation induced by IPTG. The recombinant protein was purified by Ni-NTA kit and its concentration was assayed by Bradford method. Western-Blot analysis was run for verifying the recombinant hyaluronidase A. Results: The nucleotide sequencing of the gene amplified by PCR was the same as hyaluronidase A gene from Streptococcus pyogenes. Production of the recombinant hyaluronidase A via induction by pET32a-hylA plasmid was done through IPTG. The expressed protein was purified by affinity chromatography by Ni-NTA resin. The concentration of purified protein was 500µg/ml. analysis using a mouse anti-hyaluronidase A serum was reacted with the generated protein using Western-Blot analysis. Conclusion: Recombinant HylA protein can be generated in E.coli and the resulting protein maintains its antigenic properties desirably.

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Background: Mother and newborn's health is one of the important indexes in health services of every country and one of its main assessment indexes is the number of normal deliveries in each country. Identifying the effective factors in labor helps the right selection of patients the process of delivery. The main goal of this study was to assess the association between fetal sex and unsuccessful labor process which result in cesarean section. Materials and Methods: This observational cross-sectional study was conducted on 1537 pregnant women admitted for delivery to Taleghani Hospital of Arak during 6 months. Data were catch through a check list consisting of obstetric history, physical examination, labor process, and lab tests coupled with interview and observation. The results were analyzed through Chi2, chance ration analysis, and t-test. Results: Of the 1537 pregnant women, 74% had normal delivery and 26% underwent cesarean section. Of all infants, 35.1% of those delivered by normal vaginal delivery and 13.4% of those delivered by cesarean section were male sex while 38.9% of the infants in the normal delivery group and 12.6% of those in the cesarean group were female. These results did not show any association between fetal sex and type of delivery. Overall, 36.5% of the deliveries done through cesarean section were due to dystosia (18.1% male and 18.4% female) (P=0.934). Also,14.3% of the newborns delivered through cesarean sction due to fetal distress were male and 10.8% of them were female (P=0.162) while 10.5% of newborns delivered through cesarean section due to meconium were male and 8.5% of them were male (P=0.359). Conclusion: It appears there is no association between fetal sex and labor disorders which result in cesarean section.

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Background:Hypotension is one of the common complications of spinal anesthesia. Ephedrine with sympathomimetic effects is the selective vasopressor in obstetric. The aim of this study was to compare the effect of different doses of ephedrine on hypotension due to spinal anesthesia. Materials and Methods: This randomized double-blind clinical trial included 120 parturient patients with ASA Ι and П scheduled for cesarean section under spinal anesthesia at Fatemy Hospital of Hamedan in 2008.The patients were divided into three groups. Immediately after spinal anesthesia, the patients randomly received 10 mg ephedrine, 20 mg ephedrine, or placebo intravenously. Then vital signs were recorded every minute for 5 minutes and after delivery every 10 minutes till the end of the surgery. Results: Incidence of hypotension in 10 mg ephedrine, 20mg ephedrine, and placebo groups was 37.5,12.5, 85%, respectively (P<0.001 ). The difference in the prevalanceof hypotension was significant between the three groups (P<0.05).Based on Chi2 test, the prevalence of hypotension in 20 mg ephedrine group was less than 10 mg ephedrine group, and in the 10mg ephedrine group it was less than the placebo group (P<0.05). Conclusion: Intravenous injection of 10mg and 20mg ephedrine to parturient patients undergoing cesarean section reduces the incidence of hypotension, though thisdecrease is more significant with 20 mg ephedrine.

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Background: Polymerase chain reaction is the most common technique in the field of molecular biology that use for amplification of a specific nucleic acid sequence. Degenerate primers have ability to amplify related but distinct sequences. The aim of current study was to use, two sets of degenerate primers in combination with Hemi Nested PCR for detection V3-Loop sequence of envelope gene from wide spectrum of Human Immunodeficiency Virus (HIV) subtypes. Material and Methods: In this experimental study we designed and optimized, a degenerate primer pair in combination with Hemi Nested PCR, to detect HIV-1 V3 loop from Envelop gene that has wide variations among genotypes. The developed assay was used to check, 40 HIV infected, 10 negative controls as well as 5 samples from each HCV, HBV, HGV, and TTV were analyzed using developed method. Results: after optimization, 35 out of 40 positive controls were positive using our test. None of the negative human and viral control samples showed specific band. Also, in positive samples, non-specific bands were not detected. Conclusion: In this study moreover than standard PCR, we used two degenerate primers that could detect specific region of genome. In fact, first round of PCR product act as a template for second round inner primers and can produce smaller sequence with high sensitivity due to degeneracy. Based on the current investigation, the developed assay had advantages including product confirmation and hence more sensitivity.

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Background: Today, there is growing interest in using traditional medicine for healing cutaneous wounds. Probiotics are defined as different microorganisms that may have positive effects on prevention or treatment of special pathologic conditions. The present study was designed to investigate the effect of Lactobacillus brevis on cutaneous wound healing. Material and Methods: In this experimental study, through phenol-sulfuric acid method, 22 strains of lactobacillus isolated from dairy-traditional products were investigated in terms of exopolysaccharide production. Lactobacillus brevis, which had high exopolysaccharide (EPS) production, was selected. A wound was created on the back of male Wistar rats in control, negative control, and experimental groups. Control and experimental groups underwent regional treatment by eucerin and eucerin contained Lactobacillus brevis, respectively, but the negative-control group did not receive any treatment. On days 1, 7 and 21, the rats were killed and their cutaneous wound samples were studied. Data analysis was done through SPSS version 11.5. Results: The percentage of wound healing (99.53%) and inflammation in the experimental group on day 21 compared to control (90.55%) and negative groups (91.14%) was significantly higher (P<0.001). The number of neutrophils in the experimental group decreased in later phases of wound healing compared to the control and negative control groups. Conclusion: The present study showed that Lactobacillus brevis significantly decreases inflammation and accelerates wound healing in treated rats. The findings of this study can be applied clinically in near future

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Background: Streptokinase is one of the antigenic proteins secreted by streptococcus pyogenes. This protein has an important role in bacterial pathogenesis. The aim of this study was to produce recombinant forms of this enzyme so that the product would change in accordance with changes in the media. Materials and Methods: In this experimental study, we amplified the streptokinase gene by polymerase chain reaction (PCR) method. After extraction, it was sub-cloned to prokaryotic expression vector pET32a. pET32a-Ska was transferred to E.coli BL21-DE3-plySs strain. Protein production was induced by IPTG and optimization of culture media and OD of bacteria. The recombinant protein was extracted by Ni-NTA and its concentration was measured by Bradford assay. Western- Blot analysis was used to verify the recombinant protein. Results: The nucleotide sequence of the amplified gene was the same as streptokinase gene of the streptococcus pyogenes. The production of recombinant streptokinase by induction of plasmid pET32a-Ska was done by IPTG. The recombinant streptokinase had the same antigenic properties as natural streptokinase. The largest amount of recombinant protein was produced in bacteria concentrations with OD = 0.8. Also, the production of the recombinant protein was higher in media with no glucose. Conclusion: Changes in culture media can increase the production of recombinant proteins in host bacteria. The presence of nutrients, such as glucose, alone not only can not increase the amount of production but it might even decrease it

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Background: The major aim of this study was synthesis and assay of antimicrobial activity of peptide D28 and its new analogues derivatives as dimeric peptides. Materials and Methods: Three antimicrobial peptides known as D28, Di-D28-Lys,Di-Cys-D28 including 20, 41, 42 residues were synthesized respectively. For peptide synthesis, solid phase peptide synthesis method using blocked amino acids with flourenyl methoxy carbonyl group and for peptide purification HPLC were used. Peptides compositions were confirmed by amino acid analysis and SDS-PAGE electrophoresis. Antimicrobial tests against Staphylococcus aureus and Pseudomonas aeruginosa were performed as disk and well diffusion on plate and by adding to liquid broth culture (Broth macrodilution) in different concentrations. Results: Three required peptides (D28, Di-D28-Lys, Di-Cys-D28) successfully were synthesized. All three peptides were effective against S. aureus, but Di-Cys-D28 on the contrary to two other ones, showed no antimicrobial activity against P. aeruginosa. The inhibitory activity of Di-D28-Lys against P. aeruginosa was more than that of D28 peptide. Conclusion: Improvement of antimicrobial peptides activity through dimerization depends on the methods of dimerization and the strain of bacterium. Di-D28-Lys peptide in comparison with D28 and Di-Cys-D28 showed wide range and more antimicrobial activity. Therefore, Di-D28-Lys peptide could be a suitable antibiotic candidate for future studies.

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Background: Localization of ectopic parathyroid glands is one of the most sophisticated challenges in endocrine surgery and there is considerable controversy regarding the suitable approach to localize ectopic parathyroid glands and indications for using different modalities. The failure of the first operation leads to pain, scar, and financial burden of the following operation. Case: The patient was a 39-year-old woman hospitalized with hematuria as the main complaint and noticing the presentation of hypercalcemia in the initial tests underwent more thorough examination. Ultrasonography and 99mTc sestamibi scan helped us to localize the ectopic parathyroid gland in an anterior mediastinum and treat the patient in a one stage operation. Conclusion: Paying careful attention to the symptoms and signs, considering all differential diagnoses, and using appropriate diagnostic methods can be helpful in the diagnosis of rare syndromes.

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Background: Brucellosis is an endemic disease in Iran and its treatment is a medical problem. This study was performed to observe the influence of the administration of corticosteroid on symptomatology of subjects with acute, subacute, and chronic brucellosis. Materials and Methods: In this randomized controlled trial, 48 patients with brucellosis were randomly assigned to two groups. The first group (N=30) received the standard regimen plus dexamethasone (4 mg t.d.s for 5 days) and the second group (N=17) received only the standard regimen. The results of corticosteroid administration were evaluated according to such factors as clinical status of the patient, duration of hospital stay, duration of illness, pain score, and use of analgesics. The results were analyzed by Chi-square test, Fisher’s exact test, independent sample t-test, and Mann-Whitney test. Results: No significant differences were seen in the mean of hospital stay, duration of illness, and use of oral and injectable analgesics between the two groups (P<0.05). Also, there was not a significant difference in mean pain score reduction between groups 1 and 2 (P<0.05). Conclusion: Noticing the findings of this study, corticosteroid does not seem to alter the clinical course of brucellosis significantly. Nevertheless, further controlled clinical trials with larger sample sizes are recommended

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Background: Brucella is a gram-negative intracellular bacterium. Since Brucella brings about health and socio-economic problems, its control is of primary importance. The common method of vaccination includes using live attenuated strains of this bacterium. This study was done to evaluate the immunogenicity of Brucella aburtus P39 gene in Balb/c mice. Materials and Methods: In this experimental study, P39 gene was amplified by polymerase chain reaction (PCR) method and after extraction, it was sub-cloned to eukaryotic expression vector pcDNA3. The intramuscular injection of the obtained plasmid to the Balb/c mice was done in three stages. After the last vaccination, immunologic tests, such as proliferative response in lymphocytes, IFN- assessment, IL-5, and determination of IgG2a and IgG1, were run. Results: The level of activation in splenic lymphocytes response was 3.6 and the measured IFN- was 3 ng/ml, whereas IL-5 was insignificant. IgG2a and IgG1 titers were 1.640 and 1.40, respectively. Conclusion: The findings of the immunological analysis show the appropriate immune response in Balb/c mice model after the injection of P39 gene containing plasmid. The immune system response was in Th1 form which decreased the number of bacteria in spleen. Therefore, P39 gene is of appropriate immunogenicity and DNA vaccination is efficient in the activation of cell immune response against this bacterium.

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Background: Brucellosis, especially if caused by Brucella melitensis, remains one of the most common zoonotic diseases worldwide with more than 500,000 human cases reported annually. In Iran, brucellosis was first recognized in 1932 and control of small ruminant brucellosis began in 1963. The aim of this study is to give an overview of the National Sheep and Goat Brucellosis Control Program in Iran. Materials and Methods: In this cross-sectional study, data were collected from Iran Veterinary Organization over a period of 45 years. The national control program was based on kid and lamb vaccination and testing and slaughtering infected animals. Results: B.melitensis biotype I in sheep, goat, and man was the predominant local infective biotype. This disease was reported in sheep, goat, cattle, horse, camel, and human. In addition, the prevalence of small ruminant brucellosis was estimated around 2.1%. Conclusion: Prevention of brucellosis is dependent upon increasing public awareness of ranchers through health education programs and more active co-operation between health and veterinary medicine organizations as well as animal movement control in the borders.

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Background: Because of high mortality and morbidity of severe acute pancreatitis (AP) and its increasing incidence in recent years, early detection of severity of AP is very important. Since interleukin (IL) rapidly responds to body temperature changes, this study was done to examine the relationship between blood levels of interleukin 15 and 17 and severity of acute pancreatitis. Materials and Methods: In this cross-sectional study, 52 patients with AP were studied. For all patients, paraclinical information, Ranson criteria, and APACHE-II were completed. Serum interleukin 15 and 17 levels were measured by ELISA method. Then the relationship between them and AP severity was determined based on Ranson criteria and APACHE-II. Results: In this study, 36.5% of the patients were male and 63.5% were female and the mean age was 61.06 years. The serum level of IL-17 was negatively correlated with the severity of AP based on Ranson criteria (p=0.021, r= -0.319). ROC curve showed significant values for blood level of IL-15 and CRP in AP diagnosis. Sensitivities were 92.3% and 78.8% and specificities were 40% and 48%, respectively. Conclusion: Based on Ranson criteria, the role of serum level of IL-17 as an unknown factor was seen significant in determining the severity of AP. However, the diagnostic value of serum IL-15 should also be verified with further studies.

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Background: TEM, PER, and VEB are extended-spectrum betalactamase (ESBL) enzymes that are capable of hydrolyzing penicillins, cephalosporins, and aztreonam. The aim of this study was to determine the prevalence of ESBL producing E.coli and molecular evaluation of TEM, PER, and VEB β-lactamases among E.coli strains. Materials and Methods: A total of 200 clinical strains of E.coli were isolated from clinical specimens and their antibiotic susceptibility was determined by disk diffusion method. ESBL production was determined using the combined disk method with CAZ and CTX with clavulanic acid and alone. Minimum concentration inhibition (MIC) for CAZ and CTX with clavulanic acid and alone was determined by agar dilution method. Finally, PCR with specific primers was used for determining the presence of blaTEM, blaPER, and blaVEB genes. Results: Combined disk method confirmed 94 strains (47%) to be ESBL producing E.coli. Of the 94 ESBL producing strains, 36 samples had MIC=16, 44 samples had MIC between 32-256, and 10 samples had MIC≥512 for ceftazidime, whereas 8 samples had MIC=16, 68 samples had MIC between 32-256, and 21 samples had MIC≥512 for cefotaxime. The frequency of TEM was 44% however, blaPER and blaVEB genes were not detected by PCR among ESBL producing isolates. Conclusion:The results indicated that the high percentage of ESBL producing E.coli is 47% and PCR method showed a high frequency of TEM enzyme, but PER and VEB betalactamase were not found among them.

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Background: Enterotoxigenic Escherichia coli bacterium is the most important bacterial agent causing diarrhea. Specific virulence factors, such as enterotoxins and colonization factors, distinguish ETEC from other classes of diarrheagenic E.coli. In this study, heat-labile toxin was purified which could be utilized for anti-toxin assay in GM1 gangelioside receptor-ELISA based method and for identification of ETEC producing toxin. Materials and Methods: In this experimental study, bacterial strain producing heat-labile toxin was first cultivated for production and purification of toxin. Then supernatant soluble proteins were precipitated with ammonium sulfate and purified using biochemical methods. Finally, purified protein was dialyzed against Tris 0.02 mM pH 8 and analyzed on gel electrophoresis. GM1 gangelioside receptor-ELISA based method was used for detection and assessment of the purified toxin. Through this method, the effect of anti-recombinant heat-labile toxin B subunit neutralization on heat-labile toxin was investigated. Results: Toxin purification was revealed by the presence of 12 and 28 KD protein bands. This study demonstrated that anti-recombinant heat-labile toxin B subunit antibody can detect the purified toxin and can inhibit its binding to GM1 receptor up to 80%. Conclusion: Purification of heat-labile toxin and gangelioside receptor-ELISA assay can be used for accurate detection and epidemiological study of clinical isolates.

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Background: Infantile colic is a behavioral syndrome characterized by severe crying without a specific cause in healthy under three-month-old infants. The aim of this study was to compare the effectiveness of infant massage and rocking on the duration and frequency of crying time in colicky infants. Materials and Methods: This randomized clinical trial involved 100 infants 1-2 weeks of age with colic who referred to Amir Kabir Hospital, Arak, Iran, in 2010. The infants were randomly assigned to massage group (n=50) and rocking group (n=50). In the massage group, mothers were recommended to massage their child three times a day for 7 days. In the rocking group, mothers were recommended to rock their child during crying every day for 7 days. In both groups, mothers recorded infant crying durations during one week in a checklist. Data were analyzed by SPSS software. Results: The mean difference of total crying times and durations were 8.34 and 4.12 during the first day and 4.26 time/day and 1.32 hour/day during the last day in the massage group, whereas in the rocking group, these values were 7.50 and 2.42 in the first day and 6.94 and 2.14 hour/day in the last day, respectively. The means of crying times and durations in the massage group were more than those of the rocking group (p<0.001). Conclusion: Infant massage can reduce the duration of crying in colicky infants and it can enhance the relationship between mother and child and their relaxation

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Background: H. pylori infection is common worldwide involving 50% of the general population. The aim of this study was to compare the effect of two sequential regimen therapies on the eradication of H. pylori. Materials and Methods: In this clinical trial, 150 patients were allocated to two groups of 75 each: group A and group B. The eradication of H. pylori in groups A and B was based on azithromycin and ofloxacin sequential regimens, respectively, and the results were compared between the groups. The data were analyzed by t-test, Chi-square test, and Fisher’s exact test using SPSS software version 16. Results: Mean of the patients’ age was 39.3± 1.2 within the age range of 18 to 85 years. There were not significant differences between the two groups considering the type of peptic ulcer. In group A, Urea Breath Test (UBT) was negative in 67 (89.3%) patients while in group B, it was only positive in 8 (10.7%) patients. In group B, there were 64 (85.3%) negative and 11 (14.7%) positive UBT test results. There were no significant differences in H. pylori eradication rates between the two groups (P=0.31). Conclusion: Noticing the absence of a significant difference between the two groups in terms of H. pylori eradication, it can be concluded that ofloxacin-based drug regimens have no superiority over azithromycine-based regimens and each regimen can be prescribed considering drug complication rates in different patients.

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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.