Background: Thymus is essential in creating some of the disorders and diseases. Treatment of these disorders (particularly tumors and myasthenia gravis) is possible with complete removal of the thymus.

Materials and Methods: In this retrospective study over a period of eleven years, all case of thymectomy performed at the Department of Thoracic Surgery of shahid Beheshti University has investigated. Variables examined included age, sex, primary diagnosis, surgical technique, complications and results of surgery.

Results: The total number of patients was 50 (46% male and 54% female) with a mean age of 85.14 ± 46.41 years. Primary diagnosis was myasthenia gravis in 40% of patients and thymoma in 42% of them. Myasthenic symptom was the most common presenting symptom (50%). Radical thymectomy surgery was performed in 64% of patients. Fever and atelectasis (10%) and respiratory failure (12%) were the most common postoperative complication and mortality rate was 4%. Thymoma (64%) and thymus hyperplasia (20%) were the most frequent pathology. Clinical symptoms were gone or greatly reduced in 40% of patients. The majority of them had a primary diagnosis of myasthenia gravis (36%). 50% of patients have been followed up. The mean follow-up time in these patients is 32.20 ± 36.41 months.

Conclusion: Thymectomy surgery with low morbidity and mortality, provides the possibility of treatment of thymic lesions. Especially Thymoma and Myasthenia Gravis

 Background: Selenium is a unique trace element which is benefit on inflammatory underlining diseases. MAPK (Mitogen-activated protein kinase) pathways regulate several cellular functions including inflammation, cell differentiation, migration, and apoptosis. Objective: This study aimed to find out the pathway(s) by which Selenium modifies inflammatory events in oxidative or thrombotic induced stress in platelet.

Materials and Methods: This is a basic -experimental study on Human platelets obtained from 30 healthy individuals (age 35±12) .The phosphorylation rate of P38MAPK , c –JNK (c-Jun N-terminal Kinase), and ERK1/2(Extracellular signal-regulated kinases1/2) as three important proteins in MAPK family and P-selectin were measured in presence or absence of selenium by ELISA( solid phase sandwich Enzyme Linked-ImmunoSorbent Assay). Pharmacological inhibition is done by inhibitors of P38MAPK, ERK1/2 and c- JNK in order to compare with selenium effects. The percentage of ratio of phosphorylated to total protein was used for normalizing the phospho protein contents of platelets.

Results: Selenium significantly reduced P-selectin expression (p<0.05), P38MAPK (p<0.05) and c- JNK phosphorylation (p<0.05) induced by cu2+oxidized LDL in platelets but Se couldn’t significantly reduce Thrombin induced P-selectin despite of decreasing in mentioned phospho-proeins.

Conclusion: Our results indicated that Selenium can reduce inflammation via suppression of p38MAPK-dependent signaling pathway. These results may provide insights related to development of novel Selenium therapies in atherosclerosis.

Background: Hydatid disease is a parasitic infestation by a tapeworm of the genus Echinococcus. Man is an intermediate or accidental host of this parasite, and is infested by consuming contaminated plants or vegetables, or by contact with dogs. The larvae travel through the gut wall and 60-75% are filtered by the liver, and a few travel directly to the lungs to produce a hydatid cyst there. Growth of hydatid cysts has been reported in the spleen, muscles, bones, and brain. Hydatid cyst embolism to peripheral limb arteries is extremely rare.

Case: A 41-year-old gravided woman presented with sudden pain, erythema and warming of the olden infra-inguinal mass which existed from 1 year ago. The notable findings at physical examination included 40*20 mm diameter soft mass with warming and erythema in 4 cm below inguinal ligament of right lower limb. She didn’t mentioned any previous history hydatid cyst. Intraoperatively, Percutaneous aspiration of the mass was performed which demonstrate white turbid fluid. after the surgical incision we saw the white colored subcutaneous hydatid cyst and completely remove it and send it to pathological examination which confirmed hydatid cyst diagnosis. further liver ultrasound and chest radiography hasn’t shown any evidence of liver or lung involvement.

Conclusion: Cystic echinococcosis may affect all organs, but mostly settles in the liver and lungs. We do not have data on the means by which the larvae of echinococcosis reach the inguinal area without liver and lung involvement. Considering the anatomy of the groin and its lymphatic tissue, we can make an assumption about how the hydatid cysts settle in the groin space. Although it occurs rarely, larvae in the gastrointestinal tract may pass to the lymphatic circulation, and then settle in the groin space through the rich lymphatic flow of inguinal area.

Background: Mir-210 is proangiogenic microRNAis endothelial cells. This microRNA, causes the repression of some genes and proteins target so cause angiogenesis process. The purpose of this study was to determine the effect of a High Intensity Interval Training (HIIT) on Mir-210 and EphrinA3 receptor genes expression in soleus muscles of male rats.

Materials and Methods: In this experimental study, Twelve Wistar male rats(ageof eightweeks, average weight of 210.5±9.77)were randomly divided into exercise(n=6)and control (n=6) groups. High Intensity Interval Training was formed five days a week for eight weeks to taly including three Intervals (four minutes with an intensityof 90 to 100%VO2max and two minutes with an intensityof 50 to 60%VO2max).24 hours after exercise protocol, the rats were dissected and separated soleusmuscle. Mir-210 and EphrinA3receptor genes expression was performed by Real Time-PCRtechnique. Mir-210 and EphrinA3receptor genes expression were calculated by using the2∆∆CT and in dependentt-test to determine the significance of variables.

Results: Results showed that HIIT there had no significant effects on Mir-210 gene expression (p=0.16) Whe ars EphrinA3 gene expression in the exercise group was statistically significant (p=0.000).

Conclusion: It seems that a non-significant increase of Mir-210 and reduce in EphrinA3 gene expres sion, causes proangiogenic Operation ofendothelial cells and an increase in VO2max of rats following eight weeks of HIIT performance can be due to increased angiogenesis process.

Background: Early, complete, and stable coronary revascularization is the main criteria for standard treatment in patients with ST segment elevation myocardial infarction (STEMI). The aim of this study was to evaluate the safety and efficacy of integrilin as glycoprotein IIb/IIIa receptor inhibitor in treatment of STEMI patients undergoing primary percutaneous coronary intervention (PCI).

Materials and Methods: In this clinical trial study, 106 STEMI patients who complained of acute chest pain and were referred to Amir Al Momenin hospital, Arak, entered the study. Patients were randomly divided into two equal groups. The first group was treated with integrilin immediately before angioplasty. The 2nd group was treated with conventional percutaneous coronary intervention.

Results: After receiving treatment and undergoing angioplasty, TIMI Frame Count was equal to 15.7±8.04 in the 1st group and 14.2±5.4 in the 2nd group which showed no significant difference between them (p=0.4). Ejection fraction in patients receiving integrilin was significantly more than control group in first (p=0.043) and third month (p=0.012) after treatment.

Conclusion: Based on the results of the present study, it seems that using integrilin in standard time, causes long-term benefits for patients and reduces damage to the heart wall.

Background: Nanoparticles due to their small size can overcome blood-testis barrier and affect spermatogenesis process. The aim of this study is to investigate the influence of trioxide (MoO3) nanoparticles on histological changes of testis and spermatogenesis process in adult male Wistar rats.

Materials and Methods: In this experimental study 30 adult male Wistar rats were randomely divided into five groups (n=6), including control, 2 sham groups, and 2experimental groups. Control group had no treatment. Two experimental groups received doses 5 & 10 mg/kg/BW nano molybdenum trioxide (20nm) respectively, and two sham groups received the same doses of normal saline by intraperitoneal injection. After 28 days, rats testis was removed and fixed in Bouin’s fixative for histological examination. The 5&mum sections were stained with hematoxilin-eosin.

Results: In experimental group which received 5mg/kg/BW nanoparticle, there was some disorganization of spermatogenic cells in some seminiferous tubules. In experimental group which received 10mg/kg/BW nanoparticle, a significant decrease was also observed in the number of spermatogenic and sertoli cells in comparison with the control group.

Conclusion: According to the findings of this study exposure to the high doses of (MoO3) nanoparticles can disrupt male reproductive system in a dose- dependent manner. Hence, the application of (MoO3) NPs should be carried out cautiously.

Background: Unpleasant side effect of awareness within general anesthesia is potentially an important concern in patients. The patient may sleep during anesthesia and feels the pain due to loss of pain suppression of sensory perception of pain during surgery. The aim of this study is to determine the effect of BIS monitoring on level of awareness during anesthesia in women undergoing elective caesarean section.

Materials and Methods: In this double-blind, randomized clinical trial, 214 ASAI–II patients, over 15 years of age, candidate for elective cesarean section were included in the study. Patients randomly divided to two groups of anesthesia with and without BIS monitoring. Patients were assessed for awareness within anesthesia immediately, 24 hours, and 3-6 days after operation.

Results: From 107 patients without BIS monitoring, 8 patients (7.4%) suffered from awareness during anesthesia and their awareness score was two and greater than two. While none of the patients in the BIS group experienced awareness during anesthesia. Level of awareness during anesthesia in the control group was significantly more than the BIS group (p<0.0000).

Conclusion: The incidence of awareness during anesthesia is significantly lower in BIS monitored group than the control group.

Background: Colorectal cancer is the most common gastrointestinal cancer. Investigating the factors that predict survival time for these patients is important.The purpose of this study was comparison of parametric models by estimating the prediction error and also identifying the effective factors on predicted survival time of patients with colorectal cancer.

Materials and Methods: This cohort study was conducted with 600 patients who were suffered from colorectal cancer in Taleghani Hospital of Tehran between 2001 to 2005 and they were followed up for at least 5 years. For identifying the effective factors on survival time, of the patients we analyzed the data by some parametric models such as Weibull, Exponential and Log logistic and compared these models with the estimation of prediction error by apparent loss method.

Results: Among 600 patients there was 344 men (57.3%) and 256 wemon (47.7%). Of total, 151 patients were died that 62.3% of them were men. Univariate analysis showed that the effect of BMI, sex, staging of tumor, tumor site were significant but in multivariate model staging of tumor and BMI were significant. By the estimation of prediction error, the best model was Log logistic.

Conclusion: With respect to the importance of survival time prediction, we found that we can use the prediction error to compare the parametric models. In addition, because of effectiveness of tumor stages and BMI in the patients’ survival time, survival time could be increased by an on-time diagnosis and an appropriate controled diet.

Background: Phacoemulsification is a modern cataract surgery that developed surgery from large incisions into smaller incision size and lead to faster wound heal and earlier visual rehabilitation. The purpose of this study was to compare the outcomes and complications of 3.2 and 2.65 mm main Incisions in phacoemulsification .

Materials and Methods: In this clinical study in Amir Kabir Hospital of Arak, 78 patients with senile cataract were divided into two groups. Half of them experienced 3.2 mm main incision (first group) and the others were under main incision with 2.65 mm (group 2). Immediately after operation if patients had a wound leak, the standard stromal hydration was used and a suture was placed. A day after operation, the patients were examined in the light of iris prolapse, if it existed, then a suture would be palced.

Results: The occurrence of anterior chamber wound leak was 7.7% and 2.6% in group 1 and group 2, respectively. Stromal hydration was needed 5.1% and 3.2% in group 1 and group 2 respectively. In fact, suture was needed 2.6% and 0.0% in group 1 and group 2, respectively. There was no iris prolapse in both groups.

Conclusion: There was no statistically significant difference between two groups from the point of view of wound leak and the need for suture and the rate of iris prolapse (p>0.05). Also, in low or intermediate nuclear density grade, the smaller and the more permanent incision with 2.65 mm is preferred.

Background: The pathogenesis of recurrent pregnancy loss includes complex interaction of several genetic and environmental factors. Changes in blood coagulation factors during pregnancy may play an important role in the occurrence of recurrent abortions (RA). Recently, inherited thrombophilia has been considered as a possible cause. Therefore, in this study we have investigated association of factor V (G1691A) and factor II (G20210A) polymorphisms in Iranian patients with recurrent abortions.

Materials and Methods: A total of 203 women participated in this study: 105 women with two or more consecutive unexplained miscarriage as cases and 98 women with at least two healthy children as control group. Total genomic DNA was isolated from Peripheral blood leukocytes. The presence or absence of mutation in the FV (G1691A) and FII (G20210A) polymorphisms were assessed by PCR-RFLP, using Mnl1 and HindIII digestion enzymes, respectively. Finally, the data were  analyzed using Chi-Square test.

Results: The results showed no statistical significant differences in the prevalence of FV (G1691A) and FII (G20210A) polymorphisms between patients and control group.

Conclusion: considering the results of this study, these polymorphisms Seem to have no role in etiology of recurrent pregnancy loss in the studied population.

Background: Shigella is the causative agent of human shigellosis and its lipopolysaccharide is detected by TLR4. TLR4 belongs to Toll-like receptors family and many immunological pathways are triggered when these receptors are stimulated. Many researches showed increasing in TLR4 expression in mesenchymal stem cells through lipopolysaccharide treatment. The main goal of this study is detecting the optimum lipopolysaccharide between shigella strains through stimulation of immune system for vaccine studies.

Materials and Methods: In this experimental study human bone marrow derived mesenchymal stem cells were treated with three distinct concentrations (0.1, 0.01, and 0.001) of shigella (S. flexneri, S. dysenteriae, S. sonnei) extract containing lipopolysaccharide. Then TLR4 expression in mRNA level was investigated by RT-PCR and Q-PCR. The cells treated with phosphate buffered saline have been considered as a control group.

Results: Expression of TLR4 was shown in all of case groups except treatment with concentration 0.001 of extracts from sonnei and dysenteriae and also control group. The variations in the expression of TLR4 was dose-dependent in all of case groups. The maximum expression of TLR4 related to treatment with extract from shigella flexneri strain and the minimum expression related to treatment with shigella sonnei extract. The use of lipopolysaccharide from E. coli as a positive control indicated that lipopolysaccharide in shigella extracts is responsible for the increased expression of TLR4.

Conclusion: The TLR4 expression level was increasesed by S. flexneri extract, so it could be recommended for increasing vaccine efficiency.

Background: Toxocariasis is a parasitic disease caused by presence of Toxocara larva in human body. Soil as a reservoir maintained eggs of parasite and has important role in dissemination of disease because dogs and cats defecate eggs of parasite by feces. Despite there are large number of stray cats and dogs in urban areas such as Arak city, we need to collect information about soil pollution in public places. Therefore, the aim of this study was to evaluate soil contamination with Toxocara eggs in public parks in Arak city.

Materials and Methods: In this cross-sectional study, 60 soil samples were collected from 15 public parks in the Arak city during the summer 2015. The soil samples were provided by flotation method and examined by microscope.

Results: The results of this study showed that 4 (26.6%) of 15 parks were infected with Toxocara eggs. The highest rate of infection was observed in the walking and picnic site of parks. Also, in this study, two contaminated parks were located in the center and two parks were located in the southeastern of city.

Conclusion: Considering that soil contamination with Toxocara eggs was high in Arak city, it seems that the health authorities should design and implement programs in order to prevent human infection.

Abstract

Background: 4cure models are a model to analyze survival data that these models exist for long term survivors. Cure models are a special type of survival model where it is assumed that there are a proportion of subjects who had never event, thus, survival curve will eventually reach a plateau. Therefore, standard survival models are not appropriate because they do not account for the possibility of cure.The aim of the present research is to apply non-mixture cure model to analyze survival of patients with colorectal cancer.

Materials and Methods: We studied 232 patients with colorectal cancer who were visited and treated at Taleghani Hospital Research Center for Gastroenterology and Liver Disease in Tehran. These patients were diagnosed from 1987 to 2012 and followed up until 2013. The Effect of age, gender, family history, body mass index and site of infection were studied. Kaplan-Meier and Non-Mixture cure Model were used for analzing data.

Results: The ten-year survival rate after diagnosis in the studied patients was 64 % .A total of 60 (25.8 %) deaths due to colorectal cancer were observed. The mean of age at the time of diagnosis was 51.6 years. Based on non-mixed cure model, the rangs of age was 45-65 years old and BMI were significant.

Conclusion: When the population is divided into two groups (susceptible and non- susceptible individuals), using Cox semi-parametric model is not appropriate. Therefore, we should use cure models.

Abstract

Background: The incidence of gastric cancer is different in two sexes with ratio 2 to 1 that it is more common in men. The most important biologically reason is sexual hormones between two sexes that lead to sexual dimorphism and in turn can cause a sex bias in incidence of disease between two sexes. Recently, studies have shown that microRNA is involved in sexual dimorphism in gene expression. Given the sexual dimorphism in the incidence of gastric cancer and sex hormones response elements in the regulatory regions of miR-146a and miR-148a genes, in this study, the expression of these two genes in the stomach of healthy men and women at different age groups were compared.

Materials and Methods: Using endoscopy, gastric antrum tissues of 35 healthy women and 35 healthy men were collected. After RNA extraction and synthesis of cDNA, the expression of miR-146a and miR-148a genes were compared between sexes by Real time RT-PCR and data were analyzed using independent sample t and ANOVA tests.

Results: There was no difference between men and women in genes expression of miR-146a and miR-148a. However, expression of miR-146a gene was significantly more in men under 45 years than men over 45 years (p= 0.017, df= 14,  t= 1.47). Also,  expression of miR-148a gene was significantly more in men over 45 years than men under 45 years (p=0.001, df= 12, t= 1.28). But the expression of both genes had no significant difference between women under 45 years and women over 45 years.

Conclusion: Expression of miR-146a and miR-148a genes in the stomach is increased and decreased with aging in men, respectively.