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Introduction: Different hormonal responses may appear in severe head injured patients (including increase in serum Cortisol & GH level). These changes can also be seen in recovery and rehabilitation periods, so influencing the patients, outcome.
Materials and Methods: Forty severely head injured patients, referred to emergency units of Alzahra & Kashani hospitals were studied in a cohort study (selected by convenient sampling) after dividing into two equal groups. Craniotomy was performed for one group and conservative (non-surgical) therapy for the other. In the first and seventh day of admission serum Cortisol and growth hormone were checked (using RIA method). Data was analyzed by paired and student t tests.
Results: There were significant differences between mean of GH in the first and also in the seventh day(both with P<0.05) and between mean of GH and Cortisol from first to seventh day in two study groups(P<0.05). But there were no significant differences between mean of Cortisol in the first or seventh day in two study groups.
Conclusion: Results of this study showed that craniotomy as an independent factor can raise serum GH and Cortisol levels in severely head injured patients.

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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: In many studies, immunogenicity of Brucella proteins such as P39 in animals is investigated. In this study, we evaluated antigenicity of recombinant P39 from Brucella abortus in patients with Brucellosis. Materials and Methods: In this experimental study, at first recombinant P39 was produced in Escherichia coli. Sera reactivity of six infected individuals against the recombinant P39 protein was analysed by Western Blot. Results: Data indicated that P39 protein from Brucella abortus was recognized by patients, sera antibodies. Conclusion: Our data showed that recombinant P39 protein can be detected as an antigen by sera in infected human. Therefore, recombinant P39 have same epitopes with natural form of this antigen.

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Introduction: Diabetes is one of the most prevalent diseases in the world. Today there are 100 milion diabetics around the world and in Iran it is about 1.5 milion. The prevalence of symptomatic neuropathy is 15% but with NCV it will increase to 50%. Regarding the suffer produced by neuropathy and that there is no effective treatment for that, this is necessary to investigate new treatment options. Materials and Methods: This is a clinical trial study, done during a 3 months period in vali-e-asr hospital in year 2004. 100 diabetic patients were selected randomly and divided into two equal groups. A complete sensorimotor assessment was performed and a questionnaire consisting history and clinical symptoms including limb pain, murmur and paresthesia and examinations such as pin prink test, position and vibration assessment, was completed. NCV was also done and blood sugar and HbA1c was measured. In case group 2000 micrograms vit B12 was prescribed twice weekly and in control group 10mg nortiptiline every night was prescribed. After 3 months patients were assessed again. Data was analysed using mean and standard deviation and Chi square, K-S, Leven, T and Mann Whitney tests. Results: Based on visual analage scale the difference between pain number before and after treatment was decreased 3.66 (3.66-4.25) in case and 0.48 (0.54-1.13) in control group (P<0.001). Also the difference between paresthesia number before and after treatment was decreased 2.98 (2.51-3.44) in case and 1.06 (064-1.47) in control group (P<0.001). The difference between murmur number before and after treatmat was decreased 3.48 (2.93-4.02) in case and 3.48(2.93-4.02) in control group (P<0.001). There was no significaut difference between NCV, vibration, position and pin prink test results. Conclusion: Changes in clinical symptoms in case group in comparison to those in control group was significant, but changes in physical assessment findings (pin prink, Position, vibration and NCV) was not significamt.

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Introduction: Flexor tendon entrapment of the digits (FTED) is a disorder characterized by snapping or locking of the thumb or fingers (with or without pain) and called trigger finger. Corticosteroid injections are one of the most commonly used treatments for chronic tendon disorders. Despite their popularity, the systematic evidence for their benefits are largely lacking. This study tries to determine the efficacy of local corticosteroid injection in treatment of trigger finger. Materials and Methods: This is a clinical trial research. Variables including local tenderness, trigerring stage, pain during isometric flexion and passive stretching of the tendon (based on VAS) were evaluated before local injection of corticosteroid and then 3 weeks, 3 months and 6 months after the injection. Data was collected by special forms and analyzed using Chi square and ANOVA Tests. Results: The difference between persence of A1 pulley tenderness in 4 examinations was significant (p<0.0001). The difference between pain induced by isometric flexion and pain induced by stretching the tendon passively in extension was also significant (both p<0.0001). The difference between frequency distribution of triggering was significant (p<0.0001). Patients satisfaction was 90% . Conclusion: The rate of success in local corticosteroid injection was 90% (only with one injection). The high rate of success and low side effects, make this method a suitable treatment for trigger finger.

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Introduction: There are a few clinical trials on human that show the effect of topical vitamin E on keloid and hypertrophic scars. In this investigation we try to study this effect and also show the effect of the concentrations which have not been considered yet in improving hypertrophic scar and keloid healing. Materials and Methods: In a double-blind randomized clinical trial, 32 patients who had hypertrophic scar from 12 weeks ago were given three ointments including placebo and ointments contaning injectional vitamin E (d-α tocopheryl) with different concentrations (300Iu/mg and 600Iu/mg). The scars size, erythema and hardness were evaluated by patients and physicians after 1, 4 and 12 weeks. Data was analyzed using ANOVA and Kruskal Walis tests. Results: After 12 weeks there were no signs or symptoms of dermatitis and rash. Comparison of the scar size after 1 week showed difference between the high concentrated ointment with the others and in the 12th week all of the ointments were different (p<0.001). Evaluation of the scar erythema, in the 1th, 4th and 12th week showed significant difference between vitamin ointments and placebo (p<0.001), also scar hardness in the 12th week was significantly different between groups(p<0.001), but in the first and 4th week no difference was detected in hardness. Conclusion: This study shows that topical vitamin E has good effects on keloid and hypertropic scars. Their effect in decreasing size and erythema is more considerable than scar hardness.

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Introduction: Hydronephrosis in infancy and childhood is a frequent urinary malformation. We were unable to find any reports concerning rate and causes of hydronephrosis in Iranian children therefore, we decided to evaluate it, in under 12 years old children. Materials and Methods: This was a descriptive study done in a 9-month period starting from Novemger 2004. All children under 12 years old who had visited Amir Kabir hospital of Arak for UTI or FTT were enlisted and an ultrasonography was requested. If hydronephrosis was detected, then a VCUG was performed. For those with normal VCUG results, if hydronephrosis persisted in the follow up sonography, the next step was an IVP or DTPA scan. Results: 65 patients (39 girls and 26 boys) were evaluated for hydronephrosis. 18.5% presented with FTT , 75.4% with UTI and 6.1% with FTT+UTI. The most prevalent causes of hydronephrosis were VUR (40%) and UPJO (23.5%). Grade I hydronephrosis was the most prevalent form (65%), however when VUR was present , it was mostly grades III or IV (27% and 19% respectively). 70% of girls and 31% of boys had VUR and the average age at the time of diagnosis was 2-3 years. Conclusion: Vesicouretero reflux and UPJO are the most prevalent causes of hydronephrosis and must be evaluated in children with hydronephrosis.

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Introduction: The objective of this study is to clarify the opinions of scientific board members of Sina university hospital about medical research and the ways of promoting these researches. Materials and Methods: This is a grounded theory study in which we used in-depth interviews and focus group discussions. Scientific board members and different authorities of the hospital such as the chief of hospital and the deputy of education were participated in the study. We used three different FGDs. Each group included about 5 people. We also interviewed the chief, the deputy of education and the head of clinical research center of the hospital. Results: Most of the participants in our FGDs believed that the most important factor for research promotion in the hospital was preparation of a data base of patients. They also mentioned that, different research workshops are important for empowering scientific board members in research. Conclusion: According to our study the most important strategies for research promotion in Sina hospital are data bank preparation, providing repeated research workshops, revising the bureaucratic process of proposal approvals, revising the manner of evaluation of scientific board members and more participation of the department of epidemiology in clinical researches

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Introduction: The acute response to renal ischemia-reperfusion injury involves attenuation of glomerular filtration rate, as well as reduced tubular function. The possible mediators involved in ischemia-reperfusion injury include vasoconstrictor agents including angiotensin II (Ang II). Inhibition of the angiotensin II receptor type 1 (AT1) diminishes the deleterious effects of ischemia-reperfusion on glomerular function. This study is done to investigate the effect of angiotensin II receptor type 1 antagonist on renal hemodynamic and tubular responses to ischemia-reperfusion injury in rat. Materials and Methods: In this experimental study, acute renal failure was induced by 30 minutes clamping of both renal arteries in male Sprague-Dawley rats. Renal hemodynamic and excretory function was followed for 120 minutes reperfusion, while saline or the selective AT1 receptor antagonist (Losartan) was infused. In plasma and urine samples, Cr level was measured. Also plasma and urine content of Sodium was measured. Data was analyzed using ANOVA and Duncan tests. Results: Renal ischemia for 30 minutes decreased glomerular filtration rate during reperfusion and increased urine flow and Sodium excretion up to three fold. Losartan (10 mg/kg i.v.) did not change glomerular filtration rate prior to ischemia but improved it during reperfusion and there were progressive increases in urine flow. Losartan caused a lowering of ischemia-induced rise in Sodium excretion. Conclusion: The ischemic challenge may cause release of angiotensin II, which acts on AT1 receptors to decrease perfusion.

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 Introduction: Experimental autoimmune encephalomyelitis (EAE) is an animal model of multiple sclerosis distinguished by infiltration of leukocytes into the central nervous system. Changes in composition and levels of unsaturated fatty acids, affect the integrity of blood-brain barrier. In this study, we evaluated the effect of Sesame oil on the leukocyte infiltration into the brain of MOG35-55 induced EAE male C57BL/6 mice. Materials and Methods: In this experimental study, male C57BL/6 mice were placed in two therapeutic groups (n=10 per group) with age and weight-matched as follow: 1.Sesame oil-treated EAE mice received 4ml/kg/day of Sesame oil given i.p. from day -3 until day +19 after disease induction, 2.Non-treated EAE mice (EAE control) received Phosphate buffer alone with same schedule. EAE was induced by immunization of mice with MOG35-55 peptide and complete Freund's adjuvant. Leukocytes infiltration into the brain was investigated 20 days after immunization. Data was analyzed using Mann-Whitney U test. Results: The results show that Sesame oil-treated mice had significantly less clinical score of EAE (2.6±0.4) than non-treated EAE induced mice (4.2±0.6), (p<0.001). Also, there was a significant difference at number of the infiltrating cells in brain between Sesame oiltreated (80±20) and non treated EAE-induced mice (150±30), (p<0.01). Conclusion: These results indicate that Sesame oil reduces infiltration of leukocytes into the brain of EAE mice, therefore lessening the histological changes and clinical signs and thus ameliorating the disease.

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Introduction: Endocrinopathy is a known consequence of external beam radiotherapy to the brain tumors. The aim of this study was to find out the incidence of hyperprolactinemia in brain tumor patients treated with radiotherapy, when radiation portals included whole hypothalamus and pituitary glands. Materials and Methods: This descriptive study was conducted from December 2004 to February 2006 on about 42 patients with brain tumors. They were referred to radiation oncology center of Hamadan to be treated with external beam radiotherapy, whose radiation portals included whole hypothalamus and pituitary glands. Serum prolactin levels were measured at the beginning of treatment, and at one month, three months, six months and one year after completion of radiotherapy. Data was introduced using descriptive statistics. Results: Of 42 patients 6 were excluded one because of previous hypothalamus and pituitary radiotherapy, three because of nonadherence to follow up program and two because of previous endocrinopathy Of the patients attending the follow up clinic, 11% were found to have hyperprolactinemia at six months, and 22 at one year. This condition in women and men was 37% and 15% respectively. Conclusion: Abnormality in Prolactine secretion is a late complication of brain radiotherapy and a significant number of patients develop hyperprolactinoma following radiotherapy to the brain (hypothalamus and pituitary region). It seems this complication increases by increasing the radiation dose and is more prevalent in women.

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Association between biological factors and disruptive behaviors in children and adolescents is important to investigate. Antisocial, aggressive and delinquent behaviors in adults often begin early in life. Basal cortisol is a valuable biological characteristic of children with disruptive behavior disorder (DBD). In this study the effect of family training on basal salivary cortisol in children with DBD was investigated. Materials and Methods: This is a clinical trial study. Basal salivary cortisol levels were studied in 19 children between 8-13 years old with DBD, before and 2 months after intervention (family training). The disruptive behavior of the child was assessed with child behavior checklist (CBCL). Cortisol levels and score of behavior were compared before and after intervention. Data was analyzed using descriptive statistics, paired t-test and pearson correlation. Results: Salivary cortisol before family training was 7.9±4.6 nmol/L and after that was 10.46±3.84 nmol/L which was significantly different (p<0.001). Behavior score before intervention was 72.05±10.10 and after that was 49.361±1.89 that was also significantly different (p<0.0001). Children with lower basal salivary cortisol had a better response to intervention. Conclusion: Parent training is an effective method for behavioral modification in DBD. Salivary cortisol can be considered as a predictive factor for severity of disruptive behavior, also a factor to assess the response to parent training in children with DBD.

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Introduction: Sodium arsenite is an environmental pollutant which its amounts in industrial cities are more than other places because of its use in chemical industry. Human populations are exposed to this chemical compound through food, soil, air and water which has toxic and histopathological effects on different body organs including kidney. The aim of this investigation is to study the quantitative histopathological effects of sodium arsenite on the kidney structure of rats. Materials and Methods: 12 male Wistar rats with mean body weight of 200±20 g were randomly divided into 2 groups (n=6). One treated with sodium arsenite (8 mg/kg/day in drinking water) and the other one (the control group) received drinking water only. 2 months after treatment the rats were weighed, anesthetized with ether and dissected. The left kidney was taken out, cleaned, weighed and then fixed in 10% formaldehyde solution. After obtaining 1mm thick slices, tissue processing was carried out, then 5µm thick sections were prepared and stained using H&E method. Slides were finally studied stereologically and data was statistically analyzed using paired sampled t-test and the means were considered significantly different at p<0.05. Results: The results of this investigation indicated significant reduction in the total mean volume of kidney (p<0.001), cortex (p<0.001), and medulla (p<0.003) in sodium arsenite treated group compared to the control rats. The mean volume of tubules and interstitial tissue as components of cortex reduced significantly compared to the control group (p<0.003).The mean volume of glomeruli and Bowman's capsule was significantly reduced in treated group (p<0.001), while the other components did not show a significant reduction in volume. A significant reduction was also found in the kidney (p<0.002) and the body weight (p<0. 01) in the treated group compared to the control ones at the end of the experiment. Conclusion: It was concluded that exposure to sodium arsenite leads to histopathological changes in kidney structure, however more studies are needed to determine the effects of these structural changes on the kidney function.

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Introduction: Oculogyric crisis which is a dystonic reaction, is commonly caused by neuroleptics and rarely occurs with atypical antipsychotics specially Clozapine. In this article a case of Clozapine induced oculogyric crisis is reported. Case: The patient was a 25 years old woman with auditory hallucination, loosening of association and persecutory delusion that was admitted and treated. Because of poor response to typical antipsychotics, Clozapine was prescribed. Then she experienced multiple episodes of oculogyric crisis and was treated successfully with anticholinergic medication (Artane). Conclusion: In this special case, Clozapine caused oculogyric crisis. This side effect is rare but should be considered as a possible adverse effect of Clozapine. On the basis of this report, Clozapine induced oculogyric crisis may be treated successfully with Artane

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Introduction: Sneddon syndrome is a combinaison of skin lesions (Livedo Reticularis) and acute cerebrovascular accident. The syndrome involves many organs such as kidney, heart, skin and brain. Some patients have a good prognosis when taking Aspirin and Diprydamol. In this article a case of this syndrome is reported. Case: The patient is a 40 years old woman with a history of 8 times intrauterine fetal deaths. She was admitted to the neurology ward with signs of weakness in left side of the body (hemiparesis), dysarthria, 7th central nerve paralysis, and skin lesions (Livedo Reticularis). All laboratory data such as serology and microbiology were normal. After skin biopsy from the lower limbs and rule out possible secondary etiologies, this patient was recognized with Sneddon syndrome and recieved antiplatelet treatment. Conclusion: Despite the fact that this syndrome is rare, it seems considering the probability of appearing this syndrome, especially in young patients who are suffering from acute cerebrovascular signs and skin lesions in the same time, early treatment can prevent the desease from developing to other organs.

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Background: Marital conflicts have great impact on social, economic and cultural aspects of the couples and their children. New Psychological interventions like “Imago Relationship Therapy” (IRT) have been widely used for resolving these conflicts. This study examined the efficacy of couple dialogue technique on marital relationship and children`s behavior in Iranian society. Methods and Materials: In a Clinical Trial study eighty consecutive couples refered to general pediatric clinics due to their children’s diseases, randomly allocated to intervention group(couple dialogue technique) and control group (consult usual treatment method) in consultation center. They filled "Distance and Isolation Questionnaire" and "Gottmann Love and Respect Scale" at baseline, post treatment and three months after intervention as follow up all of them. General linear Model with Repeated Measurements was used to analyze the data. Results: In this study, scores of mutual love and respect in marital relationship (Gottmann scale) and scores in Flooding, Loneliness and Retreatment subscales of Distance and Isolation Questionnaire had a better condition in IRT group just after the trial (P<0.05) but after three months, the differences between two groups were only marginal significant (P<0.1). In Parallel lives` subscale, scores were decreased in two groups, but right after trial there was not significant scores of the groups did not difference between scores. Scores after three months in IRT group was significantly lower in compare to control group. Scores of CBCL have not statistically significant differences in both groups at any time (P>0.05). Conclusion: This study revealed couple dialogue technique was an effective intervention in solving marital conflicts in Iranian population but had not a significant effect on children’s behavioral profile. This may be due to other factors or insufficient duration of intervention and needs more investigation and needs more investigation.

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Background: Pain is an unpleasant feeling which humans experience. It is a warning sign of the damaged tissue. Due to the awful sense of pain, scientists always attempt to relieve it. Retinoic acid (RT), an active metabolite of natural vitamin A has important roles in modulation of the inflammatory responses. The aim of the present study was to analyze the pain threshold of rats which had microinjections of RT, applying acute and chronic models. Methods and Materials: In this study, the tail flick and formalin tests were used to determine pain threshold. In each test, the acute and chronic pain thresholds of 252 Wistar male rats (275 ± 25 gr) were assayed. The druge were injected in the acute model one-dose30 minutes before behavioral testing and in chronic model two-dose for one or two-weeks. The rats of both models divided randomly into six groups (n=7). In four treatment groups retinoic acid (RT) intra cerebro ventricular (i.C.V) were injected as dosagc of 0.5, 3 and 6 (µg/kg) micrograms per kilogram. In control group, was microinjected by ACSF. In vehicle group injected RT solvent (DMSO+ Distil water). Results: The resuits Showed acute injection of RT did not change pain thresholds in the tail-flick methd, but the chronic administration of RT (0.5, 1, 3, 6 µg/kg) reduced tail-flick latencies of the rats (p<0.05) in compare to DMSO group. The threshold of pain in the first phase of formalin test was reduced after injection of 3µg/kg of RT for two weeks. Conclusion: It was concluded that chronic i.c.v. injections of RT can induce significant hyperalgesia in rat.

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Background: Radiotherapy is one of the cancer treatment methods. Prescribed dose for each fraction is considered based on radiosensitivity of tumoral and normal tissues. Viral agents are the effiectiv factors on tissue sensitivity. This research aimed to determine the effect of ionizing radiation of Cobal 60 on radiosensitivity of Hela cells infected with Measles virus. Methods and Materials: In this study, the radiosensitivity of Hela cells is investigated experimentally and qualitively. The cells have been cultivated in two groups (experimental and blank) and plating efficiency has been obtained. Then 100λ measles virus with serial dilution method was used to induce infection in different ratio for experimental group. After cell growth and passage, the two groups were irradiated with 2Gy gamma radiation of cobalt 60. Results: Results respectively indicated cell death increases up to 5-7%, 15-20% and 50-65%, after 2Gy irradiation by Co 60 for contaminating to Measles in low, moderate and high concentrations. Conclusion: Radiosensitivity of tumoral cells increases when they are infected by viral agent. The result in radiotherapy of cancers showed, in prescribing dose fraction non cancer disease should be considered.

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Background: There are citrullin peptides in Rheumatoid Arthritis (RA) patients that are changed by Peptidyl Arginine Deiminase enzymes (encoded by PADI genes). An association between RA and PADI-4 haplotypes has been reported by researchers. The aim of this study is evaluation of PADI-4 Gene polymorphism in patient with Rheumatoid Arthritis referring. Methods and Materials: In this cross-sectional study we extracted the genomic DNAs from the whole blood samples of 50 patients with RA ( on the basis of ACR criteria) referring to Emam Reza hospital in Mashhad and a control group involving 50 healthy khorrasanian participants. DNA genom was extracted with nonenzymatic salting out method. Genotypes were determined by PCR simple sequence specific primers (PCR-SSP). Data were analyzed with Chi-Square and Fisherexact Test. Results: 58% of the patients had genotypes of 1and 2 38%: 1,4, 2%: 1b,2 ,and 2%: 2,4 .In the control group, 72% had genotype 1,2 22%: 1 and 4, 6%: 1b,2 while none of them had genotype 2,4. Conclusion: There was not any significant relationship between the presence of different PADI-4 genotypes and RA in Khorrasanian population

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Abstract Background: Fetal Cerebrospinal fluid (CSF) develops viability and proliferation of nerve cells. Also this fluid contains many valuable factors for protection of nervous system injury cells. In this research, the effect of cerebrospinal fluid intraperitoneal injection on alpha motor degeneration after sciatic nerve compression in rat was determined. Materials and Methods: In this experimental-laboratory study, 18 male Wistar rats divided randomly in 3 groups (control, compression, and experimental). In compression and experimental group, right sciatic nerves were highly compressed. CSF was injected in experimental group each three days. After 1 month care, all rats were cordially perused by 10% formaldehyde and their L4-L6 lumbar segments of spinal cord were sampled and with processed for histological examination, the paraffin blocks were serially cut (7mm). Slices were stained with toluidine blue and numerical densities of motoneurons in spinal ventral horn were estimated stereological (dissector) technique. Quantitative data were analyzed by T-test. Results: Significant reduce in motoneurons number of compression group (47026) in comparison with control group (173978) was seen. Also there was significant difference between compression and experimental groups (992±141) in neuron density. Conclusion: CSF intraperitoneal injection may have a beneficial effect in neural regeneration.