Downregulation of extracellular matrix and cell adhesion molecules in cumulus cells of infertile polycystic ovary syndrome women with and without insulin resistance

Objective: The extracellular matrix [ECM] of the cumulus oocyte complex [COC] is composed of several molecules that have different roles during follicle development. This study aims to explore gene expression profiles for ECM and cell adhesion molecules in the cumulus cells of polycystic ovary syndrome [PCOS] patients based on their insulin sensitivity following controlled ovarian stimulation [COS]

Materials and Methods: In this prospective case-control study enrolled 23 women less than 36 years of age who participated in an intracytoplasmic sperm injection [ICSI] program. Patients were subdivided into 3 groups: control [n=8, fertile women with male infertility history], insulin resistant [IR] PCOS [n=7], and insulin sensitive [IS] PCOS [n=8]. We compared 84 ECM component and adhesion molecule gene expressions by quantitative real-time polymerase chain reaction array [qPCR-array] among the groups

Results: We noted that 21 of the 84 studied genes differentially expressed among the groups, from which 18 of these genes downregulated. Overall, comparison of PCOS cases with controls showed downregulation of extracellular matrix protein 1 [ECM1]; catenin [cadherin-associated protein], alpha 1 [CTNNA1]; integrin, alpha 5 [ITGA5]; laminin, alpha 3 [LAMA3]; laminin, beta 1 [LAMB1]; fibronectin 1 [FN1]; and integrin, alpha 7 [ITGA7]. In the IS group, there was upregulation of ADAM metallopeptidase with thrombospondin type 1 motif, 8 [ADAMTS8] and neural cell adhesion molecule 1 [NCAM1] compared with the controls [P<0.05]

Conclusion: Downregulation of ECM and cell adhesion molecules seem to be related to PCOS. Gene expression profile alterations in cumulus cells from both the IS and IR groups of PCOS patients seems to be involved in the composition and regulation of ECM during the ovulation process. This study highlights the association of ECM gene alteration as a viewpoint for additional understanding of the etiology of PCOS

Comparative in vitro evaluation of human dental pulp and follicle stem cell commitment

Objective: Pulp and periodontal tissues are well-known sources of mesenchymal stem cells [MSCs] that provide a promising place in tissue engineering and regenerative medicine. The molecular mechanisms underlying commitment and differentiation of dental stem cells that originate from different dental tissues are not fully understood. In this study, we have compared the expression levels of pluripotency factors along with immunological and developmentally-related markers in the culture of human dental pulp stem cells [hDPSCs], human dental follicle stem cells [hDFSCs], and human embryonic stem cells [hESCs]

Materials and Methods: In this experimental study, isolated human dental stem cells were investigated using quantitative polymerase chain reaction [qPCR], immunostaining, and fluorescence-activated cell sorting [FACS]. Additionally, we conducted gene ontology [GO] analysis of differentially expressed genes and compared them between dental stem cells and pluripotent stem cells

Results: The results demonstrated that pluripotency [OCT4 and SOX2] and immunological [IL-6 and TLR4] factors had higher expressions in hDFSCs, with the exception of the JAGGED-1/NOTCH1 ratio, c-MYC and NESTIN which expressed more in hDPSCs. Immunostaining of OCT4, SOX2 and c-MYC showed cytoplasmic and nucleus localization in both groups at similar passages. GO analysis showed that the majority of hDFSCs and hDPSCs populations were in the synthesis [S] and mitosis [M] phases of the cell cycle, respectively

Conclusion: This study showed different status of heterogeneous hDPSCs and hDFSCs in terms of stemness, differentiation fate, and cell cycle phases. Therefore, the different behaviors of dental stem cells should be considered based on clinical treatment variations

Oral chloral hydrate compare with rectal thiopental in pediatric procedural sedation and analgesia; a randomized clinical trial

The increasing use of diagnostic imaging in pediatric medicine has resulted in growing need for procedural sedation and analgesia [PSA] to minimize motion artifacts during procedures. The drug of choice in pediatric PSA was not introduced until now. The aim of the present study was comparison of oral chloral hydrate [OCH] and rectal sodium thiopental [RST] in pediatric PSA. In the present randomized clinical trial, 2-6 years old pediatrics who referred for performing brain computed tomography scan was enrolled and were randomly divided in to two groups. OCH [50mg/kg] and RST [25mg/kg] were prescribed and a trained nurse recorded the time from drug prescription to receiving the conscious sedation [onset of action], the total period which the patient has the Ramsay score>/=4 [duration of action], and adverse effect of agents. Mann-Whitney U test and chi-squared test, and Non-parametric analysis of covariance [ANCOVA] were used for comparisons. One hundred and forty children were entered to two groups of OCH and RST, randomly. The patients of two groups had similar age, sex, weight, and baseline vital signs except for diastolic blood pressure [p<0.001]. The onset of action in OCH and RST groups were 24.5 +/- 6.1and 28.7 +/- 5.2 minutes, respectively [p<0.001]. Duration of action in OCH and RST groups were 12.9 +/- 2.8 minutes and 13.7 +/- 2.6 minutes, respectively [p=0.085]. Non-parametric ANCOVA revealed that only diastolic blood pressure was affected by drug prescription [p=0.001]. In 11[15.7%] patients in RST group, diarrhea was observed during 24 hours [p=0.001]. Oxygen desaturation was observed only in two patients, both in OCH group. Each of the sedative has advantages and disadvantages that should be considered when selecting one for inducing short-term sedation. It seems that rectal sodium thiopental and oral chloral hydrate are equally effective in pediatric PSA and based on patient's condition we can administrate one of these agents

novel method for salvage of malfunctioning peritoneal dialysis catheter

Continuous ambulatory peritoneal dialysis [CAPD] has been widely used as an effective therapy in the management of patients with end-stage renal disease. Long-term use of CAPD needs methods with low incidence of catheter-related complications. Moreover, some complications may cause failure of fluid drainage and treatment interruption. We have innovated and studied a new minimal-invasive method of malfunctioning peritoneal catheter repair. Thirty-five patients agreed to undergo catheter rescue operation by this new method during 2004 and 2012. Under local anesthesia and light sedation, access to the abdominal cavity was made, the catheter and wrapped omentum grasped and the tip of catheter was released, debris were removed and the catheter was directed toward the pelvic floor with a finger guide. The patients were followed after catheter salvage up to the end of study [April 2012]. PD catheter function restored to the normal level in 28 [80%] of patients, and PD was started 1-2 days after the procedure. All patients had an uneventful recovery. PD catheter function was restored to the normal level in 28 [80%] patients, and PD was started 1-2 days after the procedure. Of these patients, 10 [35%] died of reasons unrelated to catheter or catheter complications; 7 [25%] were ultimately referred for kidney transplant; 8 [29%] continued PD up to the end of this study with no problem, and only 3 [11%] due to catheter complications. Catheter function did not restore to the normal level in seven patients [20%]; however, six patients continued PD for 1-18 months with the catheter. Comparing the advantages and disadvantages of this method to the previous laparoscopically repaired catheter, we concluded that this new method is efficient, and is a suitable way for malfunctioning PD catheter salvage

Topical ocular anesthetic abuse among Iranian welders: time for action

The purpose of this study is to estimate the prevalence of topical ocular anesthetic abuse among welders in Iran and suggest public health solutions for this issue In this cross-sectional study, 390 welders were randomly recruited and queried on the use of anesthetic drops. A questionnaire was administered through structured one-on-one interviews conducted by the first author. A total of 314 welders [80.5%] declared that they had used topical anesthetics at least once during their working lives. Almost 90% of them stated a preference for self-treatment over seeking help from a physician due to cultural and financial reasons. The most commonly used topical anesthetic was tetracaine. Most of the subjects [97.4%] had obtained the drugs from pharmacies without a prescription The prevalence of topical ocular anesthetic abuse among welders in Iran is alarmingly high and may partially be due to cultural issues. Although most physicians are aware that topical anesthetics should only be used as a diagnostic tool, there is a crucial need to re-emphasize the ocular risks associated with chronic use of these medications. Educational programs for both physicians and the public are necessary to address the problem

Visual fitness of public vehicle drivers in southeast of Iran

Although visual impairment of drivers is a very important risk factor for car accident, a few published papers have explored this issue in Iran. This study aims to evaluate the visual fitness of public vehicle drivers in Kerman province, southeast of Iran. A total of 4,003 public vehicle drivers were examined by one ophthalmologist for visual fitness in Kerman province between January 2009 and June 2010. Data are presented as Mean +/- SD or percentage, and with 95% confidence intervals [CIs]. Pearson Chi-square and McNemmar tests along with crude odds ratio [OR] were used to compare vision deficit between groups. Almost 361 drivers [9.0%; 95% CI: 8.1-9.9] had insufficient vision to drive public vehicles before the refractive errors [RE] correction and this number, was reduced to 68 drivers [1.7%; 95% CI: 1.3-2.1] after the correction. A number of them including 200 drivers [5.0%; 95% CI: 4.3-5.7] had insufficient vision to drive personal vehicles before the correction and this was reduced to 30 thereafter [0.8%; 95% CI: 0.5-1.0]. We also found out that the vision status got worse with aging, and RE was the most prevalent cause of sight defects. It seems that visual fitness of public vehicle drivers is a point of real concerns which might somewhat explain the high rate of car accidents in Iran

Outcomes of fasciotomy in patients with crush-induced acute kidney injury after Bam earthquake

Fasciotomy may increase the morbidity and mortality in patients with crush-induced acute kidney injury [AKI], by creating an open wound, increasing the risk of bleeding, coagulopathy, and potentially fatal sepsis. This study evaluates the outcomes of fasciotomy in these patients after Bam earthquake in Iran. We reviewed medical records of victims of Bam earthquake complicated with crush-induced AKI. Demographic, biochemical, and clinical data of patients who underwent fasciotomy were evaluated and compared with other patients with AKI. Fasciotomy was performed for 70 of 200 patients with crush-induced AKI [35.0%]. There were no significant differences regarding sex, age, time under the rubble, and muscle enzymes level between these patients and those without fasciotomy. They did not experience higher rates of disseminated intravascular coagulopathy, sepsis, adult respiratory distress syndrome, amputation, and dialysis session. Neither did they have a longer hospitalization period or higher death rate. This study showed that fasciotomy did not have any deteriorating effect on morbidity and mortality of patients with crush-induced AKI after Bam earthquake

[Effect of insulin on local and tissue ace activity in diabetic rats]

Background: the precise mechanisms of vascular diseases in insulin dependent diabetes mellitus [IDDM] are not clearly understood. There are evidences of alteration in mechanisms involved in regulating vascular tone including increased ACE activity in some tissues. To investigate the effect of insulin treatment on these changes this study was performed

Methods: three groups of 8 male Sprauge Dawely rats including control [C] and two diabetic groups [D, IT] were used in this study. Diabetes was induced by injection of 60 mg/kg STZ ip. After induction of diabetes IT group were treated with insulin [10 units/kg/day s.c.] for four weeks. The control group and the untreated diabetic group were treated with the same amount of Saline and for the same time. ACE activity was determined by HPLC method

Results: 4 weeks after induction of diabetes, SBP and ACE activity in serum, lung, heart and aorta increased in D group compared to control rats. Insulin treatment reversed these changes to normal values in IT group

Conclusion: it is concluded that increased ACE activity could contribute to the development of diabetic vasculopathy and ACE reducing activity of insulin may be partially involved in decrease of cardiovascular complications in diabetes