Living in Pain and Stigma: A Look at Lived Experiences of Mothers with Transsexual Adult Children / 정신간호학회지

Purpose@#A mother whose child wants to undergo gender transitioning may have different and even challenging experiences. These challenges are much more intense in the Middle East and Muslim countries than west countries, which are very conservative towards changes. This study aimed to explore lived experiences of mothers with transsexual adult children. @*Methods@#This qualitative study was conducted using a descriptive phenomenological approach. Data were collected through semi-structured interviews with 17 mothers with transsexual adult children in 2021 from cities of Iran. Collected data were analyzed using Colaizzi's seven-step method. @*Results@#Data analysis revealed that lived experiences of mothers could be divided into five main themes: “mother’s negative and painful feelings”, “mother’s concerns about the future of the child”, and “Frustration in the face of negative and malicious reactions from family and intimate people”, “social stigma”, and “lack of professional and government support”.DiscussionFindings of this study suggest that unawareness and inadequate information about transsexualism and gender change could cause fear, shame, and confusion in mothers with transsexual adult children. Non-governmental organizations and support associations in countries that are religiously conservative can serve as centers for informing the public and increasing their awareness.

Da Vinci SP radical prostatectomy: a multicentric collaboration and step-by-step techniques

ABSTRACT Introduction Several techniques of robotic-assisted radical prostatectomy (RARP) using the da Vinci SP (SP) have been described since its clearance by the FDA (Food and Drug Administration) in 2018 ( 1 , 2 ). Even with the expanding literature about this robot, the SP technology has been restricted to a few centers in the US and Asia due to the recent release of this robot in the marked.3 In this scenario, we provided, in this video compilation, a consensus of SP referral centers describing the current approaches and techniques of da Vinci SP Radical prostatectomy (SP-RARP). Surgical Technique We have illustrated five different techniques, including transperitoneal, extraperitoneal, Retzius-sparing, transvesical, and transperineal ( 4 - 6 ). Each surgery demonstrated crucial steps from the trocar placement until anastomosis. All approaches follow anatomic concepts and landmarks to minimize positive surgical margins, optimize oncological outcomes and promote optimal functional recovery. The trocar placement and the use of an assistant port were selected according to the operative technique of each institution. None of these surgeries had intra- or postoperative complications, and the pain management until discharge was controlled without using narcotics. All patients were discharged in less than 16 hours of surgery. Conclusion Robotic-assisted radical prostatectomy performed with the da Vinci SP is feasible and safe with optimal perioperative outcomes. Five different approaches were described in this video compilation, and we believe that the technical details provided by this multicentric collaboration are crucial for centers willing to initiate the SP approach to radical prostatectomy.

Contemporary techniques of da Vinci SP radical prostatectomy: multicentric collaboration and expert opinion

ABSTRACT Background The da Vinci SP robot consists of an innovative single port trocar that houses a flexible camera and three biarticulated arms, which minimizes the number of incisions to assess the surgical site, allowing a less invasive procedure. However, due to its recent release in the market, the current literature reporting SP-RARP is still restricted to a few centers. In this scenario, after performing a literature search with all available techniques of SP-RARP, our objective is to report a multicentric opinion of referral centers on different techniques to approach SP-RARP. Results The SP literature is provided by only a few centers due to the limited number of this new console in the market. Five different approaches are available: transperitoneal, extraperitoneal, Retzius-Sparing, transperineal and transvesical. None of the current studies describe long-term functional or oncological outcomes. However, all approaches had satisfactory operative performance with minimum complication rates. Conclusions Several techniques of SP-RARP have been reported in the literature. We performed a multicentric collaboration describing and illustrating the most challenging steps of this surgery. We believe that the details provided in this article are useful teaching material for new centers willing to adopt the SP technology.

DNA methylation is involved in the microRNA-886-3p gene expression and plays a potential role in hematopoietic stem and progenitor cell mobilization through affecting SDF-1

The role of the sympathetic nervous system (SNS) in hematopoietic stem and progenitor cell (HSPC) mobilization has been largely investigated. However, there is a critical need for the identification of the underlying contributing factors to improve HSPC yield for transplantation. It has been demonstrated that miR-886-3p targets stromal-derived factor-1 (SDF-1), the central mediator of mobilization, and therefore may play a part in this process. Besides, miR-886-3p expression can be epigenetically regulated through DNA methylation modifications inits gene promoter. Here, to assess the contribution of miR-886-3p and other epigenetic factors in HSPC mobilization, human bone marrow-derived mesenchymal stem cells (MSCs) were treated with the ?-adrenergic agonist of isoprenaline. The expression of miR-886-3p and SDF-1and the gene promoter methylation status of this miRNA were then respectively evaluated through the appropriate PCR techniques. As expected, despite a transient initial increase in SDF-1mRNA level, its expression reduced, and miR-886-3plevel remarkably increased 48 h following treatment. The gene promoter methylation pattern of miR-886-3p also changed from a full methylated state to a partially methylated one. Together, our findings suggest that miR-886-3p can be epigenetically regulated and through suppressing the expression of SDF-1 play an active role in the SNS-mediated HSPC mobilization.

Comparison of Microscopic Endodontic Techniques: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To evaluate the success rates of resin-based endodontic surgery (RES) and endodontic microsurgery (EMS), and compare their results. Material and Methods: A total of 19 and 34 full-text papers were reviewed, and finally, 2 and 6 studies were selected for RES and EMS, respectively. The stages of the study selection process were illustrated in Figure 1. The demographic characteristics were also described using the IBM SPSS Software, and the meta-analysis was fulfilled via Stata V.14. Results: A total number of 811 teeth were analyzed in this systematic review and meta-analysis, with a mean follow-up of 38.63 months. Besides, the results of the meta-analysis indicated that both methods not only differed in terms of implementation but also produced varying outcomes. Accordingly, EMS demonstrated a higher success rate likelihood with a significant difference from that of RES. Conclusion: An excellent proof was made available through this meta-analysis regarding the resin-based endodontic surgery success rate likelihood (79.9%) and an update for the endodontic microsurgery success rate possibility (100%).

Efecto de la tele-enfermería en el mejoramiento de los hallazgos ecográficos de pacientes con enfermedades de hígado graso no alcohólico: Ensayo clínico controlado / Effect of tele-nursing in the improving of the ultrasound findings in patients with nonalcoholic fatty liver diseases: A Randomized Clinical Trial study

Objective. To establish the effect of tele-nursing in the improving of the ultrasound findings in patients with non-alcoholic fatty liver disease. Methods. In this clinical trial, 60 patients with non-alcoholic fatty liver referring to specialized gastroenterology clinics affiliated to Shiraz University of Medical Sciences (Iran) were selected were randomly assigned to control or intervention group. All patients received necessary trainings on diet and physical activity. The subjects in the intervention group were followed up via phone by nurses for 12 weeks (twice a week during the first month and once a week during the following two months). The control group participants did not receive any interventions and were only followed up as usual by a specialist. Before and after the intervention, the liver size and histological status of their liver were examined using ultrasound in all the participants. Results. After 12 weeks of start of the study, the mean of liver size decreased in the group followed up via phone by a nurse (13.15±1.22 cm to 12.90±1.16 cm, p=0.013), but this did not change significantly in the control group (12.55±1.56 cm to 12.56±1.57 cm, p=0.326). The greater difference in the mean liver size between the evaluations was in the intervention group with 0.26±0.53 cm versus -0.003±0.018 cm in the control group (p=0.012). Additionally, the fatty infiltration status of the liver tissue improves in the 66.6% of the intervention group versus 6.6% in the control group (p<0.001). Conclusion. The results of this study showed that tele-nursing led to improvement in liver size and liver histology in patients with Non-alcoholic fatty liver.(AU)

Objetivo. Establecer el efecto de la tele-enfermería en la mejoría de los hallazgos ecográficos en pacientes con hígado graso no alcohólico. Métodos. En este ensayo clínico, 60 pacientes con hígado graso no alcohólico referidos a servicios de Gastroenterología especializada afiliadas a la Universidad de Ciencias médicas de Shiraz (Irán) se dividieron aleatoriamente en los grupos de control y de intervención. Todos los pacientes recibieron capacitaciones sobre aspectos de la dieta y la actividad física. Los pacientes del grupo de intervención tuvieron seguimiento telefónico por enfermera (dos veces a la semana en el primer mes y una vez por semana los otros dos meses), y los del grupo control no recibieron atenciones diferentes a las consultas usuales al especialista. Tanto al ingreso al estudio como a las 12 semanas, a todos los participantes se les evaluó con ultrasonografía el tamaño y el estado histológico del hígado. Resultados. Después de 12 semanas de inicio del estudio decreció el tamaño del hígado en el grupo con seguimiento telefónico por enfermera (13.15±1.22 cm a 12.90±1.16 cm, p=0.013), mientras que no se observó diferencia significante en el grupo control (12.55 1.56 cm a 12.56±1.57 cm, p=0.326). La más grande diferencia entre las dos evaluaciones fue en el grupo de intervención con 0.26±0.53 cm versus -0.003±0.018 cm en el grupo control (p=0.012). Adicionalmente, el estado de infiltración grasa del tejido hepático mejoró en el 66.6% del grupo de intervención versus 6.6% en el grupo de control (p<0.001). Conclusión. Los resultados de este estudio mostraron que la tele-enfermería condujo a la mejoría del tamaño de hígado y la histología hepática en pacientes con hígado graso no alcohólico.(AU)

Objetivo. Estabelecer o efeito da tele-enfermagem na melhora das descobertas ecográficos em pacientes com fígado grasso não alcoólico. Métodos. Neste ensaio clínico, 60 pacientes com fígado grasso não alcoólico referidos a serviços de Gastrenterologia especializada afiliadas à Universidade de Ciências médicas de Shiraz (Irão) foram divididos aleatoriamente nos grupos de controle e de intervenção. Todos os pacientes receberam capacitações sobre aspectos da dieta e a atividade física. Os pacientes do grupo de intervenção tiveram seguimento telefónico por enfermeira (duas vezes por semana no primeiro mês e uma vez por semana os outros dois meses), e os do grupo controle não receberam atenções diferentes às consultas usuais ao especialista. A todos os participantes ao ingresso ao estudo e às 12 semanas se lhes avaliou com ultrassonografia o tamanho e o estado histológico do fígado. Resultados. Depois de 12 semanas de início do estudo diminuiu o tamanho do fígado no grupo com seguimento telefónico por enfermeira (13.15±1.22 cm a 12.90±1.16 cm, p=0.013), enquanto que não se observou diferença significante no grupo controle (12.55 1.56 cm a 12.56±1.57 cm, p=0.326). A maior diferença entre as duas avaliações foi no grupo de intervenção com 0.26±0.53 cm versus -0.003±0.018 cm no grupo controle (p=0.012). Adicionalmente, o estado de infiltração grassa do tecido hepático melhorou em 66.6% do grupo de intervenção versus 6.6% no grupo de controle (p<0.001). Conclusão. Os resultados deste estudo mostraram que a tele-enfermagem conduz à melhora do tamanho de fígado e a histologia hepática em pacientes com fígado grasso não alcoólico.(AU)

Altered expression of MALAT1 lncRNA in chronic lymphocytic leukemia patients, correlation with cytogenetic findings

BACKGROUND: Recent studies have devoted much attention to non-protein-coding transcripts in relation to a wide range of malignancies. MALAT1, a long non-coding RNA, has been reported to be associated with cancer progression and prognosis. Thus, we here determined MALAT1 gene expression in chronic lymphocytic leukemia (CLL), a genetically heterogeneous disease, and explored its possible relationships with cytogenetic abnormalities. METHODS: MALAT1 expression level was evaluated using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) on blood mononuclear cells from 30 non-treated CLL patients and 30 matched healthy controls. Cytogenetic abnormalities were determined in patients by fluorescence in situ hybridization (FISH). RESULTS: MALAT1 expression level was up-regulated in the CLL group compared to healthy controls (P=0.008). Del13q14, followed by Del11q22, were the most prevalent cytogenetic abnormalities. We found no association between the FISH results and MALAT1 expression in patients. CONCLUSION: Altered expression of MALAT1 is associated with CLL development. Further investigations are required to assess the relationship between this long non-coding RNA and CLL patient survival and prognosis.

impact of calcium hydroxide on the osteoinductive capacity of demineralized freeze-dried bone allograft: an in-vitro study

Statement of the Problem: A great challenge in periodontal therapy is the regeneration enhancement of osseous defects through applying osteoinductive materials. Demineralized freeze-dried bone allograft [DFDBA] has already been introduced as an allograft with osteoconductive and variable osteoinductive properties. Calcium hydroxide [Ca[OH]2] is an available well-known material in dentistry, which induces hard tissue formation

Purpose: This study evaluated the efficiency of combination of DFDBA and Ca[OH]2 in improving the quality of osteoinduction of DFDBA

Materials and Method: Human bone marrow-derived mesenchymal stem cells were taken from volunteers' iliac crest. Cell proliferation was determined by MTT test at 18, 24 and 48 hours post-culture in 10 groups. The employed material were 0.5, 1.0 mg/ml Ca[OH]2 in two forms of suspension and pH-adjusted solution, 10mg/ml DFDBA per se and in combination with 0.5 and 1.0 mg/ml Ca[OH]2. Mineralization was assessed by Alizarin red staining in 10 mg/ml DFDBA, DFDBA+ 0.5 and 1 mg/ml Ca[OH]2 in solution and suspension forms. The data were statistically analyzed by using one-way ANOVA and Tukey's post-hoc test [p< 0.05]

Results: The pH-adjusted solutions exhibited better cell proliferation compared with the suspension groups. The combination of 0.5mg/ml Ca[OH]2 solution and DFDBA increased the cell proliferation and mineralization compared with DFDBA per se [p= 0.033]

Conclusion: The combination of Ca[OH]2 with DFDBA improved the osteoinductivity of DFDBA

Changes in postharvest physio-biochemical characteristics and antioxidant enzymes activity of cut alsteroemeria aurantiaca flower as affected by cycloheximide, coconut water and 6-benzyladenine / Alterações nas características físico-bioquímicas pós-colheita e atividades de enzimas antioxidantes da flor de alstroemeria aurantiaca cortada como afetada pela cicloheximida, água de coco e 6-benziladenina

Early leaf yellowing in cut alstroemeria (Alstroemeria aurantiaca) flowers before flower development and petal abscission is an important limiting postharvest quality and vase life factors. Early leaf senescence reduces postharvest longevity of cut flowers and promotes petal's wilting. A study was made to evaluate the response of cut alstroemeria flowers at varying concentrations of cycloheximide (CHI) (50, 100 and 200 mg l-1), coconut water (5, 10 and 20%) and 6-benzyladenine (BA) (50, 100 and 200 mg l-1). CHI, coconut water and BA extended the vase life at all concentrations compared to the control, but coconut water at 5% concentration (with 17.39 days) was the most effective treatment. Control cut flowers showed the least vase life (10.76 days). Ethylene production in cut flowers promoted flower senescence. All concentrations of CHI, coconut water and BA delayed ethylene production compared to the control. Treatment of cut flowers with coconut water at concentration of 5% maintained the highest fresh weight of flowers and increased the content of water uptake. The chlorophyll degradation was significantly reduced by the application of CHI, coconut water and BA. The maximum content of membrane's lipid peroxidation and antioxidant enzymes activity (super oxide dismutase and peroxidase) was obtained in control cut flowers. Thus, 5% fresh coconut water has the potential to be applied as vase solution (preservative medium) due to prolongs of cut alstroemeria flowers.

O amarelecimento precoce das folhas em flores de alstroemeria (Alstroemeria aurantiaca) cortadas antes do desenvolvimento floral e da abscisão de pétalas é um importante limitante da qualidade pós-colheita e dos fatores de vida do vaso. A senescência precoce da folha reduz a longevidade pós-colheita das flores cortadas e promove o murchamento da pétala. Um estudo foi realizado para avaliar a resposta de flores de alstroemeria cortadas em diferentes concentrações de cicloheximida (CHI) (50, 100 e 200 mg l-1), água de coco (5, 10 e 20%) e 6-benziladenina (BA) 50, 100 e 200 mg l-1). CHI, água de coco e BA prolongou a vida do vaso em todas as concentrações em comparação com o controle, mas a água de coco a 5% de concentração (com 17,39 dias) foi o tratamento mais eficaz. As flores cortadas de controlo mostraram a menor vida útil do vaso (10,76 dias). A produção de etileno em flores cortadas promoveu a senescência da flor. Todas as concentrações de CHI, água de coco e BA atrasaram a produção de etileno em comparação com o controle. O tratamento de flores cortadas com água de coco a uma concentração de 5% manteve o maior peso fresco de flores e aumentou o conteúdo de absorção de água. A degradação da clorofila foi significativamente reduzida pela aplicação de CHI, água de coco e BA. O teor máximo de atividade de enzimas antioxidantes e de peroxidação lipídica da membrana (super óxido dismutase e peroxidase) foi obtido em flores cortadas de controle. Assim, 5% de água de coco fresca tem potencial para ser aplicada como solução de vaso (meio de conservação) devido a prolongamentos das flores de alstroemeria cortadas.

effect of telenursing on self-efficacy in patients with non-alcoholic fatty liver disease: a randomized controlled clinical trial

Aim: This study aimed to assess the effect of telenursing on nutritional behavior and physical activity self-efficacy in patients with non-alcoholic fatty liver disease [NAFLD]

Background: NAFLD is the most common liver disorder, which has a chronic course. Therefore, routine monitoring of these patients by medical staff helps them actively participate in the healing process and promote their self-efficacy

Methods: In this randomized controlled clinical trial, 60 patients were chosen through convenience sampling among patients with NAFLD. After obtaining written informed consents, the participants were randomly divided into an intervention and a control group [each containing 30 subjects]. The participants received diet consultation individually and were taught how to perform physical activities. Telephone intervention was conducted in the intervention group for 12 weeks. The study questionnaires were completed by the participants before and after the intervention. The data were analyzed using the SPSS statistical software

Results: Based on the results, the mean score of nutritional behavior and physical activity self-efficacy increased in the study groups after the intervention. This increase was statistically significant only in the intervention group. Additionally, the two groups were significantly different regarding the mean scores of nutritional behavior and physical activity self-efficacy

Conclusion: Telenursing could improve self-efficacy and physical activity in patients with NAFLD

Diagnosis of approximal caries after delayed scanning of photostimulable phosphor plates

Statement of the Problem: Considering the high diagnostic accuracy and wide dynamic range of photostimulable phosphor plates [PSPs], they can be a good alternative for radiographic films

Purpose: This study was aimed to assess the effects of delay in scanning PSPs on the diagnostic accuracy of detection of approximal caries

Materials and Method: Radiographs from fifty-two extracted molar and premolar teeth were radiographed using DIGORA PSP [Soredex Corporation, Helsinki, Finland]

The teeth were either intact or with non-cavitated approximal caries. The plates were scanned immediately [time zero] and at 10 min, 30 min, 60 min and 120 min after exposure. Sixty-five images were obtained and evaluated for presence or absence of approximal caries by two oral and maxillofacial radiologists and 2 restorative specialists. The diagnostic accuracy of approximal caries detection was measured using a 5-point rating scale. Definite presence of caries was confirmed using a stereomicroscope. Analysis of caries detection data was performed by calculating sensitivity and specificity using repeated measures with ANOVA

Results: Significant differences were found in complete negative predictive value, absolute negative predictive value and complete dentine sensitivity value between different scan times [p< 0.05]

These values were significantly different at 10 min, 60 min and 120 min [p< 0.05]

However, immediate scan and 30 min delay were not significantly different [p> 0.05]

The accuracy of approximal caries detection at 120 min was less than at 60 min and at 60 min was less than at 30 min. Conclusion: In order to detect approximal caries more accurately, DIGORA PSPs should be scanned within 30 min after exposure

effect of follow up [telenursing] on liver enzymes in patients with nonalcoholic fatty liver disease: a randomized controlled clinical trial

Background: non-alcoholic fatty liver disease [NAFLD] is characterized by macro vesicular steatosis in the absence of alcohol. Patients with [NAFLD]need extensive education and support in their treatment. Our aim was to investigate the effect of telenursing on liver enzymes [ALT and AST] in patients with NAFLD

Methods: our study is a randomized controlled clinical trial. In this study, 60 patients were enrolled from patients who referred to subspecialty gastrointestinal clinics affiliated to Shiraz University of Medical Sciences. Specialists confirmed their diseases by ultrasound and laboratory test. Simple randomization, based on random number table, was used to randomize the participants into intervention [N=30] and control [N=30] groups. Patients in both groups received dietary advice from a nutritionist and were trained to perform physical activities. Telephone intervention in the intervention group lasted for 12 weeks, in order to see the effect of follow up on the recommended diet and physical activities given by the specialist, while; the control group subjects were only followed up as usual by their physician

Results: the result of an independent t-test showed that the mean difference of liver Enzymes between the two groups was statistically significant [P<0.001]. The difference of AST and ALT in the intervention and control groups was 18.03, -1.27 and 40.70, 1.52, respectively

Conclusion: we found out that; telenursing could have a positive effect on reduction of liver enzymes [ALT, AST] in patients with NAFLD

Effect of the receptor activator of nuclear factor [ka]B and rank ligand on in vitro differentiation of cord blood CD133[+] hematopoietic stem cells to osteoclasts

Objective: receptor activator of nuclear factor-kappa B ligand [RANKL] appears to be an osteoclast-activating factor, bearing an important role in the pathogenesis of multiple myeloma. Some studies demonstrated that U-266 myeloma cell line and primary myeloma cells expressed RANK and RANKL. It had been reported that the expression of myeloid and monocytoid markers was increased by co-culturing myeloma cells with hematopoietic stem cells [HSCs]. This study also attempted to show the molecular mechanism of RANK and RANKL on differentiation capability of human cord blood HSC to osteoclast, as well as expression of calcitonin receptor [CTR] on cord blood HSC surface

Materials and Methods: in this experimental study, CD133[+] hematopoietic stem cells were isolated from umbilical cord blood and cultured in the presence of macrophage colony-stimulating factor [M-CSF] and RANKL. Osteoclast differentiation was characterized by using tartrate-resistant acid phosphatase [TRAP] staining, giemsa staining, immunophenotyping, and reverse transcription-polymerase chain reaction [RT-PCR] assay for specific genes

Results: hematopoietic stem cells expressed RANK before and after differentiation into osteoclast. Compared to control group, flow cytometric results showed an increased expression of RANK after differentiation. Expression of CTR mRNA showed TRAP reaction was positive in some differentiated cells, including osteoclast cells

Conclusion: presence of RANKL and M-CSF in bone marrow could induce HSCs differentiation into osteoclast

Insight into Microenvironment Remodeling in Pancreatic Endocrine Tissue Engineering: Biological and Biomaterial Approaches

The treatment of diabetes mellitus, as a chronic and complicated disease, is a valuable purpose. Islet transplantation can provide metabolic stability and insulin independence in type 1 diabetes patients. Diet and insulin therapy are only diabetes controllers and cannot remove all of the diabetes complications. Moreover, islet transplantation is more promising treatment than whole pancreas transplantation because of lesser invasive surgical procedure and morbidity and mortality. According to the importance of extracellular matrix for islet viability and function, microenvironment remodeling of pancreatic endocrine tissue can lead to more success in diabetes treatment by pancreatic islets. Production of bioengineered pancreas and remodeling of pancreas extracellular matrix provide essential microenvironment for re-vascularization, re-innervation and signaling cascades triggering. Therefore, islets show better viability and function in these conditions. Researchers conduct various scaffolds with different biomaterials for the improvement of islet viability, function and transplantation outcome. The attention to normal pancreas anatomy, embryology and histology is critical to understand the pancreatic Langerhans islets niche and finally to achieve efficient engineered structure. Therefore, in the present study, the status and components of the islets niche is mentioned and fundamental issues related to the tissue engineering of this structure is considered. The purpose of this review article is summarization of recent progress in the endocrine pancreas tissue engineering and biomaterials and biological aspects of it.

Ultrasound accuracy in determining the tumor depth for boost field radiotherapy in breast cancer in comparison with CT scan plus clips

Background: There are miscellaneous methods of boost field determination with different levels of accuracy. One of the important parameters in boost field planning is the tumor bed depth, as it is important for determining electron energy

Objectives: The purpose of present research was the determination of ultrasound accuracy to estimate the appropriate depth for the tumor bed

Patients and Methods: Patients who were undergone breast conservative surgery with placing of 5 clips in the tumor bed [lower, upper, medial, lateral, and posterior] were included. The depth and location of the tumor bed were determined using ultrasonography. The optimum field boost was planned with an appropriate 2.5 cm margin. After putting the marker on the field boost, the CT simulation was done and then the obtained depth of the ultrasound report and that of the CT scan-clips were compared

Results: Twenty five patients were included. The average depth reported by the ultrasound was about 18 mm +/- 3 mm [range 10-26 mm], and the average obtained from the CT scan-clips was about 48 mm +/- 13 mm [range 24-80 mm], [P Value = 0.001]. In almost all cases, the depth obtained from the ultrasound was less than that obtained from the CT scan- clips

Conclusions: Ultrasound is not an accurate method to determine the appropriate depth and field for determination of breast field boost. Thus, it is better not to use ultrasound to estimate the tumor cavity depth; the CT scan images with surgical clips should be used instead

Thrombin Activatable Fibrinolysis inhibitor Thr 325 Ile polymorphism in fetuses with factor XIII deficient family history and Intracranial hemorrhage

Background: factor XIII Deficiency [FXIIID] is an inherited rare bleeding disorder with some life threatening clinical manifestation including Intracranial Haemorrhage [ICH]. Among all polymorphisms found in FXIIID, Thrombin Activatable Fibrinolysis Inhibitor [TAFI] Thr325Ile gene polymorphism increases probability of ICH about 20 fold in patients with FXIII .So, in this study we aimed to evaluate TAFI Thr 325 Ile polymorphism in Chorionic villus samples [CVS] of fetuses with positive family history of FXIIID and ICH

Materials and Methods: this study was performed on chorionic villus of pregnant mothers ´ with positive history of FXIIID accompanied with ICH in first-degree relatives of their fetus. All parents of the fetuses were completed consent form for doing Prenatal diagnosis [PND]. Chorionic villus DNA was extracted from each sample using the DNA extraction kit and PCR-RFLP was performed for TAFI Thr 325Ile polymorphism in Exon 4 of FXIII A gene

Results: all of 8 fetuses had positive family history of FXIIID. Seven out of eight fetuses [87.5%] had a family member with CNS bleeding due to FXIIID. Four fetuses had history of death due to FXIIID. There were 5 case [62.5%] that were homozygote for TAFI Thr 325 Ile, one [12.5%] was heterozygote and two [25%] were non mutant

Conclusion: detection of TAFI Thr 325 Ile polymorphism by PND program in fetuses with positive family history of ICH is seems necessary and it will help to fill many gaps in preventing life threatening features of FXIIID in newborn at the time of delivery by prophilaxy receiving and precautionary measures

Different methylation patterns of RUNX2, OSX, DLX5 and BSP in osteoblastic differentiation of mesenchymal stem cells

Runt-related transcription factor 2 [RUNX2] and osterix [OSX] as two specific osteoblast transcription factors and distal-less homeobox 5 [DLX5] as a non-specific one are of paramount importance in regulating osteoblast related genes including osteocalcin, bone sialoprotein [BSP], osteopontin and collagen type I?1. The present study sets out to investigate whether epigenetic regulation of these genes is important in osteoblastic differentiation of mesenchymal stem cells [MSCs]. In this experimental study, MSCs were differentiated to osteoblasts under the influence of the osteogenic differentiation medium. DNA and RNA were extracted at days 0, 7, 14 and 21 from MSCs differentiating to osteoblasts. Promoter regions of RUNX2, OSX, DLX5 and BSP were analyzed by methylation-specific PCR [MSP]. Gene expression was analyzed during osteoblastic differentiation by quantitative real-time polymerase chain reaction [PCR]. MSP analysis revealed that promoter methylation status did not change in RUNX2, DLX5 and BSP during MSC osteoblastic differentiation. In contrast, OSX promoter showed a dynamic change in methylation pattern. Moreover, RUNX2, OSX, DLX5 and BSP promoter regions showed three different methylation patterns during MSC differentiation. Gene expression analyses confirmed these results. The results show that in differentiation of MSCs to osteoblasts, epigenetic regulation of OSX may play a leading role

[Evaluation of the energy expenditure during walking in adolescent idiopathic scoliosis patients]

Scoliosis is one of the musculoskeletal disorders which influences the energy expenditure of patients during walking. In previous studies, metabolic cost of walking measured by oxymetry. Therefore, the aim of this study was to evaluate the energy expenditure of walking of the adolescent idiopathic scoliosis patients by use of monitoring the heart rate. This was observational comparative cross sectional study. Ten scoliotic patients and 10 normal subjects with comparable age, height and weight were recruited for this study. Energy consumption of walking in scoliotic and in normal subjects was evaluated using polar Electro Finland heart rate monitor. The heart rate during resting and walking and the walking speed were the parameters used for energy consumption based on the physiological cost index. The energy consumption of scoliotic subjects during walking based on PCI and THBI was higher than that of normal subjects, however, the difference was not statistically significant [p>0.05]. The results of this research showed that there was no significant difference between the PCI and THB index of normal and scoliotic subjects. Moreover, the walking speed of scoliotic patients did not influence by spinal deformation [p>0.05]

efficacy of two intravenous sedative drugs in management of uncooperative children for dental treatments

Statement of the Problem: Some children do not show an appropriate cooperation with their dentist. A number of them cannot be managed by local anesthesia and the usual techniques used to control behaviors, so further steps are required to control their pain and anxiety. Pharmaceutical control is recommended through sedation or general anesthesia

Purpose: This study was aimed to evaluate two groups of drugs in intravenous sedation method

Materials and Method: In this clinical trial intervention study, patients were randomly divided into two groups of 18 and 20 and each group received either intravenous midazolam-ketamine or midazolam-fentanyl. During the procedure, 0.25mg midazolam was administered to both groups if needed. The scores of intraoperative sedation and operation conditions were evaluated and recorded by dental sedation teacher groups [DSTG] system in the 10[th], 20[th], 30[th] and 40[th] minutes of the operation. The results were analyzed by SPSS [version 16] using independent T-test, Wilcoxon, Mann-Whitney and Pearson Chi-Square tests as appropriated

Results: There was no significant difference between the two groups in sedation period [p= 0.55], recovery time [p= 0.18], Frankl score [p= 0.83], score of intraoperative sedation and operating conditions [p> 0.05], and sedation complications [p= 0.612]. In addition, no complication occurred in recovery

Conclusion: There was no significant difference between the two drug groups; both were appropriate in controlling children's behavior

Correlation between methylation and expression level of P15 and P16 genes during differentiation of cord blood stem cells into erythroid lineage mediated by erythropoietin

Several influential factors such as transcription factors and intracellular signaling components are involved in differentiation of stem cells into a specific lineage. P15 and p16 proteins are among these factors. Accumulating evidences has introduced the epigenetic as a master regulator of these factors during lineage specification. The main objective of this study is to determine the correlation between the expression level and methylation pattern of P15 and P16 genes in erythroid lineage after in vitro differentiation by erythropoietin [EPO]. The purified and expanded CD34+ cord blood stem cells were differentiated into erythroid lineage in the presence of EPO. DNA was isolated from both cord blood stem cells and differentiated cells. The Real-Time PCR performed using cDNA and the isolated DNA was used in methylation Specific PCR [MSP] reaction for methylation pattern analysis in both pre and post differentiation stages. The study demonstrated that P15 and P16 genes have partial methylation after erythroid differentiation by EPO. The Expression of P15 gene was higher after differentiation and the expression of P16 gene had a slightly decreased level in post differentiation stage. Significant increase in P15 gene expression after differentiation to erythroid lineage, suggests the remarkable efficacy of this gene in erythroid function. According to upregulation of P15 gene after differentiation despite unchanged methylation status and slight down regulation of P16 gene with slight hyper-methylation of the gene it can be suggested that although the methylation can affects the expression level of P16 gene, the P15 gene is not affected by this mechanism during erythroid differentiation mediated by EPO