Factors influencing sperm retrieval following testicular sperm extraction in nonobstructive azoospermia patients / 대한생식의학회지

OBJECTIVE: Azoospermia owing to testicular disorders is the most severe manifestation of male infertility. The main concern for patients with nonobstructive azoospermia (NOA) is the probability of successful sperm retrieval following testicular sperm extraction (TESE). Therefore, the goal of this study was to determine predictive factors correlated with sperm retrieval. METHODS: We assessed the testicular histopathological patterns, the choice of TESE surgical procedure, hormone levels, and chromosomal abnormalities in patients with NOA (n=170). The histopathology specimens were analyzed based on the histopathological patterns of hypospermatogenesis, maturation arrest, and Sertoli cell-only syndrome. RESULTS: The mean rate of sperm retrieval was 48.8%. The rate of sperm retrieval was significantly higher in the hypospermatogenesis group than in the other groups (p<0.001). There was a positive correlation between micro-TESE (vs. conventional TESE) and the sperm retrieval rate (odds ratio, 8.077; p<0.01). A logistic regression model demonstrated that high levels of follicle-stimulating hormone (FSH) and small testicular volume were significantly associated with lower chances of successful sperm retrieval. CONCLUSION: Some parameters, including testicular histopathology patterns, FSH levels, testicular volume, and method of TESE surgery, may be able to predict the chances of obtaining spermatozoa in patients with NOA. However, despite the efficiency of some predictive models, the hope of retrieving any functioning spermatozoa may be sufficient to disregard predictive factors of the success of intracytoplasmic sperm injection in these patients.

Th1, Th2 and Th17 cytokine profile in patients with multiple sclerosis following treatment with rapamycin

Background: Management of multiple sclerosis [MS] is based on the usage of immunosuppressive and immune-modulating medications. Cytokines play an important role in the pathogenesis of MS

Objective: To evaluate the effects of rapamycin on the concentrations of Th1/Th2/Th17 serum cytokines in patients with MS

Methods: Six patients with relapsing remitting MS as a case group and 6 healthy individuals as a control group were enrolled. The patients have been receiving 2 mg rapamycin daily for 6 months. The individuals in control group received nothing during 6 months of the experiment. Enzyme linked immunosorbent assay [Simultaneous Multi-Analyte ELISA] technique was used for determination of serum concentrations of IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-13, IL-17, IFN-gamma, TNF-alpha, G-CSF and TGF-beta before and after therapy with rapamycin

Results: The mean absorbance of 10 out of the 12 studied cytokines showed reduction after the therapy with rapamycin including IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-13, IL-17, IFN-gamma and TNF-alpha. The only statistically significant reduction was observed in the absorbance of IFN-gamma [p=0.028]. Two cytokines illustrated increase in the patients sera after the therapy, including G-CSF and TGF-beta, but only increase in TGF-beta was statistically significant [p=0.046]. None of the studied cytokines in the control group varied significantly after 6 months

Conclusion: Based on the findings of this study, rapamycin has some immunosuppressive effects, such as decreasing IFN-gamma, which can improve the quality of life of the patients with multiple sclerosis. Also the increased level of TGF-beta may also have benefits on the disease, which needs further clinical studies

Prevalence of parasomnia in school aged children in Tehran

Parasomnias can create sleep disruption; in this article we assessed parasomnias in school-aged children in Tehran. In spring 2005, a total of 6000 sleep questionnaires were distributed to school-aged children in 5 districts of Tehran [Iran]. A modified Pediatrics sleep questionnaire with 34 questions was used. Parasomnias varied from 0.5% to 5.7% among the subjects as follows: 2.7% sleep talking, 0.5% sleepwalking, 5.7% bruxism, 2.3% enuresis, and nightmare 4%. A group of children showed parasomnias occasionally- this was 13.1% for sleep talking, 1.4% for sleepwalking, 10.6% for bruxism, 3.1% for enuresis and 18.4% for nightmares. A high proportion of children starting school suffer from sleep problems. In many cases this is a temporary, developmentally related phenomenon, but in 6% of the children the disorder is more serious and may be connected with various stress factors and further behavioral disturbances

Study of glucose-6-phosphate dehydrogenese [G6PD] gene mutations in deficient patients of Fars and Esfahan provinces

Glucose-6-phosphate dehydrogenase [G6PD] deficiency is the most common human enzyme defect, being present in more than 400 million people worldwide. The aim of this study was the molecular analysis of common G6PD mutations, including Mediterranean, Chatham, Cosenza and A-[G202A/A367G] in the patient with favism in Fars and Esfahan provinces. In this basic study, 96 non-relative patients with G6PD deficiency [34 from Fars and 62 from Esfahan province] were studied. Genomic DNA was analyzed by PCR-RFLP and product electrophoresis method for known mutations such as Mediterranean [C-T] nt, Chatham, Cosenza and A202 [G-A]/367 [A-G] mutation. Of 96 samples, 79 [82.3%] and 8 [8.3%] had G6PD Mediterranean and G6PD Chatham, respectively. None of the samples had Cosenza and A-[G202A/A367G] mutation. This study showed that G6PD Mediterranean is the most prevalent mutation in Iran

BCL-2 associated athanogene-1 overexpression in diffuse large B-cell lymphoma

Apoptosis and cell cycle regulation play an important role in pathogenesis and tumor progression in patients with Diffuse Large B-Cell Lymphoma [DLBCL]. Bcl-2 associated athanogene-l [BAG-1] is an antiapoptotic protein as well as a regulator of cell growth. There is no conclusive evidence about BAG-i protein expression in this disease. To investigate the expression level of BAG-i protein in DLBCL. Methods: Thirty patients diagnosed from 1997-2004, as having DLBCL, were selected. Also 30 normal lymph nodes were included as normal counterparts in this study. BAG- 1 expression was determined by inmiunohistochemical staining in both DLBCL and normal lymph node samples. Of the 30 DLBCLs examined, 100% were positive for nuclear and 83% were positive for cytoplasmic BAG-1 staining. Of the 30 normal lymph nodes investigated, 20% were positive for nuclear and 0% were positive for cytopiasmic BAG-1 staining. Nuclear staining in DLBCL samples was significantly higher than those of normal lymph nodes [100% versus 20%, p < 0.001]. Besides, cytoplasmic staining in DLBCL samples was significantly higher than those of normal lymph nodes [83% versus 0%, p < 0.001]. There was no association between BAG-i staining and patients' overall survival. Our data indicated that BAG-i protein was deregulated in this disease similar to some other malignancies such as breast and colon cancer. Overexpression of BAG-I in DLBCL suggests that this protein probably plays an important role in the pathogenesis of DLBCL. Besides, higher nuclear BAG-1 staining might be correlated with poor prognosis

Relationship between Brucella immunocomplex and glomerulopathies

Brucellosis is a zoonotic disease with a very wide spectrum of clinical findings. Brucellosis is about 10 times more prevalent in patients with renal failure [dialysis patients] compared to population background. Precipitation of immunocomplexes produced by brucellosis is important in causing glomerulonephritis. Because the hallmark of glomerular diseases is abnormal protein loss in the urine we have decided to study proteinuria in brucellosis immunocomplex. The aim of this study was to evaluate probable relationship between brucellosis and glomerulonephritis. This cross sectional study, performed on 200 patients with a history of the disease for about 1 year, diagnosed as having chronic brucellosis. The diagnosis was confirmed in 150 patients and by applying Brucella Standard Agglutination Test [SAT] and 2-mercaptoethanol test [2-ME]. Titers of IgG/IgM and IgG/IgA in two groups of "with proteinuria" and "without proteinuria" was measured. Both SAT and 2-ME tests test demonstrated that proteinuria increases with rising antibodies titers. In SAT, titer 1/160 was the most frequent, observed in 44% of the patients. In 2-ME test 1/40 titer was observed in 44% of the patients and was the most frequent. Our results clearly demonstrated that in both chronic and acute patients, proteinuria increases with rising IgG/IgA and IgM/IgG titers. Therefore brucellosis can cause nephropathy but chronic or untreated brucellosis is more important because it can permanently damage kidney

qualitative study of psychiatrists' view about a pilot objective structured clinical examination [OSCE] in Iran

In Aug 2004, for the first time, a psychiatric OSCE was piloted in Iran. The objective of current study was to explore the view and opinion of both candidates and examiners after they took part in the exam. Two focus groups were formed. There were 10 participants in each group. Each group was asked to discuss the advantages and disadvantages of the OSCE. The discussion was tape recorded and then converted into a script before being analyzed. Standard format of the exam and its unbiased evaluation of candidates' abilities were reported as the most significant advantages of OSCE. However, participants criticized the artificiality of the setting and use of simulated patients. Although expensive and time consuming to organize, OSCE was viewed as a standard and fair method of assessing candidates' skills. To overcome the artificiality of the setting, participants asked for a better training of the actors and actresses

Prevalence of cigarette smoking in Tehran: a household study

Cigarette smoking is a highly addictive behavior and nicotine dependence is a well known model for drug dependence. It also acts as a gateway drug for the use of other illicit substances. In 1999, Iran Ministry of health and the national research center carried out a study which revealed that 11.9% of Iranian population use cigarette. The present study is a cross-sectional household survey which was carried out in 2004.The target population of this study consisted of residents [age>15] of the sixth district of the municipality of Tehran. The sample was selected through multistage stratification and systematic randomization [n= 2705]. Data was gathered using face-to-face interviews. Our study showed that 540 [19.9%] subjects reported regular use of cigarette sometimes in their life. Three hundred and eighty one [14.1%] reported that they were current smokers. The Prevalence of smoking and the mean number of cigarette smoked daily were lower in women compared to men. About seventy four percent of the smokers reported that they smoked their first cigarette before the age of 25. Only 7.8% reported that they started smoking after the age of 35. The self-reported lifelong prevalence and the prevalence of current smoking are much lower in Iran compared to many other Middle East countries. Moreover, according to the findings of this study, the number of attempts to quit smoking in Iran is lower than the reported rate in other countries of the region

[Frequency of patterns of obsessive - compulsive symptoms]

Since the obsessive compulsive symptoms have cultural themes, understanding their frequency and variety in our society can help with more diagnosing it more precisely and setting clearer therapeutic goals. In a cross-sectional research, 61 patients with obsessive - compulsive disorder [23 males, 38 females] were selected by convenience sampling, and diversity and severity of their symptoms were measured using Yale - Brown scale. Subjects were clients at Tohid psychiatry and counseling center, and a private office, and the diagnoses were made by a psychiatrist [based on DSM-IV-IR]. This study showed that the obsessive thought mostly included contamination and aggregation, and contamination was significantly different in men and women. Compulsions were mostly checking and washing, with marked difference between the genders. There was a significant association between level of education and of contamination and somatic obsessions. Single and married patients were different only in contamination and counting significantly. Patients with obsessive - compulsive disorder have distinction symptomatologic and demographic features, but can be explained cultural varieties. This has major diagnostic and clinical implications in obsessive - compulsive disorder

[Prevalence of depression in hemodialysis patients of Shahid Hashemi Nejad Hospital]

Objective: The purpose of this research was to determine the prevalence of depression in patients undergoing hemodialysis and also to prevent and treat depression by clarifying the risk factors for these patients

Method: 60 patients [21 men, 39 women] who had undergone hemodialysis were selected as the subjects of the study by convenient sampling. A demo-graphic questionnaire and Beck Depression Inventory were used to collect data the results were then analyzed by c2 statistical test

Findings: In this study, 50% of the subjects were afflicted with depression of which, 33.3% suffered from mild depression, 15% from moderate depression, and 1.7% suffered from severe depression. There was no significant difference between the two groups of depressed and non depressed patients across gender, age, marital status, and duration of dialysis factors. There was however a negative correlation noted between the level of education and depression

Results: Considering the high prevalence of depression, attending to the mental health of dialysis patients is indispensable in the area of depression. Specific plans need to be executed to prevent and treat their depression