Sperm retrieval in patients with klinefelter syndrome: a skewed regression model analysis

Background: The most common chromosomal abnormality due to non-obstructive azoospermia [NOA] is Klinefelter syndrome [KS] which occurs in 1-1.72 out of 500-1000 male infants. The probability of retrieving sperm as the outcome could be asymmetrically different between patients with and without KS, therefore logistic regression analysis is not a well-qualified test for this type of data. This study has been designed to evaluate skewed regression model analysis for data collected from microsurgical testicular sperm extraction [micro-TESE] among azoospermic patients with and without non-mosaic KS syndrome

Materials and Methods: This cohort study compared the micro-TESE outcome between 134 men with classic KS and 537 men with NOA and normal karyotype who were referred to Royan Institute between 2009 and 2011. In addition to our main outcome, which was sperm retrieval, we also used logistic and skewed regression analyses to compare the following demographic and hormonal factors: age, level of follicle stimulating hormone [FSH], luteinizing hormone [LH], and testosterone between the two groups

Results: A comparison of the micro-TESE between the KS and control groups showed a success rate of 28.4% [38/134] for the KS group and 22.2% [119/537] for the control group. In the KS group, a significantly difference [P<0.001] existed between testosterone levels for the successful sperm retrieval group [3.4 +/- 0.48 mg/mL] compared to the unsuccessful sperm retrieval group [2.33 +/- 0.23 mg/mL]. The index for quasi Akaike information criterion [QAIC] had a goodness of fit of 74 for the skewed model which was lower than logistic regression [QAIC=85]

Conclusion: According to the results, skewed regression is more efficient in estimating sperm retrieval success when the data from patients with KS are analyzed. This finding should be investigated by conducting additional studies with different data structures

[ relationship between T CD4[+] cells count and IL-17, IL-11 serum level in idiopathic thrombocytopenic purpura]

Immune Thrombocytopenic Purpura [ITP] is an acquired autoimmune disorder characterized by a low platelet count; because of anti platelet auto-antibodies. ITP patients have auto antibodies against platelet antigens. T CD4[+] lymphocytes are effective cells in immune system that has an important role in auto reactive antibody production and class switching. The pathophisiology and mechanism of ITP is complex and unknown. Numerous studies have difference results about role of T cells in ITP patients. T lymphocytes have been characterized to different subsets. To further investigate about the pathogenesis of ITP, we studied the role of T CD4[+] cells and cytokines attributed with platelet count. Therefore, in this research, we evaluated T CD4[+] lymphocytes count and interleukin 17 [IL-17], interleukin 11 [IL-11] levels in ITP in comparison with control. In a case-control study, we have studied 60 patients with ITP and 50 normal individuals as the control group. Peripheral blood mononuclear cells were isolated by ficoll histopaque 1.077. T CD4[+] cells count in ITP patients and control subjects were studied by flow cytometry method and serum interleukin 17 [IL-17], interleukin 11 [IL-11] concentration were measured by enzyme-linked immunosorbent assay [ELISA] test. All data were expressed as mean +/- SD. Differences between means were considered significant at the P<0.05. Tests were performed using SPSS software version 16. This study showed, T CD4+ cells and plasma IL-17 concentration were not significantly different between patients with ITP and the control group. But plasma IL-11 levels were significantly increased in immune thrombocytopenic purpura patients in comparison with controls [P=0.031]. In summary, our study indicated a role of IL-11 in ITP patients, also showed that ITP may not be associated with changes of plasma IL-17 levels and T CD4[+] cells count relative to control population. Therefore, measurement of plasma IL-11 levels may be important criteria in development of ITP. In addition, it is concluded that determination of IL-11 can be a diagnostic marker to recognize thrombocytopenic purpura patients

[Evaluation of caspase 3 and 9 gene polymorphisms in gastric cancer patients in Mazandaran province: a brief report]

Gastric cancer is the most prevalent cancer with poor survival in gastrointestinal tract. Caspase 3 and 9 play an important role in the development and progression of cancer. Polymorphisms in the genes for these enzymes can affect gene activity and thus may influence susceptibility to gastric cancer. In this study, caspase 3 and 9 genes polymorphisms in patients with gastric cancer were examined. In a case - control study, 100 patients with gastric cancer and 100 healthy individuals were evaluated in the region rs4647601: G> T for caspase-3 and -1263 A> G gene promoter for caspase 9. DNA extraction was performed from whole blood according to manufacture protocol. RFLP-PCR method was carrying out for detection of caspase 3 and 9 genes genotype in two groups. In this study, 143 men and 57 women were evaluated. All of them were selected from the same race and geographical area. The results indicated an increase of the mutant G allele in the control group, which leads to a decreasing in the incidence of gastric cancer [P<0.0001, OR: 0.096, [%0.95CL] =0.04-0.23]. It seems that screening of -1263 A> caspase 9 polymorphism could be a useful marker in personal sensitivity to gastric cancer and help to cancer treatment and prevention process. It is concluded that caspase gene variation may be a diagnostic factor in the gastric cancer.

Prevalence of EPIYA motifs in Helicobacter pylori strains isolated from patients with dyspeptic disorders in northern Iran

Cytotoxin-associated gene A [CagA]-positive strains of Helicobacter pylori are associated with gastroduodenal diseases. Evidences have suggested that the type of H. pylori CagA EPIYA motifs may be associated with recurrent dyspepsia [i.e. gastritis, peptic ulcer, or gastric cancer]. We investigated the prevalence of different EPIYA motifs [A, B, C, or D] in H. pylori strains isolated from patients with recurrent dyspepsia who underwent upper gastrointestinal [GI] endoscopy. We investigated the prevalence of different EPIYA motifs [A, B, C, or D] in H. pylori strains isolated from patients with recurrent dyspepsia who underwent upper gastrointestinal [GI] endoscopy. H. pylori strains were isolated from biopsy specimens of 220 patients with recurrent dyspepsia. The presence of glmM gene, as a housekeeping gene, CagA gene, and pattern of CagA EPIYA motifs were determined using polymerase chain reaction [PCR] method. The association between the type of motifs and disease state was determined by the Chi-square test, Fisher's exact test, and logistic regression. CagA-positive H. pylori strains were identified in 125 [57%] of patients, including 36 [28.6%] gastritis, 31 [24.6%] duodenal ulcer, and 58 [46.4%] gastric cancer. The frequency of pattern of CagA EPIYA motifs were detected as 39 [31.2%] AB motifs, 54 [43.2%] ABC motifs, 32 [25.6%] ABCC motifs,and no D motifs. The risk of gastric cancer occurrence was estimated to be 2.57 times higher in patients infected by strains with ABCC motif when compared with gastritis and duodenal ulcer patients [p=0.03]. Moreover, patients with C-containing motifs were 2.27 times more likely to be afflicted with gastric cancer than with duodenal ulcer. AB motif was more associated with gastritis and duodenal ulcer than ABC and ABCC motifs. The results suggested that CagA-EPIYA ABCC might be associated with gastric cancer, while EPIYA-AB might be associated with duodenal ulcer