Lumbosacral non-terminal myelocystocele associated with teratoma: case report and review of literature.

Non-terminal myelocystoceles are commonly found in the cervical or thoracic spinal region. Their sac can rarely be associated with tumor. A rare case of an infant with a lumbosacral non-terminal myelocystocele and accompanying mature teratoma is reported in whom the tumor was attached to the placode not as a part of the sac.

Human sperm DNA damage has an effect on immunological interaction between spermatozoa and fallopian tube.

BACKGROUND: Toll-like receptors play a crucial role in the immunological interaction between the spermatozoa and fallopian tube and contribute to the ovulation, sperm capacitation, fertilization, and pregnancy. OBJECTIVES: To investigate the expression of toll-like receptors and their adaptor molecules and cytokines under the effect of spermatozoa with high DNA fragmentation (high DF) in human fallopian tube cell line (OE-E6/E7) and compare to those in normal spermatozoa. MATERIALS AND METHODS: Fresh semen samples were obtained from 10 unexplained infertile males with high DF (more than 20%) and from 10 healthy donors with a DF less than 3%. After sperm preparation, samples were co-cultured with OE-E6/E7. Toll-like receptors, myeloid differentiation factor 88 (MyD88), TIR domain-containing adapter protein (TIRAP), TIR domain-containing adapter-inducing IFN-b (TRIF), TRIF-related adapter molecule as well as IL-6, IL-8, IFN-ß, and TNFα mRNA expression were evaluated by quantitative real-time PCR. Protein levels of these cytokines and chemokines were measured using ELISA method. RESULTS: TLR 1-6 mRNA expression in OE-E6/E7 was significantly higher under the effect of spermatozoa with high DF compared to the spermatozoa with low DF. Furthermore, significantly increased mRNA expression of MyD88, TIRAP, and TRIF was observed in the high DF group compared to the low DF group, except TRIF-related adapter molecule. Moreover, the expression of IL-6 and IL-8 in the high DF group was significantly higher than low DF group, although there was no significant difference in IFN-ß and TNFα expression between the groups. DISCUSSION AND CONCLUSION: Damage-associated molecular patterns from DNA damage activate TLR signaling pathway in human fallopian tubes and result in the upregulation of inflammatory cytokines and chemokines. This situation may provide pathologic environment for capacitation, fertilization, embryo development, and implantation in female reproductive tract and can be one of the mechanisms of infertility in men with high DF.

Evaluation of immunological interaction between spermatozoa and fallopian tube epithelial cells.

Toll-like receptors (TLR) are one of the major compartments of innate immune system. It was revealed that the TLR have relevance in ovulation, sperm capacitation and fertilisation. So, in this study, the expression of TLR, their adaptor molecules and cytokines in human fallopian tube cell line under the effect of human normal spermatozoa was evaluated. TLR mRNA and protein were evaluated in OE-E6/E7 cell line. Semen samples from 10 donors were collected and co-incubated with OE-E6/E7 cell line and used as sperm group, and cell line without spermatozoa was used as control group. Afterwards, the level of TLR, their adaptor molecule and cytokine mRNA expression was compared using qPCR in sperm and control groups, and supernatant was used for ELISA. To determine whether elevated cytokine reaction to spermatozoa in OE-E6/E7 cell line is mediated via TLR, TLR3 function-blocking antibody was used. OE-E6/E7 cell line expressed TLR1-6 genes and proteins. TLR expressions, especially TLR3 and TLR5, in OE-E6/E7 cell line under the effect of spermatozoa were significantly higher. Also, levels of adaptor molecules and cytokine production were increased in sperm group than in control group (P < 0.05). So, it may be hypothesised that TLR are essential for spermatozoa and fallopian tube immunological interaction and for preparing safe environment for important events in fallopian tube.

A real time PCR assay on blood for diagnosis of invasive candidiasis in immunocompromised patient.

BACKGROUND AND PURPOSE: Invasive candidiasis (IC) is a significant cause of morbidity and mortality in patients with hematologic disorders and bone marrow transplant recipients. Rapid, specific and sensitive test for the timely accuracy in immunocompromised patients to reduce mortality rates and prevent IC progress is necessary. We established a real-time PCR assay on blood for the diagnosis and differentiation of the causative Candida species. MATERIALS AND METHODS: Whole blood samples were collected twice, from 72 patients for Real Time PCR and blood culture assays. The primers and hybridization probes were designed to potentiate the specific sequence of 18S rRNA genes using Light Cycler system and Fluorescence Resonance Energy Transfer (FERT). The patients with hematologic malignancies and bone marrow transplant recipients were evaluated for IC based on the revised European Organization for Research and Treatment of Cancer/ Mycoses Study Group (EORTC/MSG) criteria. RESULTS: From 2009 to 2011, 72 patients with hematologic malignancies and bone marrow transplant recipients were evaluated for IC. The female to male ratio was 27:45; the mean age was 32.1 years. The most common malignancy in this patient was acute myeloid leukemia (AML) (27.8%) and acute lymphoblastic leukemia (ALL) (26.4%). Out of 72 patients, 11 patients (15.3%) had positive real time PCR /probe results. Based on the melting temperature (Tm) analysis, 5 (45.4%) C. krusei, 3 (27.2%) C. tropicalis, 2 (18.1%) C. parapsilosis and 1 C. albicans (9%) were identified. According to the revised EORTC / MSG, 1 patient (9%) and 10 patients (91%) were defined as proven and possible groups of IC, respectively. The mortality rate in proven and possible IC patient was found 54.5%. CONCLUSION: The established Real-time PCR/FRET probe assay is an appropriate diagnostic tool for the detection of Candida species DNA and the management of patients suffering from hematologic malignancies and bone marrow recipient are at risk for IC.

A 3-D constitutive model for pressure-dependent phase transformation of porous shape memory alloys.

Porous shape memory alloys (SMAs) exhibit the interesting characteristics of porous metals together with shape memory effect and pseudo-elasticity of SMAs that make them appropriate for biomedical applications. In this paper, a 3-D phenomenological constitutive model for the pseudo-elastic behavior and shape memory effect of porous SMAs is developed within the framework of irreversible thermodynamics. Comparing to micromechanical and computational models, the proposed model is computationally cost effective and predicts the behavior of porous SMAs under proportional and non-proportional multiaxial loadings. Considering the pressure dependency of phase transformation in porous SMAs, proper internal variables, free energy and limit functions are introduced. With the aim of numerical implementation, time discretization and solution algorithm for the proposed model are also presented. Due to lack of enough experimental data on multiaxial loadings of porous SMAs, we employ a computational simulation method (CSM) together with available experimental data to validate the proposed constitutive model. The method is based on a 3-D finite element model of a representative volume element (RVE) with random pores pattern. Good agreement between the numerical predictions of the model and CSM results is observed for elastic and phase transformation behaviors in various thermomechanical loadings.

Risk of gestational diabetes mellitus in patients undergoing assisted reproductive techniques.

OBJECTIVE: To compare the incidence of gestational diabetes mellitus (GDM) between pregnancies conceived spontaneously and pregnancies conceived following assisted reproductive technology (ART). STUDY DESIGN: This cross-sectional study evaluated the medical records of 215 women who conceived spontaneously and 145 women who conceived following ART from September 2011 to October 2012. Exclusion criteria were: polycystic ovary syndrome, maternal age ≥40 years, family history of diabetes in first-degree relatives, pre-pregnancy diabetes, glucose intolerance treated with hypoglycaemic agent (e.g. metformin), history of GDM, history of stillbirth, recurrent miscarriage, history of baby with birth weight ≥4kg (macrosomia), parity >3, Cushing syndrome, congenital adrenal hyperplasia and hypothyroidism. For better comparison of the incidence of GDM, the ART group was further subdivided into: (i) an in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) group (n=95); and (ii) an intrauterine insemination (IUI) group (n=50). The diagnosis of GDM was based on the criteria of the American Diabetes Association. RESULTS: The incidence of GDM was significantly higher in the IVF/ICSI and IUI groups (43% and 26%, respectively) compared with the spontaneous pregnancy group (10%). Age, pre-pregnancy body mass index (BMI) and weight gain in pregnancy were similar among women with GDM in all three groups. In addition, the incidence of pregnancy-induced hypertension was significantly higher in the IVF/ICSI group (21%) compared with the spontaneous pregnancy group (7%). Logistic regression analysis demonstrated four strong risk factors for GDM: age, BMI, mode of ART and progesterone use during pregnancy. CONCLUSION: This study indicated that the risk of GDM is two-fold higher in women with singleton pregnancies conceived following ART compared with women who conceived spontaneously. In addition, progesterone use during pregnancy was found to be an important risk factor for GDM. This subject requires further study.

Functional deficits and morphological changes in the neurogenic bladder match the severity of spinal cord compression.

UNLABELLED: Following spinal cord injury (SCI), loss of spinal and supraspinal control results in desynchronisation of detrusor vesicae (parasympathicus) and external urethral sphincter (sympathicus) activity. Despite recovery of lower urinary tract function being a high priority in patients with SCI, effective treatment options are unavailable largely because mechanisms are poorly understood. PURPOSE AND METHODS: We used a clinically relevant model of thoracic SCI compression injury in adult female Wistar rats and confirmed that lesion volumes following severe injuries were significantly greater compared to moderate injuries (p < 0.05). Between 1-9 weeks, we assessed recovery of bladder function as well as return of locomotor function using the Basso, Beattie and Bresnahan (BBB) score. Bladder morphometrics and overall intramural innervation patterns, as assessed with ß-III tubulin immunohistochemistry, were also examined. RESULTS: Despite variability, bladder function was significantly worse following severe compared to moderate compression injury (p < 0.05); furthermore, the degree of bladder and locomotor dysfunction were significantly correlated (r = 0.59; p < 0.05). In addition, at 9 weeks after SCI we saw significantly greater increases in bladder dry weight (p < 0.05) and wall thickness following severe compared to moderate injury as well as increases in intramural axon density (moderate: 3× normal values; severe 5×; both p < 0.05) that also correlated with injury severity (r = 0.89). CONCLUSION: The moderate and severe compression models show consistent and correlated deficits in bladder and locomotor function, as well as in gross anatomical and histopathological changes. Increased intramural innervation may contribute to neurogenic detrusor overactivity and suggests the use of therapeutic agents which block visceromotoric efferents.

Intussusception of the appendix secondary to mucinous cystadenoma: A rare cause of abdominal pain.

A 35-year-old woman was seen as an outpatient with a 3-month history of pain in the right iliac fossa. A CT scan of her abdomen revealed the presence of a mucocele of the appendix. Intra-operatively, an appendico-appendicular intussusception was found. Histology confirmed the presence of a mucinous cystadenoma with the presence of acellular mucin on the serosal surface of the appendix. This association has rarely been described in the literature. Prompt surgical intervention is advocated to prevent the subsequent development of pseudomyxoma peritonei. We present a case of intussusception of the appendix with a mucinous cystadenoma as its lead point.

Psychomotor delay, a possible rare presentation of moyamoya disease.

Moyamoya disease is a rare, chronic cerebrovascular occlusive disease of unknown etiology. It is characterized by progressive stenosis of the arteries of the circle of Willis leading to ischemic strokes in young people and cerebral hemorrhage, which is more frequent in adults. Secondarily, an abnormal network of fine collateral vessels arises at the base of the brain. The term moyamoya refers to the angiographic appearance of the cerebral vasculature. We present such a disease in an 18-month-old Iranian girl with global developmental delay, which is a very rare presentation of moyamoya disease. She was diagnosed by magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA).

Sodium Valproate versus Propranolol in paediatric migraine prophylaxis.

In a randomized clinical trial the effect of Sodium Valproate in pediatric migraine prophylaxis was compared with that of Propranolol. One hundred and twenty patients with common migraine (migraine without aura) aged from 3 to 15 years who met the defined criteria enrolled into the study. Randomly the patients were divided in two groups of A and B, treating with sodium Valproate and Propranolol, respectively. Three phases of baseline period (phase I), titration and adjustment period (phases II) and fixed -dose treatment period (phase III) have been designed. A total of 57 patients in group A, and 58 patients in group B completed all phases of the trial. Seventy two percent of patients in group A and 69% of patients in group B have responded to Sodium Valproate and Propranolol, respectively, as a reduction of more than 50% in headache frequency per month. Further more both drugs have shown efficacy in reducing the severity and duration of headache and also better response to rescue medications (p value <0.01). There was no significant difference in all previously mentioned therapeutic effects between two groups (p value <0.05).

Follicle stimulating hormone as a predictor of ovarian response in women undergoing controlled ovarian hyperstimulation for IVF.

OBJECTIVE: To evaluate the effect of basal follicle stimulating hormone (FHS) level on ovarian response in women undergoing controlled ovarian hyperstimulation for in vitro fertilization. METHODS: A descriptive and analytic study of 212 cycles of IVF chosen from about 2200 files of women treated at Royan Institute, Tehran, Iran, from 1991 to 1999. Treatment was started with intranasal or subcutaneous buserlin (0.5 cm3), on day 21 (long protocol). On day 2 of the next cycle, stimulation with human menopausal gonadotropin (hMG) was initiated. When the number and size of follicles were suitable, human chorionic gonadotropin (hCG) was given intramuscularly for ovulation induction, followed by oocyte retrieval 36 to 40 h later. Embryos were transferred about 48 to 72 h after oocyte retrieval. The women were assigned to 2 groups on the basis of day 3 serum FSH levels (>or=15 IU/mL, group 1 and <15 IU/mL, group 2). RESULTS: There were statistically significant differences between the 2 groups in number of follicles, number of oocytes retrieved and embryos transferred (lower in group 1), and level of serum luteinizing hormone and number of canceled cycles (higher in group 1). There were no statistical differences in number of ampoules of hMG used or age of patients. CONCLUSION: Day-3 serum FSH level was a predictor of ovarian response and IVF outcome in this study.

The effect of carotenoids obtained from saffron on histone H1 structure and H1-DNA interaction.

It is already known that transcriptional activation of genes occurs due to the H1 dissociation from linker DNA; hence, histone H1-DNA complex is considered as a model of chromatin. Anticancer property of saffron and its carotenoids has already been reported. The present study aimed at investigating the effect of saffron carotenoids on H1 structure and H1-DNA interaction as a possible mechanism of their anticarcinogenic action. After purification of the saffron carotenoids (crocin, crocetin and dimethylcrocetin), their interaction with histone H1 was studied using spectrophotometry and spectrofluorometry. Some changes on the absorption spectra of H1 indicated the complex formation between this protein and saffron carotenoids. Also, the fluorescence emission of H1 was quenched by the mentioned ligands. The binding parameters of all the three ligands were obtained through Schatchard analysis of the quenching data. Then, the effect of each ligand on the H1-DNA interaction was studied. The results showed a shift in the precipitation curve to the left in the presence of the mentioned carotenoids, which is due to the reduction in the interaction of H1 with DNA. These observations led to the suggesting a mechanism in which the H1 depletion may promote transcription.

Blood pressure distribution among healthy schoolchildren aged 6-13 years in Tehran.

To obtain blood pressure distribution for Iranian children, we assessed 10,288 students aged 6-13 years (4871 boys and 5417 girls) in Tehran. Mean systolic and diastolic blood pressure showed incremental increases with age, weight and height in both sexes. Mean increases in systolic blood pressure for boys and girls were 1.7 and 0.8 mmHg per year respectively and for diastolic blood pressure were 0.7 and 0.9 mmHg respectively. According to Second Task Force (STF) criteria, 4.9% of boys and 3.5% of girls had significant systolic hypertension and 10.1% of boys and 3.3% of girls had significant diastolic hypertension. Mean systolic and diastolic blood pressures were higher than STF reports, especially among boys.

Blood pressure distribution among healthy schoolchildren aged 6-13 years in Tehran

To obtain blood pressure distribution for Iranian children, we assessed 10,288 students aged 6-13 years [4871 boys and 5417 girls] in Tehran. Mean systolic and diastolic blood pressure showed incremental increases with age, weight and height in both sexes. Mean increases in systolic blood pressure for boys and girls were 1.7 and 0.8 mmHg per year respectively and for diastolic blood pressure were 0.7 and 0.9 mmHg respectively. According to Second Task Force [STF] criteria, 4.9% of boys and 3.5% of girls had significant systolic hypertension and 10.1% of boys and 3.3% of girls had significant diastolic hypertension. Mean systolic and diastolic blood pressures were higher than STF reports, especially among boys

Epidemiology of diarrhoea caused by rotavirus and Escherichia coli in lambs in Kashmir valley, India.

One hundred and twenty-nine faecal samples, collected over a period of 1 year, from 96 diarrhoeic and 33 non-diarrhoeic lambs aged between 0 and 3 months were examined for presence of rotavirus and Escherichia coli (E. coli). Group A rotavirus was detected in 24 (25%) of diarrhoeic lambs using sandwich enzyme linked immunosorbent assay (ELISA) and ribonucleic acid-polyacrylamide gel electrophoresis (RNA-PAGE). Statistically no significant relation was found between rotavirus infection and age of the lambs. The prevalence of group A rotavirus was more related to meterological changes than age of the lambs as the number of diarrhoeic lambs with rotavirus infection was found to increase in spring months during which temperature and humidity ranged between 7.34 and 28.9 °C and 34.28 and 82.58%, respectively. The migration pattern of ovine rotavirus RNA in PAGE was typical of mammalian group A rotaviruses. O25, O26, O30, O43, O75, O76, O102, O113, O132, O153 and O157 E. coli serogroups were isolated from diarrhoeic lambs positive for rotavirus infection while as O8, O20, O21, O26, O39, O43, O45, O69, O75, O82, O104, O107, O113, O120, O127, O139, O141, O143, O153 and O157 serogroups of E. coli were isolated from diarrhoeic lambs without rotavirus infection. O8, O21, O43, O82, O104, O113, O120, O127, O132 and O139 serogroups, recovered from diarrhoeic faecal samples with or without rotavirus, were positive for congo red dye binding activity. O88, O113, O157 and O168 serogroups were isolated from non-diarrhoeic faecal samples out of which O88 and O168 were congo red positive. None of the lambs without diarrhoea carried rotavirus infection. Group B rotavirus infection commonly reported in diarrhoeic lambs outside India was not detected in any of the faecal samples screened.

Determination of bovine rotavirus G genotypes in Kashmir, India.

Rotavirus ribonucleic acid (RNA) was extracted from ten faecal samples of diarrhoeic calves positive for group A rotavirus by enzyme-linked immunosorbent assay (ELISA). A portion of the extracted RNA was run in polyacrylamide gel to determine the presence of rotaviral RNA and the rest subjected to reverse transcriptase-polymerase chain reaction (RT-PCR) to generate the near full length VP7 gene. Only six samples yielded the desired product. The amplified products were subjected to G-typing by PCR using a cocktail of G6, G8 and G10 typing primers. All of the six samples were characterised as G10 and none of the samples revealed mixed infection by twin G types. Four samples, despite possessing sufficient rotavirus particles as revealed by ELISA and polyacrylamide gel electrophoresis, did not yield any amplified product on RT-PCR. This could be due to non-specific inhibitors of the PCR reaction, present in the faecal samples, being carried through the extraction procedures.

Detection of a mammalian-like group A rotavirus in diarrhoeic chicken.

The present investigation describes detection of a mammalian-like electropherogroup A rotavirus in chicken with diarrhoea. This also records the first detection of a rotavirus in an avian species from India. During the investigation 75 diarrhoeic faecal samples collected from adult chicken were screened for the presence of group A rotavirus antigen by sandwich ELISA. All three samples positive for rotavirus antigen revealed 11 bands of RNA in polyacrylamide gel electrophoresis (PAGE). In contrast to avian group A rotavirus, segment 5 was found to migrate closer to 6 as is the case with mammalian group A rotaviruses. Segments 7, 8 and 9 were found to migrate as a tight triplet, which is characteristic of group A rotavirus.

Pre-optimization of radiotherapy treatment planning: an artificial neural network classification aided technique.

A method has been developed which, by using the geometric information from treatment sample cases, selects from a given data set an initial treatment plan as a step for treatment plan optimization. The method uses an artificial neural network (ANN) classification technique to select a best matching plan from the 'optimized' ANN database. Separate back-propagation ANN classifiers were trained using 50, 60 and 77 examples for three groups of treatment case classes (up to 21 examples from each class were used). The performance of the classifiers in selecting the correct treatment class was tested using the leave-one out method; the networks were optimized with respect their architecture. For the three groups used in this study, successful classification fractions of 0.83, 0.98 and 0.93 were achieved by the optimized ANN classifiers. The automated response of the ANN may be used to arrive at a pre-plan where many treatment parameters may be identified and therefore a significant reduction in the steps required to arrive at the optimum plan may be achieved. Treatment planning 'experience' and also results from lengthy calculations may be used for training the ANN.