Molecular Identification of Escherichia coli Pathotypes and their Antimicrobial Resistance Profiles in Stool Samples Isolated from Patients in the West of Iran.

BACKGROUND: Gastroenteritis refers to an infection in the stomach and small intestine that may be caused by bacteria, viruses, and other pathogenic agents. Most strains of Escherichia coli (E. coli) in the gastrointestinal system have shared a symbiotic relationship with humans, but some serotypes are pathogenic. This study aimed to identify E. coli pathotypes isolated from stool samples and determine the antibiotic resistance profiles of these pathotypes in the west of Iran. METHODS: The study was conducted on 106 samples of diarrheal feces which were sent to Imam Reza laboratory. First E. coli was detected and then the DNA was extracted. Next, the antibiotic sensitivity test was performed by the disk diffusion method. The E. coli pathotypes were qualitatively detected using the Amplisense Escherichioses-FRT PCR kit after DNA extraction from E. coli isolated in the stool sample. RESULTS: In this study, out of 106 E. coli-positive samples, pathogenic E. coli were detected in 62 samples including 5 samples (8.1%) which only contained the EPEC pathotype, 10 samples (16.1%) contained only the EAEC pathotype, and 12 samples (19.4%) had only the EHEC pathotype. ETEC and EIEC were not isolated from any of the samples. The sensitivity to Meropenem (97%) and Gentamicin (96.2%) showed the highest frequency among the samples. The highest level of resistance was related to Amoxicillin (93.4%) and Ampicillin (78%). CONCLUSIONS: The epidemiological results show that the predominant pathotype among all isolates is EHEC and most antibiotic resistances were related to Amoxicillin and Ampicillin. Finally, a comprehensive molecular diagnosis of E. coli pathotypes, investigation of their incidence, and antibiogram profiles will help to determine better diagnostic and therapeutic measures for managing diarrheal diseases.

Comparison of Immunohistochemical Methods (IHC) and Fluorescent in Situ Hybridization (FISH) in the Detection of HER 2 /Neu Gene in Kurdish Patients with Breast Cancer in Western Iran.

Background: Amplification of HER2 is an important factor in the diagnosis and treatment of breast cancer. Fluorescence in situ hybridization (FISH) is the gold standard for the detection of HER2-positive tumors. However, the Immunohistochemistry (IHC) assay for the detection of HER2 is more popular in the preclinical laboratory since it is faster and more economical compared to the FISH test. Materials and Methods: In this study, the status of HER2 amplification is determined by the FISH test using 44 formalin-fixed paraffin-embedded tissue samples and comparing the results with the IHC test to determine the reliability of the IHC test. Also, the relationship between HER2 amplification and estrogen, progesterone receptors, P53, age, menopausal status, family history of breast cancer, tumor size, and histological grade were determined. Results: Examination of HER2 in 44 samples by IHC showed 3 (6.8%) and 5 (11.4%) samples were positive (IHC 3+) and negative (IHC 0, 1+), respectively, and 36 (81.8%) samples were ambiguous (IHC 2 +), but examination by FISH showed 21 samples (47, 7%) were positive and 23 samples (52, 3%) were negative. There was a significant difference between IHC and FISH in the detection of HER2 amplification (P=0.019). Also, there was a significant difference between HER2 amplification and menopause in patients (P=0.035). Conclusion: This result demonstrated that the IHC test is not a reliable test to determine HER2 amplification. This study represented that FISH analysis is more reliable than IHC and must be preferentially performed for all cases, especially for HER2 +2 cases for whom the IHC result is 2+.

Antidiabetic potential of the isolated fractions from the plants of Rosaceae family in streptozotocin-induced diabetic rats.

BACKGROUND AND PURPOSE: Diabetes is a group of multifactorial disorders characterized by chronic-elevated blood glucose levels (hyperglycemia). Natural remedies are used as alternative medications to treat diabetes. Here, we tested the protective effect of the plant extracts of the Rosaceae family on improving insulin secretion and repairing the pancreatic beta cells in diabetic rats. EXPERIMENTAL APPROACH: The oligosaccharide fraction was isolated from the Rosaceae family of herbs. LC-MS/MS was applied to characterize the isolated fractions. The male Wistar rats were randomly divided into six groups, 10 each, including the control group with no intervention, diabetic rats without treatment, diabetic rats that received the extract of Malus domestica (apple), Cydonia oblonga (quince), Prunus persica (nectarine), and Prunus persica (peach), separately. Rats were monitored for the weight, fasting plasma glucose, and insulin levels. The effect of extracts in streptozotocin (STZ)-induced diabetic rats on the pancreatic islets was evaluated by morphometric analysis. FINDINGS/RESULTS: LC-MS/MS results indicated a similar mass spectrum of isolated fractions from nectarine and peach with Rosa canina. Oral administration of nectarine and peach extracts to STZ-induced diabetic rats showed restoration of blood glucose levels to normal levels with a concomitant increase in insulin levels. Morphometric analysis of pancreatic sections revealed the increase in number, diameter, volume, and area of the pancreatic islets in the diabetic rats treated with extracts compared to the untreated diabetic rats. CONCLUSION AND IMPLICATIONS: Nectarine and peach extracts' anti-diabetic properties improved insulin secretion and pancreatic beta-cell function and subsequently led to restoring pancreatic islet mass in STZ-induced diabetic rats.

Survey of low ER-positive expression and its correlation with other clinical and pathological factors in breast cancer.

INTRODUCTION: Breast cancer is the most common cancer in women. Owning to the prominent role of biomarkers in molecular classification of breast cancer in recent years, evaluation of estrogen receptor (ER), progesterone receptor (PR), and Her2/neu seems to be required for prognosis and treatment of patients. MATERIAL AND METHODS: One-hundred twenty two patients with primary breast carcinoma were selected and immunohistochemistry staining for ER, PR, and Her2/neu were performed on representative paraffin blocks. ER level can be semi-quantified by immunohistochemistry using the H-score. The score, given as the sum of the percent of tumor cells staining multiplied by the intensity level, ranges from 0 to 300 as low, intermediate, and high grades. The statistical association of ER expression with the level of PR and Her2/neu, tumor size, necrosis, microscopic grade, vascular invasion, and lymph node involvement were analyzed using SPSS16 software. RESULTS: Results showed that among 122 studied patients, 44.3% were in the low ER-positive group where most of these cases (22.1%) were Her2/neu negative. Although there was a reciprocal interplay between the expression of ER and Her2/neu, increased expression of ER had a direct relation with PR level. However, there was no statistical relation between ER level with age, tumor size, necrosis, microscopic grade, vascular invasion, and lymph node involvement. DISCUSSION: The study clearly indicated that low ER group encompasses the high frequency of breast cancer patients. Furthermore, the most cases of low ER patients were in Her2/neu negative group.

Association Between Human Papillomavirus and Transitional Cell Carcinoma of the Bladder.

PURPOSE: Bladder carcinoma is one of the most common malignancies in worldwide. Among several risk factors, Human Papilloma Virus (HPV) have been presumed to play a causative role in the etiology of bladder cell carcinoma. The aim of this study was to evaluate the involvement of HPV infection in biopsy specimens of patients with transitional cell carcinoma at the west of Iran. MATERIALS AND METHODS: In this study, 97 biopsy specimens including 67 patients with transitional cell carcinoma (TCC) of bladder and 30 cases of control group with the mean age of 63 years were studied using immunohistochemistry to identify HPV. RESULTS: 22.4% of patients with TCC of bladder and 3.3% of control group were positive for HPV with a meaningful relation (P=.019). The prevalence of HPV was 4.3 fold higher in men than women. Most TCC patients werebelonged to grades II and III. CONCLUSION: Considering the higher incidence of HPV positivity in patients with TCC of bladder compared to control group, it seems to be a meaningful association between HPV infection and TCC of bladder, at least in the west of Iran.

Using siRNA-based spherical nucleic acid nanoparticle conjugates for gene regulation in psoriasis.

Psoriasis is a T-cell-mediated skin disease with autoimmune nature that is generally not observed in animals, this lack of a relevant experimental animal model of psoriasis has hindered the investigation of pathogenesis of disease. Application and systemic delivery of small interfering RNAs offer many effective therapeutic advantages for gene regulation in the skin. In this study, we present an IMQ animal model of psoriasis and designed a safe fusion peptide carrier, spherical nucleic acid gold nanoparticles conjugate, to improve penetration of the siRNA into the cells and skin and their targeting ability to gene regulation. We evaluated the model of psoriasis and EGFR siRNA treatment (as spherical nucleic acid nanoparticles), phenotypically (signs of erythema, scaling, inflammation and thickening), microscopic evaluation of cell proliferation and immunohistochemically evaluation of CD3, CD4, and CD8 markers. Also, we monitored suppression of EGF&EGFR genes after treatment of A431 cells by SNA-NCs. The expression of genes was validated by qRT-PCR in human skin cells. The results showed that the SNA-NCs were stable and non-toxic. In vitro experiments indicated that EGF&EGFR siRNAs conjugated with spherical nucleic acid gold nanoparticles can significantly reduce gene expression in cells. In vivo experiments showed that the topical application of siRNAs delivered by SNA-NCs through the skin can significantly inhibit the proliferation of cells. Microscopic evaluation of mice back skin and immunohistochemistry process approved Inhibitory effect of SNA-NCs siRNA in the mouse model of psoriasis. Since the proliferation of T cells was crucial for the development of a psoriatic phenotype. These results demonstrate that topical application of SNA-NCs siRNA may improve psoriatic-like skin lesions by suppressing gene expression and functional activity of T cell production.

Comparison Between Two Detection Methods for HPV16, HPV18 and P16Ink4a Biomarkers in Diagnosis of Abnormal Cervical Cytology

Background: Cervical cancer is the second most common cancer among women in many populations. While the Pap smear is a well established screening test it suffers from both false-positive and false-negative results in diagnosis of cancers and precancerous states. In this study, immunocytochemistry of the P16 biomarker and HPV-PCR were compared for their diagnostic potential. Materials and methods: In the study, we obtained pairs of specimens from 45 women with cervical dysplasia. One sample was placed in a liquid-based solution, and processed for staining of sections with antibodies to P16. HPV-PCR was performed on the other and the results obtained were analyzed by T-test using SPSS v. 15. Results: Using HPV-PCR 71% of the samples were found to be infected with either HPV 16 or HPV 18, and the rate of infection did not have a statistically significant relationship with higher grades of dysplasia (p= 0.253). In contrast, with immunocytochemistry evaluation of P16, 64% of the specimens were positive, but the percentage of positive results significantly increased with higher grades of dysplasia (p= 0.0001). Conclusion: Employment of the P16 marker as an optional test might be preferable over HPV-PCR for cervical dysplasia in our geographical region.

Solitary Plasmacytoma in the Mandible Resembling an Odontogenic Cyst/Tumor.

A 46-year-old male patient referred to Department of Oral Medicine, with the primary chief complaint of a painless swelling in the right side of mandibular. A panoramic radiograph revealed a well-defined, multilocular radiolucent bony lesion with thin and straight septa in the right side of mandible extending from distal of canine to mesial of third molar. Histological examination showed a solid proliferation of atypical plasmacytoid cells, which was indicative of plasmacytoma. A systemic workup for the final diagnosis was performed to rule out multiple myeloma.

Effect of executive programs of infection control committees on the prevalence of nosocomial infections in Kermanshah's Hospitals (2010-2011).

The aim of this study was to investigate the effect of executive programs of infection control committees on the incidence of nosocomial infections in hospitals affiliated with the Kermanshah University of Medical Sciences (Kermanshah, Iran) during 2010 and 2011. The numbers of patients admitted in 2010 and 2011 were 8084 and 7166, respectively, and the average prevalence of nosocomial infections in 2010 and 2011 was 0.8 and 1.9 infections per 100 patients, respectively. In 2010, the mean scores obtained by hospital for regular Infection Control Committee meetings, regular gatherings, registration of program information analysis, and regular follow-up meetings were 19, 31, 30.5, and 41.7 (out of 100), respectively. In 2011, they were 20.2, 36.4, 38.1, and 50, respectively. The results of this study indicated that executive programs of infection control committees had no effect on the incidence of nosocomial infections; therefore, the experts who assess hospitals should pay more attention to the systems that are used to conduct surveillance of nosocomial infection control programs.

Gray-scale vs. color doppler ultrasound in cold thyroid nodules.

We intended to compare gray-scale vs. color Doppler ultrasound findings in cold thyroid nodules. Sixty-four patients with cold thyroid nodules for whom the presumptive diagnosis of malignancy (based on isotope scan study) had been made were consecutively included. They underwent gray-scale and color Doppler sonography studies. Based on histopathologic examination of surgically removed nodules, there were respectively 25 (39%) and 39 (61%) malignant and benign nodules. On color Doppler sonography, preference central hypervascularity was the most common finding in malignant nodules (17 nodules, 68%). Among benign nodules, preference perinodular hypervascularity was the most common finding (26 nodules, 66.7%). The most sensitive and specific Doppler sonography findings for malignant nodules were preference central hypervascularity (68%) and only central vascularity (97%), respectively. On gray-scale sonography, absent halo sign was the most common finding in malignant nodules (20 nodules, 80%). Among benign nodules, microcalcification was the most common finding which was reported in 12 nodules (30.7%). Hypoechogenicity was the most specific finding (76.9%) for malignant nodules. Since both gray-scale and color Doppler ultrasonography are inexpensive, non-invasive, and accessible methods to diagnose thyroid malignant cold nodules, it is recommended that these methods be applied by clinicians to assist or even substitute other invasive methods.

Hypocellular/lymphohistiocytic variant of Anaplastic Large Cell Lymphoma of lymph node, mimicking granulation tissue.

Anaplastic Large Cell Lymphoma (ALCL) is a subgroup of T/null cell non-Hodgkin lymphoma (NHL) in WHO classification. Lymphohistiocytic (LH) variant constitutes about 10% of all ALCLs and characterized by presence of abundant reactive histiocytes that can mask the neoplastic nature of the lesion, leading to misdiagnose as "reactive lymphadenopathy". Here we introduce a 16-year-old female patient, diagnosed as hypocellular LH variant ALCL with unusual histologic feature including granulation tissue- like appearance. We emphasize that in young patients with unusual- looking reactive lymphadenopathy, ALCL should be considered as one of differential diagnoses. A brief review of the nature of the lesion and differential diagnoses is also included. 

Immunohistochemical study of enteric nervous system in hirschsprung's disease and intestinal neuronal dysplasia.

BACKGROUND: Hirschsprung's disease (HD) is one of the most common motility disorders in pediatric age groups and it is very important that it be differentiated from other types of motility disorders, especially intestinal neuronal dysplasia B (IND B). Although many studies regarding the differences between the two disorders by immunohistochemical studies exist, there is as yet no consistent result. The purpose of this research was to study the immunohistochemical findings of enteric nervous system in these two motility disorders in comparison with colectomies without motility disorder. METHODS: Full wall thickness specimens of three groups of patients (HD, IND B and non motility disorders) were included in the study to be evaluated by immunohistochemistry (IHC). Markers were specific for neuronal cells and pace maker cells composed of PGP 9.5, c-kit, synaptophysin, S100 and CD56. The number of cells was evaluated in the muscularis properia, and myenteric plexus. RESULTS: The number of all the IHC markers i.e. PGP9.5, c-kit, synaptophysin, S100 and CD56 was completely different in HD from the two other groups, while IND B was quite similar to control group. CONCLUSION: Our finding suggests that there is a marked and significant difference between HD and IND B by IHC markers, which can be used as an additional test for the diagnosis of HD with more accuracy. Further multicenter studies with a greater number of cases would be necessary to find a cut-off point for every IHC marker to differentiate HD and IND B.

Does inhibin-B help us to confidently refuse diagnostic testicular biopsy in azoospermia?

BACKGROUND: In the recent years, the use of laboratory blood factors such as FSH and inhibin-B for the assessment of spermatogenesis in different studies has increased; of course, the conflicting results have also been achieved. OBJECTIVE: To investigate if the measurement of inhibin-B can help surgeon to reduce unnecessary diagnostic testicular biopsies in males with azoospermia. MATERIALS AND METHODS: This cross-sectional study was done during July 2006 to September 2007 on 41 patients with azoospermia. FSH and inhibin-B were measured and bilateral open testicular biopsy was performed for all patients. RESULTS: Sperm was seen in 29% of biopsies that in 100% of these samples inhibin-B was more than 100 pg/mL and FSH was less than twice the normal (p=0.001). Inhibin-B had significant correlation inversely with testicular fibrosis and Sertoli cell only syndrome (p=0.043 and p=0.011, respectively) and directly with incomplete spermatocytic maturation arrest and obstructive azoospermia (p=0.027 and p=0.013, respectively). FSH was only correlated with obstructive azoospermia (p=0.001). CONCLUSION: We suggest that if FSH is less than twice the normal, inhibin-B should be measured and if its level is less than 100 pg/mL, we can cancel about the half of unnecessary diagnostic testicular biopsies.

Frequency of Ki-67 (MIB-1) and P53 expressions among patients with prostate cancer.

CONTEXT: Prostate cancer is the most common malignant tumor in men. Tumor grade is one of the most important prognostic factors of prostate cancer. P53 and Ki-67 expressions have also been considered to be prognostic factors. AIMS: This study was performed to investigate the frequency of these proteins expression and compare the obtained results with Gleason's grading. SETTINGS AND DESIGN: In this cross-sectional study, 49 paraffin blocks of prostate cancers were assessed. Tumor grade was determined according to the Gleason's criteria. MATERIALS AND METHODS: Ki-67 and P53 expressions were determined by immunohistochemical staining. STATISTICAL ANALYSIS: The obtained results were analyzed and evaluated using Spearman's statistical test (SPSS version 15). RESULTS: Three out of 49 (6.1%) cases were well differentiated, 21 (43%) moderately differentiated and 25 (51%) were poorly differentiated. P53 was negative in all well-differentiated cases. Ki-67 was negative in 14 cases (28%) including all well-differentiated tumors. Among moderately and poorly differentiated tumors Ki-67 was negative in eight (38%) and three (12%) of cases, respectively. A statistically significant relation was observed between the increased Ki-67 labeling index (LI) and increased Gleason's grade. Conversely, no statistically significant relation was found between P53 expression and increased Gleason's grade. CONCLUSIONS: According to the findings of this study, it seems that Ki-67 can be used as a prognostic factor for prostate cancer. On the other hand, the probable relation between P-53 and prostate cancer prognosis requires further studies.