Vol 13, No 3 (2019)

Original Article(s)

  • XML | PDF | downloads: 174 | views: 286 | pages: 108-115

    Background: Phospholipase C epsilon 1 (PLCE1) gene harbors different single nucleotide polymorphisms (SNPs), which can be correlated with the risk of different types of cancers. In this case-control study, the relationship between rs2274223 (A>G), a single nucleotide polymorphism in phospholipase C epsilon gene (PLCE1), and gastric cancer was evaluated among Iranian patients.
    Materials and Methods: The PLCE1 rs2274223 polymorphism was genotyped in 60 patients with gastric cancer and 69 control subjects using polymerase chain reaction and restriction fragment length polymorphisms (PCR-RFLP) methods. Clinical and pathologic parameters such as tumor characteristics and disease stage were also recorded.
    Results: There were 48 (80%) male patients and 45 (65.5%) healthy male individuals (p=0.077). About 34 (56.6%) patients were smokers. A family history of gastric cancer was found in 21 (35%) cases. GG genotype was observed among 15% of patients and 8.7% of normals, respectively. There was no significant difference between the AA and AG genotypes. Also, there were no significant correlations between AA, AG or GG genotypes and the risk of gastric cancer, gender, tumor size, tumor stage, grade, as well as tumor location and metastasis.
    Conclusion: The PLCE1 rs2274223 polymorphism was not correlated with gastric cancer in Iranian population. However, a further comprehensive study with largersample sizes is needed.

  • XML | PDF | downloads: 148 | views: 365 | pages: 116-121

    Background: Prunus armeniaca is a member of the Rosacea family. The most important ingredient of this family is amygdalin that is believed to have anti-tumor and analgesic properties. The aim of this study was to evaluate the anti-proliferative effects of Armeniacae semen extract on the acute leukemia, NALM-6, and KG-1 cell lines, and investigate the effect of the extract on apoptosis of these cell lines and caspase-3 gene expression.
    Materials and Methods: We prepared aqueous, ethyl acetate, and hydro alcoholic extracts of the Armeniacae semen. The NALM-6 and KG-1 cell lines and mononuclear cells (PBMCs) of healthy controls were treated with different doses of the extracts for 48 hours, and then cell viability was investigated with the MTT test. High-Performance Liquid Chromatography was done for amygdalin identification. The percentage of apoptotic cells was determined using the Annexin V-FITC/PI flow cytometric kit, and caspase-3 gene expression was evaluated.
    Results: MTT test revealed that the strongest Inhibition Concentration (IC50) in KG-1 and NALM-6 cell lines was related to the ethyl acetate extract. This extract did not have toxic effects on PBMCs. Flow cytometric analysis showed that the ethyl acetate extract at its IC50 concentration led to almost 50% apoptosis in both cell lines after 48 hours. In the molecular examination, after treatment, a significant increase was seen in caspase-3 gene expression in NALM6 and KG1 cells compared to the control (P<0.001 and P <0.05, respectively).
    Conclusion: Our data confirmed that the ethyl acetate extract of Prunus armeniaca could reduce the proliferation of KG-1 and NALM-6 cell lines probably by activating the apoptotic pathway.

  • XML | PDF | downloads: 159 | views: 301 | pages: 122-131

    Background: Abnormal blood glucose (BG) levels during hematopoietic cell transplantation (HCT) are associated with increased infections, delayed engraftment, and prolonged hospitalization, though little is known about these associations.
    Materials and Methods: We retrospectively evaluated mean BG levels in the week prior to HCT and subsequent outcomes for 852 HCTs at our hospital from 1/2009 – 12/2013 pertaining to 745 patients. Outcomes included infections (pneumonia, C. difficile, positive cultures, administration of antimicrobials, or neutropenic fever), time-to-engraftment (TTE), and quality indicators (30- and 90-day readmission rates [RR] and median length-of-stay [LOS]).
    Results: We retrospectively evaluated mean BG levels in the week prior to HCT and subsequent outcomes for 852 HCTs at our hospital from 1/2009 – 12/2013 pertaining to 745 patients. Outcomes included infections (pneumonia, C. difficile, positive cultures, administration of antimicrobials, or neutropenic fever), time-to-engraftment (TTE), and quality indicators (30- and 90-day readmission rates [RR] and median length-of-stay [LOS]).|
    Conclusion: Pre-HCT BG trends may be a prognostic biomarker for adverse outcomes, and thus can help improve quality of care for HCT patients.

  • XML | PDF | downloads: 155 | views: 394 | pages: 132-139

    Background: Nowadays, remarkable attention has been drawn towards the effective therapeutic characteristic of natural products targeting cancerous cells. This study aimed to investigate the anti-cancer effect of Artemisia annua extract (AAE), a Chinese herbal medicine alone and in combination with a microtubule binding agent used in ALL treatment, vincristine (VCR), in B-Acute lymphoblastic leukemia (ALL) Nalm-6 and Reh cells.
    Materials and Methods: Cytotoxic activity of AAE and VCR was determined using MTT assay in Nalm-6, and Reh cell lines and synergism was evaluated using the CompuSyn software. Caspase 3 activity and Annexin/PI staining were performed for apoptosis assessment. The expression level of apoptosis-related genes, caspase 3, Bax and Bcl-2 were determined using real time-PCR. One-way ANOVA and post hoc Tukey multiple comparisons were used for statistical analysis.
    Results: Our findings revealed that a single administration of AAE exerted an anti-leukemic effect in both ALL-derived cells in a time- and dose-dependent manner. Interestingly, the growth inhibitory activity of the extract was more potentiated when combined with 0.1 and 1 nM VCR through caspase 3-dependent apoptosis. Moreover, real-time PCR analysis showed that VCR-induced cytotoxicity was augmented by AAE through alteration of Bax, and Bcl-2 mRNA expression.
    Conclusion: Overall, owing to the nontoxic nature of AAE and its explicit role in enhancing VCR effectiveness, our study provided new insight into the development of a novel combinatorial approach in ALL using natural herbs. The practical implication of the research requires further investigation through clinical trials, opening avenues for forthcoming treatment improvements.

  • XML | PDF | downloads: 130 | views: 304 | pages: 140-145

    Background: Detailed history taking, physical examination and laboratory tests are useful tools to document any abnormal bleeding risk before an operation or an invasive procedure. Although coagulation tests are routinely used to demonstrate the pathological situations at the coagulation cascade or to follow-up the anticoagulation therapies, their role in determining the bleeding risk in preoperative patients is controversial.
    Materials and Methods: In this study, we aimed to evaluate the patients referring to our hematology clinic at Izmir Katip Celebi University Hospital for preoperative consultation due to elevated levels of coagulation tests.
    Results: Fifty-six patients with high PT/PTT levels were enrolled in this study. Twenty-six (46.4%) patients were male and 30 (53.6%) were female. The median age was 34 (18-75) years. We documented bleeding history in 12 (21.4%) patients. The patients having a bleeding history revealed mostly abnormal uterine bleeding, epistaxis, and gingival bleeding. Life threatening bleeding was not reported in any of the patients.  The operations were cancelled or postponed at least one month in 38 (67.8%) and 10 (17.8%) patients, respectively. Per-operative or post-operative abnormal bleeding was not documented. We did not find any statistically significant difference between groups with or without elevated coagulation tests in terms of abnormal bleeding in the operations.
    Conclusion: Coagulations tests should be studied in selected group of patients. Additionally, mildly elevated results should be interpreted carefully to decrease the rate of cancellation and delay in operations and unnecessary increase in costs.



  • XML | PDF | downloads: 131 | views: 259 | pages: 146-152

    Background: Lumbar puncture (LP) is a hematology procedure that can require repeated attempts leading to traumatic LP (TLP), which has been related to the central nervous system (CNS) relapse. LP success can depend on the size and anatomy of the patient and the skill of the hematologist. The main objective was to determine the influence of body mass index (BMI) on LP outcomes.
    Materials and Methods: Adults with lymphoid malignancies requiring LP were included prospectively over one year; hematology residents performed most procedures. A 22-gauge Quincke needle was employed. Comparison between non-traumatic vs. traumatic LPs according to BMI, CNS relapse, and residents’ year was performed.
    Results: Fifty-four patients with a mean age of 31.5±15.57 years were included. Diagnosis was Acute Lymphoblastic Leukemia-B (74%), Acute Lymphoblastic Leukemia-T (13%) and Non-Hodgkin Lymphoma (13%). 227 LPs were performed, 121 (53.3%) successful, 98 (43.2%) traumatic, 11 (11.2%) TLPs were macroscopically detectable and 87 (88%) microscopic; 8 (3.5%) were dry-taps. Median time between punctures was 11 days (1-202). Median BMI was 25 (22.8-39.6). Main indication for LP was prophylactic (74.5%); 39.2% were performed by first-year, 35.2% by second-year, 19.6% by third-year hematology residents. No difference (p = 0.145) for a TLP was found among residents. A BMI ≥30 (p = 0.040), non-palpable intervertebral space (p = 0.001) and more than one attempt (p = 0.001) were significant for TLP. TLP was not associated with CNS relapse (p = 0.962).
    Conclusion: Obesity predicted a TLP. A traumatic puncture did not increase the risk of CNS relapse at one-year follow-up.

  • XML | PDF | downloads: 133 | views: 298 | pages: 153-163

    Background: Hepatocellular carcinoma (HCC) is a highly fatal tumor which represents a major health problem worldwide. Due to asymptomatic nature of HCC, most patients present with the progressive stage of the disease, so, unfortunately, there are no effective therapies. Existing techniques for HCC surveillance and diagnosis lack the required accuracy. Therefore, searching for new diagnostic and/or therapeutic tools could improve patient survival. This study aimed to estimate the diagnostic role of Dickkopf-1 (DKK1) and amphiregulin (AREG) and to find out their correlation with different clinicopathological parameters in HCC patients.
    Materials and Methods: Serum levels of DKK1 and AREG in 55 HCC patients, 20 cirrhotic patients, and 15 healthy subjects as control group were measured using the ELISA technique.
    Results: Both of DKK1 and AREG showed a significant increase in the HCC group compared to cirrhotic and healthy groups. DKK1 at a cutoff point of 8.92 ng/ml showed that the area under the curve (AUC) was 0.826 with 87.3% sensitivity and 82.9% specificity. DKK1 showed a significant correlation with tumor size, liver dysfunction, and poor performance status in HCC patients. AREG at a cutoff point of 8.74 pg/ml showed a sensitivity of 74.5% but low specificity (47.1%). AREG showed a significant correlation with portal vein thrombosis and tumor metastasis in HCC patients.
    Conclusion: Serum DKK1 could be a diagnostic biomarker for HCC. Both of DKK1 and AREG may play significant roles in tumor progression and may offer promising therapeutic targets in HCC patients.

  • XML | PDF | downloads: 184 | views: 1686 | pages: 164-171

    Background: Migraine headache is an episodic abnormality which usually presents with a severe headache, accompanied by nausea, photo and sound sensitivity, and autonomic symptoms. Iron accumulation in brain, especially peri-aqueductal grey is associated with duration of the disease, and apparently there is an association between body iron storage status and the incidence of migraine; hence, the present study was conducted to investigate the plausible association between iron-deficiency anemia and migraine in a case-control design.
    Materials and Methods: After signing the written informed consent, the blood samples were collected by a well-trained technician from the patients proved to have migraine, those having migraine clinical criteria and those having migraine attack frequency as high as that prophylaxis was required, and non-migraine healthy individuals, those having not migraine and anemia except iron-deficiency anemia. Based on the sample size, each group composed of samples with at least 100 individuals.
    Results: There were statistically significant differences between female cases and controls regarding hemoglobin, serum ferritin levels and iron-deficiency anemia (P-value: .0004; .006; .001), but no differences were observed among males (P-value: .606; .38; .303). Furthermore, the case-control comparisons revealed a significant difference in iron-deficiency anemia (P-value: .032), but no significant difference was seen in hemoglobin and serum ferritin levels (P-value: .161; .178). 
    Conclusion: The present study suggests an association between iron-deficiency anemia, hemoglobin and serum ferritin levels and the incidence of migraine in females. As a result, there might be an association between body iron storage status and the incidence of migraine, especially among females, reflecting the fact that iron supplements might be an effective treatment or prophylaxis in patients with migraine associated with iron-deficiency anemia. However, further studies are required to provide a conclusive answer to the issues remained controversial.