Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 30 195 2012 08 22 Detection of Legionella Spp. in Water from Cooling Towers Detection of Legionella Spp. in Water from Cooling Towers 13831 FA Farzaneh Baghal Asghari Lecturer, Department of Environmental Health Engineering, Khoy School of Nursing and Health, Urmia University of Medical Sciences, Urimia, Iran Mahnaz Nikaeen Associate Professor, Department of Environmental Health Engineering, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-1852-1547 Maryam Hatamzadeh Laboratory of Microbiology, Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran Marzieh Vahid Dastjerdi Department of Environmental Health Engineering, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Akbar Hassanzadeh Lecturer, Department of Statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 09 17 Background: Legionella are Gram negative and non-spore bacteria which are found in various natural and manmade aquatic environments. Legionella can cause legionnaires' disease or Pontiac fever. Inhalation of aerosols from contaminated water sources leads to Legionella infections or legionellosis. Contamination of waters from cooling towers with Legionella was recognized as a major source for legionellosis. Therefore, this study was conducted to survey the Legionella contamination of waters from cooling towers. Methods: A total of 33 water samples were taken from cooling towers. After measuring temperature and pH, the samples were examined for the presence of Legionella in two methods of culture and polymerase chain reaction (PCR). We also evaluated turbidity, iron, magnesium, zinc, and copper content, and heterotrophic bacteria of the samples. Findings: From the 33 cooling towers examined, 15% and 70% of the samples were positive for Legionella by the culture method and nested PCR, respectively. Biochemical tests showed Legionella pneumophila to be the main detected species in contaminated water samples. Conclusion: The results of the study indicated that cooling towers can potentially transmit Legionella infections. Therefore, regular monitoring and application of control measures such as disinfection of waters of cooling towers are needed to minimize human exposure to Legionella, especially in hospital environments with high risk patients. Keywords: Legionella, Water, Cooling tower, Polymerase chain reaction Background: Legionella are Gram negative and non-spore bacteria which are found in various natural and manmade aquatic environments. Legionella can cause legionnaires' disease or Pontiac fever. Inhalation of aerosols from contaminated water sources leads to Legionella infections or legionellosis. Contamination of waters from cooling towers with Legionella was recognized as a major source for legionellosis. Therefore, this study was conducted to survey the Legionella contamination of waters from cooling towers. Methods: A total of 33 water samples were taken from cooling towers. After measuring temperature and pH, the samples were examined for the presence of Legionella in two methods of culture and polymerase chain reaction (PCR). We also evaluated turbidity, iron, magnesium, zinc, and copper content, and heterotrophic bacteria of the samples. Findings: From the 33 cooling towers examined, 15% and 70% of the samples were positive for Legionella by the culture method and nested PCR, respectively. Biochemical tests showed Legionella pneumophila to be the main detected species in contaminated water samples. Conclusion: The results of the study indicated that cooling towers can potentially transmit Legionella infections. Therefore, regular monitoring and application of control measures such as disinfection of waters of cooling towers are needed to minimize human exposure to Legionella, especially in hospital environments with high risk patients. Keywords: Legionella, Water, Cooling tower, Polymerase chain reaction https://jims.mui.ac.ir/article_13831_aba2b11d01c3742d77a4391276731579.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 30 195 2012 08 22 Anti-Angiogenic Effects of Pomegranate Peel Extract (Punica Granatum L.) on Human Umbilical Vein Endothelial Cells Anti-Angiogenic Effects of Pomegranate Peel Extract (Punica Granatum L.) on Human Umbilical Vein Endothelial Cells 13832 FA Nasim Dana Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Shaghayegh Haghjooy Javanmard Assistant Professor, Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Fazilati Associate Professor, Department of Biochemistry, Payam-e-Noor University, Tehran, Iran Ali Asghar Pilehvarian Assistant Professor, Department of Basic Sciences, Isfahan Payam-e-Noor University, Isfahan, Iran Journal Article 2012 04 25 Background: Angiogenesis, the process of forming new blood vessels from previously existing vessels, plays an important role in the development of various physiological and pathological phenomena including tumor growth. Currently, angiogenesis inhibition is considered as a supplement for the conventional cancer treatments like chemotherapy and radiation therapy. This study aimed to investigate the anti-angiogenesis effects of pomegranate peel extract. Methods: Hydroalcoholic extract was prepared from the peel of black pomegranate (from Yazd, Iran). Afterwards, 1×105 human umbilical vein endothelial cells (HUVEC) were cultured on Matrigel and treated with different doses of extract (10, 100, and 1000 μg/ml) for 24 hours. The cells were then stained with calcein and investigated by fluorescent microscopy. The obtained images were analyzed by AngioQuant software. Data analysis was performed in SPSS15 using Kruskal-Wallis and one way analysis of variance (ANOVA). Findings: Significant dose-dependent reductions were detected in the length, size, and number of junctions of the tubes at all 3 doses of pomegranate peel extract. The most significant anti-angiogenic effect was observed as the dose 1000 µg/ml. Compared to the other 2 doses, this dose could better reduce tube size (19.46 ± 2.61 vs. 20186 ± 1627 at 10 μg/ml and 11195.67 ± 5454 at 100 μg/ml) and tube length (66 ± 12 vs. 5602 ± 1108 at 10 μg/ml and 3084.4 ± 1541 at 100 μg/ml). Furthermore, there were no junctions at 1000 µg/ml while the junction formation was 93.67 ± 50 and 26 ± 13 at 10 and 100 μg/ml, respectively. Conclusion: Our results indicated anti-angiogenic effects of pomegranate peel extract. It can thus be considered as a candidate for the inhibition of angiogenesis in pathologic angiogenesis-dependent diseases. Keywords: Punica granatum, Human umbilical vein endothelial cells, Angiogenesis Background: Angiogenesis, the process of forming new blood vessels from previously existing vessels, plays an important role in the development of various physiological and pathological phenomena including tumor growth. Currently, angiogenesis inhibition is considered as a supplement for the conventional cancer treatments like chemotherapy and radiation therapy. This study aimed to investigate the anti-angiogenesis effects of pomegranate peel extract. Methods: Hydroalcoholic extract was prepared from the peel of black pomegranate (from Yazd, Iran). Afterwards, 1×105 human umbilical vein endothelial cells (HUVEC) were cultured on Matrigel and treated with different doses of extract (10, 100, and 1000 μg/ml) for 24 hours. The cells were then stained with calcein and investigated by fluorescent microscopy. The obtained images were analyzed by AngioQuant software. Data analysis was performed in SPSS15 using Kruskal-Wallis and one way analysis of variance (ANOVA). Findings: Significant dose-dependent reductions were detected in the length, size, and number of junctions of the tubes at all 3 doses of pomegranate peel extract. The most significant anti-angiogenic effect was observed as the dose 1000 µg/ml. Compared to the other 2 doses, this dose could better reduce tube size (19.46 ± 2.61 vs. 20186 ± 1627 at 10 μg/ml and 11195.67 ± 5454 at 100 μg/ml) and tube length (66 ± 12 vs. 5602 ± 1108 at 10 μg/ml and 3084.4 ± 1541 at 100 μg/ml). Furthermore, there were no junctions at 1000 µg/ml while the junction formation was 93.67 ± 50 and 26 ± 13 at 10 and 100 μg/ml, respectively. Conclusion: Our results indicated anti-angiogenic effects of pomegranate peel extract. It can thus be considered as a candidate for the inhibition of angiogenesis in pathologic angiogenesis-dependent diseases. Keywords: Punica granatum, Human umbilical vein endothelial cells, Angiogenesis https://jims.mui.ac.ir/article_13832_2d8fe42de2f833581faa077f788329fa.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 30 195 2012 08 22 The Relationship between Spiritual Wellbeing and Stress, Anxiety, and Depression in Patients with Breast Cancer The Relationship between Spiritual Wellbeing and Stress, Anxiety, and Depression in Patients with Breast Cancer 13833 FA Amir Musarezaie MSc Student, Department of Nursing, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Homayoon Naji Esfahani Assistant Professor, Department of Operating Room, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Tahereh Momeni Ghaleghasemi MSc Student, Department of Nursing, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Jahangir Karimian Associate Professor, Department of of Physical Education, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran Amroallah Ebrahimi Assistant Professor, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-0267-3407 Journal Article 2012 05 22 Background: As a highly prevalent disease among women, breast cancer causes deep psychological and emotional complications such as stress, anxiety, and depression. Due to previous paradoxical findings, we performed this study to survey the relationship between spiritual wellbeing and stress, anxiety, and depression in patients with breast cancer who referred to a specialized cancer treatment center affiliated with Isfahan University of Medical Sciences (Iran) in 2012. Methods: This descriptive, analytic study was conducted on cancer patients who were selected using simple sampling. A total number of 297 hospitalized patients with breast cancer were enrolled. The depression, anxiety, and stress scale (DASS-42) and the spiritual wellbeing questionnaire (by Ellison and Paloutzian) were used to measure stress, anxiety, depression, and spiritual well-being. Data was analyzed using statistical methods such as independent t-test and Pearson's correlation coefficient in SPSS18. Findings: The mean scores of religious and existential aspects of spiritual wellbeing were 51.38 ± 8.17 and 42.47 ± 10.21 (both out of 60), respectively. The mean total score of spiritual wellbeing was 93.69 ± 10.04 out of 120. The spiritual wellbeing scores of the majority of participants (60.6%) were in the range of medium. Pearson's correlation coefficient showed statistically significant relationships between spiritual wellbeing and stress (p < 0.001, r = -0.44), anxiety (p < 0.001, r = -0.27), and depression (p < 0.001, r = -0.48) in patients with breast cancer. The 2 aspects of spiritual wellbeing were also significantly correlated with stress, anxiety, and depression. Conclusion: According to our findings, breast cancer patients with higher scores of spiritual wellbeing had lower levels of stress, anxiety, and depression. Therefore, the treatment of patients with breast cancer needs to pay simultaneous attention to spiritual well being and physical health. Keywords: Anxiety, Depression, Neoplasm, Spirituality, Stress Background: As a highly prevalent disease among women, breast cancer causes deep psychological and emotional complications such as stress, anxiety, and depression. Due to previous paradoxical findings, we performed this study to survey the relationship between spiritual wellbeing and stress, anxiety, and depression in patients with breast cancer who referred to a specialized cancer treatment center affiliated with Isfahan University of Medical Sciences (Iran) in 2012. Methods: This descriptive, analytic study was conducted on cancer patients who were selected using simple sampling. A total number of 297 hospitalized patients with breast cancer were enrolled. The depression, anxiety, and stress scale (DASS-42) and the spiritual wellbeing questionnaire (by Ellison and Paloutzian) were used to measure stress, anxiety, depression, and spiritual well-being. Data was analyzed using statistical methods such as independent t-test and Pearson's correlation coefficient in SPSS18. Findings: The mean scores of religious and existential aspects of spiritual wellbeing were 51.38 ± 8.17 and 42.47 ± 10.21 (both out of 60), respectively. The mean total score of spiritual wellbeing was 93.69 ± 10.04 out of 120. The spiritual wellbeing scores of the majority of participants (60.6%) were in the range of medium. Pearson's correlation coefficient showed statistically significant relationships between spiritual wellbeing and stress (p < 0.001, r = -0.44), anxiety (p < 0.001, r = -0.27), and depression (p < 0.001, r = -0.48) in patients with breast cancer. The 2 aspects of spiritual wellbeing were also significantly correlated with stress, anxiety, and depression. Conclusion: According to our findings, breast cancer patients with higher scores of spiritual wellbeing had lower levels of stress, anxiety, and depression. Therefore, the treatment of patients with breast cancer needs to pay simultaneous attention to spiritual well being and physical health. Keywords: Anxiety, Depression, Neoplasm, Spirituality, Stress https://jims.mui.ac.ir/article_13833_08b94fd98ee63a60c5d191649dcfe29a.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 30 195 2012 08 22 A Comparative Survey on the Expression of P16 as a Tumor Suppressor Protein in Cancerous and Non-Cancerous Colorectal Tissue Samples Using Immunohistochemistry Method A Comparative Survey on the Expression of P16 as a Tumor Suppressor Protein in Cancerous and Non-Cancerous Colorectal Tissue Samples Using Immunohistochemistry Method 13834 FA Mehdi Nikbakht Dastjerdi Associate Professor, Department of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Moeini Student of Medicine, School of Medicine And Student Research committee, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 06 16 Background: P16 is known as a tumor suppressor protein. This study was conducted to evaluate the association of P16 expression and pathogenesis of colorectal cancer. The presence of P16 in cancerous and non-cancerous colorectal tissue samples were thus compared using immunohistochemistry method. Methods: In this stud, 50 paired tissue samples were provided. The pairs were comprised of samples of cancerous colorectal tissue and normal peers from non-cancerous tissue adjacent to cancerous ones. Expression of P16 was studied on paraffined sections using immunohistochemistry method. Findings: Although P16 was expressed in all tissue samples, we found a lower expression in colorectal cancerous tissue in comparison with normal tissue samples. This difference was revealed to be statistically significant (P < 0.001). Conclusion: The presence of P16 can be regarded as an appropriate biological marker and a valuable prognostic factor for colorectal cancer. Keywords: Colorectal cancer, Immunohistochemistry, Tumor suppressor gene, P16INK4a Background: P16 is known as a tumor suppressor protein. This study was conducted to evaluate the association of P16 expression and pathogenesis of colorectal cancer. The presence of P16 in cancerous and non-cancerous colorectal tissue samples were thus compared using immunohistochemistry method. Methods: In this stud, 50 paired tissue samples were provided. The pairs were comprised of samples of cancerous colorectal tissue and normal peers from non-cancerous tissue adjacent to cancerous ones. Expression of P16 was studied on paraffined sections using immunohistochemistry method. Findings: Although P16 was expressed in all tissue samples, we found a lower expression in colorectal cancerous tissue in comparison with normal tissue samples. This difference was revealed to be statistically significant (P < 0.001). Conclusion: The presence of P16 can be regarded as an appropriate biological marker and a valuable prognostic factor for colorectal cancer. Keywords: Colorectal cancer, Immunohistochemistry, Tumor suppressor gene, P16INK4a https://jims.mui.ac.ir/article_13834_042aec9e604155f2f06c0a16c5f9ba06.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 30 195 2012 08 22 Causes of Infection and CD4+ Counts in Patients with HIV/AIDS Causes of Infection and CD4+ Counts in Patients with HIV/AIDS 13835 FA Alireza Emami Naeini Associate Professor, Department of Infectious Diseases, School of Medicine And Infectious and Tropical Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Helia Hemmasian Ettefagh Student of Medicine, School of Medicine And Student Research committee, Isfahan University of Medical Sciences, Isfahan, Iran. Kiana Shirani Resident, Department of Infectious Diseases, School of Medicine AND Student Research Committee AND Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-2960-9624 Farnoush Mirzadeh Resident, Department of Infectious Diseases, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Ahmad Bagheri Resident, Department of Infectious Diseases, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2012 06 30 Background: Infection with human immunodeficiency virus (HIV) causes progressive dysfunction of cell-mediated immune system. HIV-related immunosuppression significantly increases the risk for acquiring opportunistic infections due to bacteria, viruses, fungi, parasites, and protozoa. These opportunistic infections are a major source of morbidity and mortality in HIV-infected patients. These infections have different clinical manifestations in terms of etiological factors and infected organ. Awareness of these infections and infected organs can help physicians for early diagnosis and appropriate therapeutic intervention. Methods: In a cross-sectional study during 2006-2010, all HIV infected patients who had been admitted to Alzahra Hospital (Isfahan, Iran) with the diagnosis of infection were studied. Demographic information, etiology of infection, kind of infected organ, and CD4+ (cluster of differentiation 4) count were surveyed and analyzed by statistical tests. Findings: The etiology of infection among the 64 studied patients was bacterial (68.8%), viral (15.6%), protozoal (10.9%), and fungal (4.7%). The most and least commonly infected organs were respiratory system (28.1%) and gastrointestinal system (1.6%), respectively. The mean CD4+ counts in bacterial, viral, fungal, and protozoal infections were 190.5, 170.9, 203.7, and 158.1, respectively. Conclusion: The most common etiology of infection was bacterial infections and the most common infected organ was respiratory system. The mean CD4+ count was 185. According to the analysis of variance, the mean CD4+ counts did not significantly differ based on the infected organ or the type of infection. Keywords: Infection, Human immunodeficiency virus, Acquired immunodeficiency syndrome Background: Infection with human immunodeficiency virus (HIV) causes progressive dysfunction of cell-mediated immune system. HIV-related immunosuppression significantly increases the risk for acquiring opportunistic infections due to bacteria, viruses, fungi, parasites, and protozoa. These opportunistic infections are a major source of morbidity and mortality in HIV-infected patients. These infections have different clinical manifestations in terms of etiological factors and infected organ. Awareness of these infections and infected organs can help physicians for early diagnosis and appropriate therapeutic intervention. Methods: In a cross-sectional study during 2006-2010, all HIV infected patients who had been admitted to Alzahra Hospital (Isfahan, Iran) with the diagnosis of infection were studied. Demographic information, etiology of infection, kind of infected organ, and CD4+ (cluster of differentiation 4) count were surveyed and analyzed by statistical tests. Findings: The etiology of infection among the 64 studied patients was bacterial (68.8%), viral (15.6%), protozoal (10.9%), and fungal (4.7%). The most and least commonly infected organs were respiratory system (28.1%) and gastrointestinal system (1.6%), respectively. The mean CD4+ counts in bacterial, viral, fungal, and protozoal infections were 190.5, 170.9, 203.7, and 158.1, respectively. Conclusion: The most common etiology of infection was bacterial infections and the most common infected organ was respiratory system. The mean CD4+ count was 185. According to the analysis of variance, the mean CD4+ counts did not significantly differ based on the infected organ or the type of infection. Keywords: Infection, Human immunodeficiency virus, Acquired immunodeficiency syndrome https://jims.mui.ac.ir/article_13835_51e2038e383ecfc953bf1ab5a0747c63.pdf