Tehran University Medical Journal

---

Artifacts in histopathology, could create serios errors and cause misdiagnosis. In some cases, the degree of artifactual damage is so large that may involve the entire specimen, rendering it suboptimal or useless for diagnostic purposes. Usually, cases of oral cavity specimens are of small size and fine texture, and as a result, the astifacts are more effective on them. However, there are very limited reports in this respect. The present study included a relatively vast range of possible causative factors (which could cause artifacts in histiomorphology). 100 specimens went under the influences of 22 factors. We found that in common, causative factors with reports of Mehregan and Margarone our results are, somehow similar in other cases, which were for the first time applied to, the results were interesting and impressive for some kind of mucosal lesions such as pemphigoids are on malignant and premalignant lesions.

---

Job stress results from a mismatch between job requirements and capabilities, resources, or needs of the worker. Physiological, psychological and behavioral outcomes caused by job stress not only hurt the person but also impose expensive costs on organizations. Firefighting is a job that exposes workers to job stress. The purpose of this study is to determine the level of job stress and some related factors in firefighters of Tehran safety services and firefighters organization. This cross sectional study includes 155 male firefighters whom had selected randomly. In this research we used Leiden University Questionnaire. Also Karasek Questionnaire is used for classification of workers according to karasek’s model. Collected data were analyzed by spss9 software. The final grade of firefighter’s job stress shows a significant positive relationship with second job and a significant negative relationship with age. The level of job satisfaction have a significant negative relationship with job insecurity and lack of meaningfulness, and a significant positive relationship with skill discretion, social support supervisor and social support co-workers. According to karasek classification this job is grouped in active not in high strain grup. The highest level of job stress was seen in physical exertion and hazardous exposure factors. Also in work and time pressure factor, job stress level is high. But job stress is in a moderate or low level in other factors. The level of job stress in younger firefighters and in individuals with a second job indicate a significant increase. However, in western country’s studies, this job is classified as high-strain but in this research it is classified as active group.

---

Background: The role prophylactic antibiotics in otologic surgery continues to be debated and perhaps misused. Prior studies have provided conflicting evidence with benefits obtained from the use of prophylactic antibiotics in surgery for chronic otitis media.

Materials and Methods: The current study was designed to evaluate the role of prophylactic antibiotics in the wound infection and outcome of surgery for chronic ear disease. It was the authors' impression that there was no difference between topical and systemic antibiotics in such surgery. Patients who met the inclusion criteria (n=193) were randomly assigned to a topical treatment group or a control group receiving only intravenous antibiotics for 1 dose intra operatively and 3 dose there after. Patients were followed post-operatively and observed for clinical evidence of infection, graft failur and hearing status.

Results: There was no statistically significant difference between the two groups with regard to the incidence of postoperative infection or graft survival.

Conclusion: The use of prophylactic antibiotics in surgery for chronic otitis media can be recommended as an alternative method.

---

Introduction: PMA is known to induce the differentiation of monocytes to macrophages. This agent also increases the killing effect of the monocytes/macrophages through oxidative burst and can be used as a stimulant for oxidative burst assay. The present experimental study was intended to investigate the in vitro effects of PMA on the differentiation, morphological changes, cell adherence and the viability of monocyted-derived macrophages (MDMs). Besides, MDM capacity for free radical production was assessed, indicating the oxidative burst events.

Materials and Methods: This experimental study has been design in Department of Immunology of S.B.M.U in Tehran Iran (year 2000). Peripheral mononuclear cells from adult Balb/c mice were isolated and cultured in complete tissue culture medium and divided in two group: control, (without PMA) and test (were added Pma=450 ng/ml). MDMs wee counted on the hours 1, 2, 3, 4, 6 and 18 and their characteristics were confirmed by morphological analysis (histological features) in both groups. Viability of MDMs was assessed using trypan blue. In the peak time of MDMs activation the oxidative burst was determined by NBT reduction.

Results: The obtained results suggested that PMA had significant effect on the differentiation of monocytes to macrophages. The morphologic maturation tended to occur in earlier stages in the PMA treated cells comparing to the control MDMs. Also, the number of adherent cells was considerably more in PMA stimulated monocytes. The peak time of cell adherence in the presence of PMA was no the second hour. As the incubation period increased, the significant difference between the numbers of adherent cells in two culture systems decreased. However, viability decreased significantly in the PMA treated MDMs, i.e. PMA treatment induced rapid apoptosis in the MDMs after their activation. PMA stimulated MDMs markedly (60%). Also we mentioned that the primary un-stimulated MDMs only revealed (55%) of NBT reduction after treatment with PMA at NBT reduction stage.

Conclusion: Phagocytic function and oxidative burst assay in monocyte-macrophage lineage can be a diagnostic tool for identification and management of some Immunological abnormality and defect and can be establish distinct from other phagocytic system assessment.

---

Background: Tympanic membrane perforation as a sign of different otologic disorders have multiple causes, for example trauma .Traumatic perforations heal spontaneously in most cases but in large and stable perforation otolarngologist intervention is necessary . In the stable perforation of tympanic membrane , if there isn’t infection in the tympanic cavity , the paper patch or myringoplasty may be used. These procedures need remedy charge and time and may be with morbidity and other complications. Recently materials like hyaluronic acid and epidermal growth factors has been used to speed healing of tympanic membrane perforation, and their effect has been proved. Pentoxifylline an anti-thrombotic drug has positive effect on increasing perfusion and wound healing in pathological conditions. Alike we have used pentoxifylline to show it’s effect on the healing of guinea pig perforated tympanic membrane.

Materials and Methods: This study has been done prospectively, on 32 guinea pig ears.

  Results & Conclusion: Final otomicroscopic study after three weeks showing no significant difference in the healing rate of tympanic membrane in pentoxifylline group versus control group.

---

Background: The damaging effect of exposure to loud noise on the structures of internal ear has been studied from many years ago. The effect of drill-generated noise on the non-operated ear is one of the problems that are less discussed. This study aims to evaluate the hearing loss that occurs in the non-operated ear in patients who undergo mastoidectomy by use of PTA (pure tone audiometery) and DPOAE (distortion product otoacoustic emission).

Materials and Methods: In this descriptive- analytic study, 49 patients who underwent mastoidectomy in Amir-Alam and Iman Khomeini hospitals, were evaluated for noise trauma generated by drilling on the non-operated ear. Patients were between 9-55 years old (mean age= 29) and they consisted of 25 males and 24 females. The patient's preoperative state were measured by PTA and DPOAE on the opposite ear also the postoperative state were re-evaluated by PTA and DPOAE.

Results: As a result, in 4 cases a significant change in PTA thresholds were observed, while two of them showed recovery after one month. Seven cases showed significant change in DPOAE amplitudes, of whom five cases recovered later.

Conclusion: In conclusion, the drill-induced hearing loss on the non-operated ear occurs in a few patients and it is often reversible.

---

Background: Community-acquired pneumonia could be a life-threatening condition especially in elderly patients. The factors influencing the outcome in elderly patients are thought to be different from those in young adults. We compared the clinical and paraclinical profiles in elderly and nonelderly patients with community-acquired pneumonias.
Methods: In this cross-sectional study, seventy nine patients who were hospitalized with community acquired pneumonia over a period of one year were included. Patients' medical records were reviewed and data related to comorbid conditions, signs and symptoms, laboratory and radiographic findings were gathered using a checklist.
Results: The clinical features, laboratory parameters and complications from pneumonia were almost similar in 41 elderly (group I, age ≥65years) and 38 young (group II, age<65years) subjects. Delirium was seen more in elderly group (p=0.05). The average body temperature and pulse rate were significantly higher in nonelderly group. Sixty one percent of elderly patients and 21% of young patients have Po2 less than 60 (p=0.02). Smoking (29.1%), neurological disturbances (19%), congestive heart failure (15.2%), chronic obstructive pulmonary disease and diabetes mellitus (13.9%) were associated comorbidities in both groups. In non elderly group, immune compromise and IV drug use were more common as underlying comorbid conditions. Two of three mortalities were due to elder patients.
Conclusion: Community acquired pneumonia could have more serious clinical and abnormal laboratory features in the elderly than younger patients. Mortality rate may be higher in older patients. Comorbid conditions are frequently seen in both elderly and nonelderly patients with community acquired pneumonia, but IV drug use and immune compromise are more frequent in nonelderly patients.

---

Background: Infertility is a worldwide problem. Many different factors may cause infertility. Among them, bacterial infection of the reproductive system is one of the main factors. Recently, some limited investigation has revealed that H. pylori is capable of causing genital inflammation that may lead to infertility. Although known to be a causative agent of gastritis and duodenal ulcers, this species may be transferred orally to the vagina and asymptomatic infection leads to inflammation of the system and finally manifestation of infertility. In addition, infertility may be due to antibodies synthesized against H. pylori cross-reacting with the genital tissue.
Methods: In the present study, 180 women consisting of 90 cases referred to IVF center of Yazd and 90 matched controls were enrolled. Serum was taken from all women for detection of IgG and IgM using the ELISA technique.
Results: A total of 117 (65%) serum samples were positive for Helicobacter, of which 63.3% were from fertile and 66.7% from infertile women. The serum positive population was found to be predominantly in the age range of 25-35, although some 35-42 year olds were also serum positive. When the prevalence of Helicobacter infection status was compared with marriage duration in both groups, it was found that antibody titer in subjects from marriages with durations of greater than five years was significantly higher than those of five-year marriages. In addition, higher antibody titers were found in infertile women with fallopian tube (FT) factor and lower titers in those with polycystic factors.
Conclusion: Although the results were not significant, they nevertheless indicate that the Helicobacter antibody titers in infertile women were higher than those of fertile women (P =0.6). Therefore, further studies are necessary to determine the role that Helicobacter infection plays with regard to infertility among women. Since the antibody titer in infertile cases with FT factor was higher than others, it may indicate that inflammation caused by H. pylori plays an indirect role in the induction of infertility.

---

Background: The misdiagnosis of urinary tract infection (UTI) may lead to kidney deficiency and even pyelonephritis. Since different species may cause this disease, urine culture (UC) and antibiogram of the isolated species should be performed and results compared to urine analysis (UA) parameters to obtain the best diagnosis.
Methods: The urine specimens from 1509 patients (1195 women and 314 men) were processed for UA, UC and antibiogram. First of all, the sterile urine samples were cultured using differential media, including EMB and blood agar. After 24 hr incubation, the colonies were identified and differentiated by biochemical tests. Antibiograms for all isolated species were determined using Muller Hinton agar. All results obtained from this survey were analyzed using SPSS software.
Results: Of the 1509 samples, 986 (65.3%) were positive for pathogenic bacteria, 170 (17.2%) of which were from men and 816 (82.8%) from women. E. coli was the most prevalent with 591 cases (58.7%), followed by Enterobacter 115 (11.4%) and Klebsiella 88 (8.8%). Data analysis revealed that the correlations between the WBC, RBC, nitrite, crystal, and protein were significantly higher in culture-positive samples. Of the antibiotics tested, isolated species were most sensitive to amikacin and most resistant to ampicillin.
Conclusion: The present study revealed a correlation between pyuria and bacteruria however, it should be noted that the clinical signs and the presence of WBC in urine could not be used to confirm the UTI. In addition, since different bacterial species are able to cause UTI, in order to administer proper treatment while controlling improper use of antibiotics, thorough testing, including UA and UC together with antibiogram, is strongly recommended.

---

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer in the pediatric population. With modern treatments, the chance of the complete recovery is nearly 100%. The most important prognostic factors are appropriate treatment protocol and determination of patient risk factors based on clinical, morphological, immunological and cytological characteristics. In this study we reviewed frequency of these factors, like as age, gender, the primary white blood cell number, sub- group on the base of FAB classification, immunophenotype and the clinical progress.

Methods: In this retrospective study, we reviewed 877 pediatric patients with the diagnosis of ALL between the years of 1994 and 2004. In these patients the age, gender, primary WBC count, sub-group based on the FAB classification, immunophenotype and the clinical progress in 177 patient with acute lymphoblastic leukemia at Imam Khomeini Hospital between the years of 1994 to 2004 were determined.

Results: Of these patients, 1.6% was younger than one year, 24.8% more than ten years old and 73.6% were between the ages of one and ten years 63.8% were male. WBC counts were above 50,000/ul in 28.8% of the patients. FAB classifications included L1 in 80.2%, L2 in 17.5% and L3 in 2.3% of the patients. Immunophenotypes included pre-B cell in 63.8%, early pre-B cell in 23.1%, T cell in 12.3% and mature B cell in 0.8% of the patients. Marker CD10+ was detected in 88.1% of the B cell cases. In this study group, 74% of the patients recovered, 16.3% died and 16.5% relapsed.

Conclusions: The prevalence of FAB-L1 and pre-B cell cases in this study is greater than a previous study, while the prevalence of FAB-L2 and early pre-B cell cases is less than that of the previous study.

---

Background: Cirrhosis and portal hypertension influence the hepatic circulation. The purpose of this study was to evaluate the diagnostic accuracy of liver Doppler ultrasonography parameters in cirrhosis.

Methods: This case-control study involved 118 subjects. All case subjects had biopsy-proven hepatic cirrhosis. The controls were healthy people, case-matched for age and gender. All cases and controls underwent Doppler ultrasonographic evaluation. We compared the area under the ROC curve of each parameter for cases vs. controls using Fisher's exact test, with p <0.5 indicating significance.

Results: The means of the following parameters for case vs. control subjects were: frequency of portal venous flow inversion, portal vein diameter 12.67±2.72 vs. 10.59±1.69, and hepatic arterial resistance index 0.81±0.07 vs. 0.74±0.09. The mean hepatic artery pulsatility index (1.87±0.48 vs. 1.34±0.23), was significantly higher among the case subjects (P=0.001). The maximum flow rate of the portal vein was also significantly lower in the case subjects (16.50±5.59 vs. 36.74±8.74 cm/s, P=0.001). We did not observe significant differences in the means of the hepatic artery maximum flow rate and end-diastolic flow rate. For diagnosing cirrhosis, the application of 24.1 cm/s as the cutoff point for the portal vein maximum flow rate, we obtain an accuracy of 95.45% (91.23%-97.70%, CI=95%), whereas a cutoff point of 1.54 or more for the hepatic artery pulsatility index yields an accuracy of 85.71% (79.48%-90.29%, CI=95%). Utilizing a hepatic arterial resistance index of 0.765 or greater is associated with an accuracy of 71.05% (62.81%-78.11%, CI=95%) in diagnosing cirrhosis.

Conclusions: Doppler ultrasonography and assessment of hepatic artery and portal vein parameters are accurate methods in the diagnosis of cirrhosis.

---

Background: Several therapeutic modalities have been cited for patients with microtia. Recently there are several reports about using cadaveric homograft cartilage for some other purposes. The aim of this study was to assess the results of auricular reconstruct-tion in 10 patients (12 ears) with congenital atresia using homograft rib cartilage from the Iranian Tissue Bank.

Methods: We enrolled 10 patients with microtia who were referred to the Imam Khomeini Hospital from September 2006 to July 2007 for auricular reconstruction. The reconstruction was performed using a pre-shaped homograft(s) of each patient's ear(s) made by the Iranian Tissue Bank from the 6th, 7th and 8th costal cartilage according to the method of Marquette. In six patients, the second stage of reconstructive surgery was performed three months after the first stage. The patients were followed regarding the ear appearance, the dimensions of cartilage and tissue reaction.

Results: The mean age of the patients was 11.08 (SD=5.57) years and the average duration of follow-up was 6.29 (SD=3.12) months. Eight cases had unilateral involvement (six right and two left), in addition to two cases of bilateral involvement. During the follow-up period, the appearance of the helix was satisfactory in 11 ears and the lobule in 10 ears. The height and width of the reconstructed auricles was an average of 1-2 millimeters different from the opposite ear. Erythema was the most common early complication. Late complications, including cartilage exposure and infection, were observed in one patient.

Conclusion: Auricular reconstruction using homograft costal cartilage in patients with microtia has promising results. The short term resorption can be ignored and significant early or late complications are infrequent.

---

Background : Septic Arthritis is an acute infection of intra-arthicular space. Delay in diagnosis and in appropriate treatment may lead to prolongation of treatment duration and poor outcome. We decided to evaluate clinical aspects of this disease in our department pediatric department, Imam Khomeini Hospital complex, Tehran, Iran during a 10 years period.

Methods : In a retrospective cross-sectional study, 60 patients with age from 1 month to 14 year-old during 1996-2005 were evaluated. The demographics characteristics, clinical observations (signs & symptoms) and paraclinic values were gathered from medical records and analyzed with statistical tests.

Results : Pain and Swelling was seen in all, joint limited motion in 80% ( 50 cases) claudicating in 64% ( 38 cases), fever in 80% ( 48 cases), monoarticular disease in 80% ( 48 cases) and polyarticular one in 20% ( 12 cases) of them. Hip was most Common involved joint 62% ( 37 cases), elevated ESR was seen in all patients. CRP was positive in 85% ( 51 cases). Leuckocytosis was found in 65/8% ( 17 cases) of cases. In infectious cases, Staphylococcus aurous was responsible organism in 65.6% ( 16 cases), klebsiella in 12.4% ( 3 cases), Streptococcus pneumonia in 12.3% ( 3 cases), group b streptococcus in 4.1% ( 1 case), Hemophilus Influenza type b in 4.1% ( 1 case) of study patients. With therapy ESR was normalized in 64% ( 39 cases) and CRP was normalized in all patients.

Conclusions: In general, all children with complaint of fever, pain, and limited joint motion or claudicating should be suspected for septic arthritis.

---

Background: In according to immunomodulatory effect of probiotics and effect of these bacteria on the effectiveness of immune responses, at the present work we proposed the evaluation of oral administration of L.acidophilus on the immune statues in BALB/c mice bearing breast cancer.
Methods: A total of 30 In-bred BALB/c mices aged from six to eight weeks weighting 25-30g were randomly enrolled in our study, in two groups each consist of 15 mices. The L.acidophilus ATCC4356 strain used in this study was inoculated in MRS broth and cultivated for a day at 37°^C under anaerobic conditions, collected by centrifugation and resuspend in Phosphate Buffer Saline (PBS). After preparation of proper amount of these suspensions it was orally administered to the mice with a gastric feeding, Control mices received an equal volume of PBS in duration of study.
Results: Results showed the increase in production of IFnγ (p<0.005), and decrease in production of Th2 cytokines such as IL4 (p=0.347) in the L.acidophilus administered mice in comparison to control group of mice. In addition the proliferation of immune cells in probiotic group was significantly higher than controls, and most importantly probiotic administered mice showed an increase in survival rate of this group compared to control mice (p<0.001).
Conclusion: Results of our study suggested that daily consumption of Lactobacillus acidophilus can regulate immune responses skewed Th1 balance that is needed against tumor, further studies is needed to investigate the other mechanisms of this effect.

---

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Recombinant antibodies are new versions of monoclonal antibodies that are produced by recent molecular biology techniques. These antibodies can be isolated by phage display technology from immune or non-immune libraries. Recombinant antibodies are applied to treatment of some diseases and also are increasingly used for diagnosis and detection of many antigens. In the latter case, the presence of antigen-antibody complexes has to be detected by further approaches. The aim of current research was to stain an anti-K99 phage antibody with two different protein dyes and to apply them directly for detection of E. coli K99 fimbriae.
Methods: In order to stain above antibody, a phagmid vector carrying the anti-K99 single-chain Fv (scFv) antibody was isolated, purified and transformed into TG1 strain of E. coli. Afterward, the antibody was expressed in this cell as phage-scFv antibody. Phage antibodies were subsequently eluted, purified and stained with Disperse Red dye 60 and Coomassie Brilliant Blue. Finally, the binding activity of coloured phage antibodies towards the purified K99 fimbriae was verified by immunoblotting.
Results: The results showed that anti-K99 phage antibody was stained with both dyes and the coloured phages were able to recognize the corresponding antigen.
Conclusions: These protein stains that they usually do not alter the protein structure can be used for staining phage antibodies. The coloured phage antibodies retain their binding affinity for the antigens, and therefore can be applied to detection of relevant antigens.

---

Background: One of the most important components of coronary artery bypass graft surgery is need for blood transfusion that increases morbidity and mortality. The aim of this study was to evaluate the factors affecting the need for blood transfusion during off pump coronary artery bypass (OPCAB) surgery.
Methods: In this descriptive case control study 923 patients who had undergone OPCAB at Afshar Hospital in Yazd, Iran, from July 2008 to January 2010 were evaluated. The data was gathered from their records and was analyzed.
Results: 54% of male and 79% of female patient need blood transfusion. Mean age in patients needed transfusion was 61.58±11.11 years and in other group was 60.27±10.98 years of the patients that needed transfusion (p= 0.08). 563 (61%) of the patients needed transfusion with the average of two units. The need for blood transfusion was higher in female gender (p< 0.0001), low hematocrit (p< 0.0001), diabetes (p< 0.001), hypertension (p< 0.025) and multiple grafts (p< 0.027). There were no significant differences in preoperative hemostasis tests, affection to hyperlipidemia, CVA or renal failure, antiplatelet drug administration and the application of left internal mammary artery between the transfusion and non transfusion groups.
Conclusion: In this study preoperative hematocrit was most important risk factor in transfusion in patients that underwent OPCAB. Female gender, preoperative low hematocrit, multiple grafts, diabetes and hypertension increased the rate of blood transfusion. According to the high prevalence of blood transfusion in OPCAB, considering factors that affect the transfusion rate is essential.

---

Background: Numerous use of Beta Lactame in treatment of bacterial infections resulted in increments of drug resistance of such bacteria. One of difficulties in treatment of hospital infections is Extended Spectrum Beta Lactamase (ESBL) among isolated clinical strains of E.coli. Since some of ESBL strains shows double reaction in drug sensitivity test at in vitro and in vivo condition, therefore it makes difficulties in selection of right treatment. In the last years, CTX-M enzymes have become the most prevalent ESBLs in worldwide. The prevalence of ESBL types largely remains unknown in many parts of the Iran. This study was made to find the prevalence of ESBL-producing E.coli and molecular detection of CTX-M-1 in Tabriz.

Methods: In the present study, 400 urine samples collected between November 2009 and April 2010, from Tabriz Hospitals were studied. Out of the 400 samples, 188 E.coli isolates were detected by standard biochemical tests. Susceptibility to antimicrobial agents was tested to 10 antibiotics by the disk agar diffusion (DAD) method. ESBL production was screened by phenotypic test that included both separate and combined disk agar diffusion techniques. The screened isolates were investigated by PCR assay to detect CTX-M-1 gene.

Results: From the total 188 E.coli isolates, 82 (43.6%) were shown to produce ESBLs by phenotypic test. During the PCR method on the 82 isolates, 69 (84.1%) were confirmed as CTX-M-1 producing group.

Conclusion: The present study showed that CTX-M-producing isolates were increasing among E.coli strains and indicated the need for adequate susceptibility tests in laboratories for choosing the appropriate antibiotics for treatment.

---

Background: Regarding the immunomodulatory effects of lactobacillus bacteria, this study aimed to evaluate the effect of oral administration of Lactobacillus reuteri, as probiotic bacteria, on natural killer cell cytotoxicity and tumor-specific lymphocyte proliferation in Balb/c mice with breast adenocarcinoma.

Methods: A total of 30 female mice, aged 6- 8 weeks and with a weight of approximately 17- 19 g, were randomly divided into two groups of 15 mice. The case group received Lactobacillus reuteri at a dose of 2.7× 108 bacteria in half a milliliter of sterile phosphate buffer saline (PBS) and the control group only received PBS. The probiotic group received the regimen for two weeks prior to tumor transplantation, as they did for 30 days after transplantation with three-day intervals and durations of seven days. For the evaluation of natural killer cell cytotoxicity and also tumor-specific lymphocyte proliferation response, LDH and BrdU assays were performed respectively according to the manufacturers' instructions.

Results: The study showed that the mice in the case group which were receiving Lactobacillus reuteri had statistically significant differences in the replication of tumor -specific lymphocytes, natural killer cell cytotoxicity and delayed hypersensitivity responses Compared to the mice in the control group.

Conclusion: Daily consumption of probiotics seems to regulate the immune system and consequently it can be helpful in people with cancer. Moreover, consumption of probiotics in healthy individuals can also boost the efficiency of the immune system against a variety of abnormalities.

---

Background: Several reports indicate that the probiotics can increase body resistance against malignant tumors. The aim of this study is to evaluate the effect of Lactobaci-llus reuteri Persian type culture collection (PTCC) 1655 in preventing tumor growth, improving weight and survival rate in mice with breast cancer.
Methods: Twenty mice, the BALB/c at six weeks age, weighing approximately 17 gram were divided into two groups. Oral administration of 500 micro liters of Lactobacillus reuteri suspension performed for the first group 14 days before tumor transplantation. The second group (control) received the same volume of phosphate buffer saline (PBS). Then the mice had tumor transplantation surgery. Lactobacillus reuteri was prescribed in the first group in seven-day period and three-day interruption pattern. At the same time the second group (control) received PBS. This process was continued until 45 day. The tumor growth, histology and body weight were evaluated in both group and the mortality of mice was recorded.
Results: In the mice transplanted tumors that had received probiotics, tumor growth decreased in comparison with control group. In this group the body weight increased (P>0/05). In addition, the survival of these mice had significantly increased compared to control group (P=0.002). The evaluation of tumor tissue also showed increased immune system function in mice receiving the probiotic (P>0/05).
Conclusion: Lactobacillus reuteri can improve immune system function and have an important role to help treatment of cancer.

---

Background: The role of gram-positive cocci especially Staphylococci species in causing urinary tract infection are well known. Among the Staphylococci species Methicillin Resistance Staphylococcus aureus (MRSA) is the most important. The rate of MRSA is increasing worldwide. This is alarming because the danger of these organism in public health. Therefore the aim of this study was to determine the sensitivity of gram-positive cocci, as well as MRSA to vancomycin and other antibiotics.
Methods: This was a descriptive study, and were carried out on 300 patients with urinary tract infections (UTI) caused by gram-positive cocci, referred to Imam Khomeini hospital during eight months. Prior to the antibiotic sensitivity testing all the isolates were identified according to the standard conventional biochemical procedure, and then the antibiotic susceptibility test were carried out according to Bauer-Kirby method.
Results: Among the gram positive cocci causing UTI, the most abundant were Staphylococcus saprophyticus (37.7%), followed by Staphylococcus epidermidis (22.3%) and Staphylococcus aureus (18%) respectivley. The sex distribution of patients were 163 female (54.3%) and 137 male (45.7%) respectively, and the prevalence rate of urinary tract infections in female was (8.6%) higher than male. The rate of sensitivity of isolated Staphylococci were as followed, sensitive to vancomycine (100%), Ciprofloxacin (89.2%), rifampin (87.6%), and amikacin (71.8%) respectivley, but were resistant to penicillin and amoxicillin (100%). The antibiotic sensitivity rate of isolated  Streptococci was to vancomycine (85.1%), ciprofloxacin (50.7%) and penicillin (79.1%) respectively.
Conclusion: Vancomycin is still a suitable antibiotic for the treatment of Staphyloco-ccus infections. Although 6% rate of enterococci resistance to vancomycin is alarming, and use of this antibiotic in the treatment of other gram-positive bacteria should be done with precaution.