CD44 rs13347C>T Variants in 3'UTR and Prostate Neoplasms: A Case-control Study and Bioinformatics Approach.

CD44, a cell-surface receptor and a key player in cellular signaling, can act as both tumor suppressor and promoter. This study aimed to investigate the association of CD44 rs13347C>T variants with prostate neoplasms, including both benign prostatic hyperplasia (BPH) and prostate cancers using a case-control and bioinformatics approach. Genomic DNA was extracted from 545 blood samples (225 BPH, 225 prostate cancers, and 95 control) and the CD44 rs13347C>T genotypes were identified using PCR-RFLP. We explored miRNA interactions using the miRNASNP-v3 database and GeneMANIA for co-expression networks. Results showed cancer patients had significantly higher PSA levels compared to both controls (p= 0.03) and BPH (p= 0.01). Additionally, digital rectal examination-positive and smoker BPH patients showed significantly the increased cancer risk (p= 0.004, p= 0.046). Prostate cancer group indicated significantly higher frequency of CD44 rs13347C>T mutant allele compared to control and BPH groups, particularly in TT and CT+TT genotypes (p < 0.05). miRNA SNP-v3 database predicted the mutant allele of CD44 rs13347C>T could lose 1 and gain 6 miRNAs for a new site created. Co-expression analysis revealed a direct interaction between CD44 and aryl hydrocarbon receptor (AHR), a gene known to be dysregulated in smokers. Furthermore, these genes alone display co-expression interactions with integrin subunit alpha 4 (ITGA4), protein plays a paradoxical role, both suppressing and promoting tumors. Based on the findings, the mutant allele of CD44 rs13347C>T may disrupt miRNA binding, which may potentially impact CD44, AHR, and ITGA4 expression in smokers, possibly contributing to prostate cancer progression.

Mutant Allele of CD44 (rs8193C>T) and Pum2 Regulatory Element as A Prognosis Factor of Prostate Neoplasms: A Case-Control and In Silico Studies.

OBJECTIVE: Expression of CD44 variant 6 (CD44v6) as a homing-associated cell adhesion molecule (HCAM), has proved to change most cancer cells. Aim of the study is the effect of mutant allele of CD44 (rs8193C>T) and Pum2 regulatory element as a prognosis factor of prostate neoplasms: a case-control and in silico studies in the Mazandaran province-Iran. MATERIALS AND METHODS: In a case-control study, CD44-rs8193C>T genotyping of the 420 prostate neoplasms (210 benign prostatic hyperplasia (BPH) patients and 210 prostate cancer patients) and 150 healthy samples are performed by the touchdown polymerase chain reaction with confronting two-pair primers (PCR-CTPP) method. The T mutant allele effects on the mRNA structure and cell pathways were also investigated in silico methods. RESULTS: Our results showed that the increase of T mutant allele frequency was significantly associated with BPH compared with prostate cancer. Furthermore, results showed TT genotype was significantly associated with BPH [odds ratio (OR)=0.572 and P=0.015], and also influenced the CD44v6 transcript secondary structure, miRNA binding, and regulatory element-binding site for Pum2 protein. Attachment of Pum2 to standard CD44 transcript may lead to transcript isoform-switching and shift-expression to a variety of CD44 isoforms, which can trigger some of the cell signaling pathways, such as Nanog-Stat, PKC-Nanog, and PKC-Twist. CONCLUSION: Based on this, the presence of the T mutant allele of CD44 (rs8193C>T) in the populations may create a regulatory element-binding site for Pum2. So, it could be known as a prognosis factor and prediction of prostate neoplasms. However, more comprehensive studies in different populations (with various ethnicities and large population sizes), and also CD44v6 gene expression studies in protein and transcript levels are required to confirm our data.

Circulating plasma miR222-3P status and its potential diagnostic performance in prostate cancer.

BACKGROUND: Although studies suggest that miR222-3p is dysregulated in prostate cancer (PC) cells and tissues, the possible changes in the level of miR222-3p in the plasma samples of PC patients remained unclear. The present study aimed to evaluate the diagnostic value of the plasma miR222-3p expression level as a potential biomarker in PC, benign prostatic hyperplasia (BPH) and healthy people. METHODS: Blood samples were collected from 100 adult males (54 patients with PC, 27 patients with BPH and 19 healthy individuals) referred to our affiliated hospital. The expression level of miR222-3p was evaluated using a quantitative reverse transcription-polymerase chain reaction. Receiver operating characteristic curves were used to evaluate miR222-3p diagnostic accuracy for discriminating between the PC, BPH and healthy individuals. RESULTS: The expression level of miR222-3p was significantly higher in PC patients compared to healthy individuals as a fold change of 5.3 (p = 0.009), but not for BPH individuals. The diagnostic value of the plasma miR222-3p for discrimination of the PC patients from healthy individuals was reasonable [cut-off value (fold change relative to miR16-5p) = 1.69, area under the curve = 0.73, sensitivity = 0.75 and specificity = 0.74]. CONCLUSIONS: Circulating plasma miR-222-3p significantly upregulated in PC patients, but not in BPH ones. Besides these preliminary results showed that miR222-3p has the potential to discriminate PC patients from healthy ones. Addittional studies with a larger sample size are required to confirm these data.

The most important medicinal plants affecting sperm and testosterone production: a systematic review.

OBJECTIVE: Infertility, defined as the inability to conceive after one year of intercourse without the use of contraception, affects 15% of couples. Many factors, such as genitourinary tract infections, endocrine disorders, immunological factors and drug-related injuries, affect the male reproductive system and cause infertility. Due to men's fear of infertility, it is very important to pay attention to medicinal plants that are effective in male fertility. Therefore, the aim of this study was to evaluate the medicinal plants that affect sperm and testosterone production in men. METHODS: In this review, we used the following search terms, consisting of herbal medicine, traditional medicine, traditional therapies, sperm, testosterone, testicles and Iran were used to retrieve the relevant articles published in the journals indexed in the Information Sciences Institute, Science Direct, PubMed, Scopus, PubMed Central and Scientific Information Databases. We searched and used papers published between 2000 and 2020. Then, we analyzed the eligible papers. We collected and analyzed 35 papers from the databases. We selected only the articles about herbs that affect sperm and testosterone production. RESULTS: Based on the results, herbs Apium graveolens, Cinnamomum camphora, Cornus mas, Satureja khuzestanica, Withania somnifera, Fumaria parviflora, zingiber officinale, cinnamomum zeylanicum and Phoenix dactylifera are used in the male reproductive system. CONCLUSIONS: Plants can probably be useful in increasing fertility due to their antioxidant power and low side effects.

Clinical values of expression signature of circCDR1AS and circHIAT1 in prostate cancer: Two circRNAs with regulatory function in androgen receptor (AR) and PI3K/AKT signaling pathways.

BACKGROUND: Prostate cancer (PCa) is a genetically heterogeneous disease with highly molecular aberrations. It has been revealed that a newly discovered class of non-coding RNAs called circular RNAs (circRNAs) play key roles in dictating tumor behaviors and phenotypes of the prostate tumors. In the current study, our aim was to determine the expression profiles of circHIAT1 and circCDR1AS in PCa compared with benign prostatic hyperplasia (BPH) tissues, as well as their clinicopathological relevance. METHODS: The 50 prostate tissues including 25 PCa tissues and 25 BPH samples were collected for analyzing the expression levels of target circRNAs by quantitative real-time PCR (qRT-PCR). RESULTS: The results revealed that expression of circCDR1AS was significantly elevated in PCa compared with the BPH (p < 0.05). We also observed that PCa patients over the age of 60 had a higher expression of the circCDR1AS than patients under the age of 60 (p = 0.017). Moreover, a lower expression level of circHIAT1 was found in the PCa than BPH tissues (p < 0.05), and finally, the findings indicated that the area under the curve (AUC) of circCDR1AS was 0.848, with 92% sensitivity and 76% specificity, as well as an AUC of 0.828, with the 80% sensitivity and 76% specificity for circHIAT1. CONCLUSION: These observations suggest that the abnormal expression of circCDR1AS and circHIAT1 can be regarded as two different types of molecular pathology with potential biomarker values for PCa, although further studies are needed.

A rare case of papillary cystadenoma of epididymis presented with painless scrotal mass.

BACKGROUND: It is a rare cardiac malignant primary tumor that seems to derive from the same cellular line as myxomas, but the prognosis is very different. It is a rare cardiac malignant primary tumor that seems to derive from the same cellular line as myxomas, but the prognosis is very different. It is a rare cardiac malignant primary tumor that seems to derive from the same cellular line as myxomas, but the prognosis is very different. Cardiac myxosarcoma is a rare neoplasm that appears to rise from the same cellular source like myxoma. It is difficult to differentiate a myxoma tumor from a myxosarcoma tumor because of its appearance and pathology examination. Myxosercoma tumor requires surgery and chemoradiotherapy, but myxoma is treated only by surgery. CASE PRESENTATION: We describe a case of a 58-year-old patient with a left atrium myxosarcoma, presenting with congestive heart failure. Transthoracic echocardiogram (TTE) showed a large polypoid and mobile mass in the left atrium, the patient underwent cardiac surgery and the tumor was successfully extracted, and histopathological result revealed typical features of myxoma. 15 days after surgery, he underwent explorative laparatomy because of progressive GI bleeding. Laparatomy revealed extensive metastatic masses in abdomen and the pathology diagnoses was myxosaroma. Unfortunately, in spite of supportive care, the patient expired on postoperative day one. CONCLUSION: It is difficult to differentiate a myxoma tumor from a myxosarcoma tumor because of its appearance and pathology examination. Maybe magnetic resonance imaging can help us to achieve more data suggesting malignancy.

Congenital adrenal hyperplasia presented with bilateral testicular tumor: A case report.

BACKGROUND: Congenital adrenal hyperplasia (CAH) refers to group of congenital diseases resulting from impaired adrenal steroidogenesis, and its most common cause is 21-hydroxylase deficiency. Testicular adrenal residual tumor (TART) is one of the major complications of CAH, possibly resulting from ectopic remnants of intra-testicular adrenal tissue which is stimulated by excessive secretion of adrenocorticotropic hormone (ACTH). This tumor can be misdiagnosed as Leydig cell tumor (LCT) in these people. CASE PRESENTATION: The patient we are presenting is a 20-year-old man with a history of precocious puberty and a height below 3% of the population who underwent radical left testicular orchiectomy with a complaint of bilateral testicular mass, which is reported LCT in the pathology report. In preoperative imaging examinations, bilateral adrenal hyperplasia is observed. In hormonal examinations, the patient is diagnosed with CAH and has been treated with corticosteroids for one year. CONCLUSION: In patients who present with bilateral testicular mass, it is the best image by abdominopelvic CT scan before surgery to detect CAH.

Xanthogranulomatous pyelonephritis combined with emphysematous pyelonephritis: A rare case report.

BACKGROUND: Xanthogranulomatous pyelonephritis (XGP) is a rare and intense type of chronic kidney infection characterized by subversion of the renal tissue and its replacement by lipid- laden macrophages. XGP combined with emphysematous pyelonephritis(EPN) is rare and up until now only 7 cases with these presentations have been reported; so abundant clinical skills and appropriate radiographic imaging is required to reach the correct diagnosis. In this report, we present a case with two uncommon variants of pyelonephritis. CASE PRESENTATION: A 55-year-old female presented with a history of type 2 diabetes mellitus, and a stroke leading to a left-sided hemiplegia state for 7 years, coronary artery bypass grafting(CABG), hypertension(HTN) , seizure, progressive fatigue, loss of appetite , fecal and urinary incontinence and right costovertebral angle tenderness. According to clinical signs, symptoms and documentation of gas within the renal parenchyma on computed tomography (CT) of abdomen, of EPN diagnosis was suggested; however histopathologic evaluation showed acute emphysematous pyelonephritis on chronic xanthogranulomatous pyelonephritis. CONCLUSION: EPN can emerge in a patient suffering from XPG which would add to the severity of the situation. In the case presented, concurrent underlying diseases such as diabetes mellitus, stroke, CABG, HTN along with severe fatigue and loss of appetite existed. Surgical treatment produces dramatic results.

C-Reactive Protein as a Prognostic Indicator in COVID-19 Patients.

While some biomolecules have been explored to identify potential biomarkers for the prognosis of COVID-19 patients, there is no reliable prognostic indicator of the disease progression and severity. We aimed to evaluate the ability of the C-reactive protein (CRP) to predict COVID-19 infection outcome. This retrospective study was conducted on 429 patients diagnosed with COVID-19 between March 30, 2020, and April 30, 2020. The study population was divided into severe (n = 175) and nonsevere cases (n = 254). Data on demographic characteristics, clinical features, and laboratory findings on admission were collected. The proportion of patients with increased CRP levels was significantly higher in severe cases than in nonsevere patients. Analysis of the receiver operating characteristic (ROC) curve found that CRP could be used as an independent factor in predicting the severity of COVID-19. Also, patients with CRP >64.75 mg/L were more likely to have severe complications. In conclusion, CRP serum levels can predict the severity and progression of illness in patients with COVID-19.

Appendiceal Conduit: A Novel Technique to be Applied After Radical Cystectomy: A Case Report.

This paper introduces a novel technique, known as appendiceal conduit. It could be used as an alternative for ileal conduit and cutaneous ureterostomy, ultimately applied after radical cystectomy. The six-month follow-up indicated that the patient had appendix-stoma as nipple without any stenosis, nor did he have any hydronephrosis, as confirmed by abdominal sonography.

Evaluation of the plasma level of long non-coding RNA PCAT1 in prostatic hyperplasia and newly diagnosed prostate cancer patients.

BACKGROUND: Prostate cancer (PCa) is generally detected by prostate-specific antigen (PSA) as one of the most widely applied tumor markers over decades for its high sensitivity. Nevertheless, it causes overtreatment or an unnecessary biopsy because of its limited specificity. PCa-associated ncRNA transcript 1 (PCAT1), the newly identified long non-coding RNA (lncRNA) has been reported to associate with the progress of PCa. In vitro studies proposed that PCAT-1 may be an appealing candidate for diagnostic accuracy improvement with regard to its notable overexpression in PCa cells. The present study aimed to evaluate the diagnostic potential of the plasma PCAT1 expression levels in PCa patients in comparison to benign prostatic hyperplasia (BPH) patients and healthy controls. METHODS: The plasma lncRNA PCAT1 level was measured by a real-time quantitative reverse transcriptase-polymerase chain reaction in 40 men newly diagnosed with PCa, 20 patients with BPH and 20 healthy subjects. The results were analyzed statistically using SPSS, version 25 (IBM Corp., Armonk, NY, USA). RESULTS: The expression of PCAT1 was significantly higher in healthy subjects compared to BPH patients (p = 0.03). The diagnostic accuracy of the plasma lncRNA PCAT-1 for discrimination of the healthy subjects than BPH patients was reasonable (area under the receiver operating characteristic curve = 0.799; sensitivity = 71%; specificity = 74%; negative predictive value = 74%; positive predictive value = 71%). CONCLUSIONS: It appears that the plasma levels of PCAT1 expression have reasonable diagnostic accuracy for the discrimination of healthy individuals compared to those with BPH, although no significant difference of PCAT1 expression levels was observed in comparisons between the PCa with BPH and normal groups.

Comparison of bladder ultrasonographic and rigid cystoscopic findings in patients with hematuria.

BACKGROUND: Bladder cancer ranks ninth in world-wide cancer incidence and is 2.5-4 times more common in men, and painless gross hematuria is its typical clinical symptom. Cystoscopy is used to evaluate the cause of hematuria in bladder while the use and reliability of ultrasonography is questionable for this purpose. Therefore, the aim of this study was to compare abdominal ultrasonography and rigid cystoscopy in the diagnosis of bladder tumors in Babol Shahid Beheshti Hospital. METHODS: In this cross-sectional study, 60 patients who were candidate for cystoscopy referred to Babol Shahid Beheshti Hospital in Iran in 2017-2018. In this study, rigid cystoscope was used to view the bladder after doing sonography. The numbers, demographic information (age, gender and residence) and clinical characteristics (indication of cystoscopy, history of chronic disease, sonographic and cystoscopic results) of patients were recorded in the checklist. RESULTS: The mean age of patients (37 (61.7%)=males) was 58.65±14.26 (19-85) years and 48 (80%) of them were >50 years old. The sensitivity and specificity of sonography was 71.43 (95% CI: 29.4, 96.33) and 96.23% (95% CI: 87.02, 99.54) in detecting bladder tumors, respectively. The negative predictive and positive predictive values in sonography were 96.23 (95% CI: 88.76, 98.8) and 71.43% (95% CI: 37.25, 91.33) respectively. CONCLUSION: The results of this study indicate that since sonography has high negative predictive values in evaluating hematuria; therefore it can be replaced with rigid cystoscopy for patients with lower risk of malignancy.

A systematic review and meta-analysis on incidence of prostate cancer in Iran.

Background: Prostate cancer is a global health concern. In Iran, its epidemiology is not precisely recognized. We aimed to evaluate incidence of prostate cancer among Iranian populations. Methods: In this systematic review, we searched the databases PubMed, Web of Sciences, Scopus and Google Scholar for English studies and the databases Magiran, Scientific information Database, IranMedex and IranDoc for Persian studies, using related keywords. The cross sectional articles published from inception to 31 December 2018 were included. Meta-analysis was conducted on the collected data with STATA software using random effects model. Results: Out of 763 articles initially obtained, 9 articles were finally included after applying the predefined exclusion criteria. Analysis of 9 studies on the incidence of prostate cancer showed a crude rate of 7.1 per 100000 population (95% confidence interval [CI]: 5.6-8.6). Also, the pooled age-standardized incidence rate was 8.7 per 100000 (95% CI: 6.7-10.4). Studies performed in the period 2004-2012 had significantly a higher pooled estimate of the crude incidence rate (9.2 per 100000 [95% CI: 7.9-10.4]) compared with those conducted in the period 1996-2003 (4.5 per 100000 [95% CI: 2.8-6.2]). This trend was also observed based on the age-standardized incidence rate (11 per 100000 [95% CI: 9.4-12.5] versus 6.3 per 100000[95% CI: 4-8.5]). Conclusion: Despite low rate of prostate cancer occurrence in Iran, it is recommended that preventive measures be taken against this disease by health policymakers. Also, more epidemiological studies are needed to better find out the pattern of prostate cancer among Iranian populations.

Comparative analysis of resected prostate weight in diabetic and non-diabetic benign prostatic hyperplasia Patients.

BACKGROUND: Benign prostatic hyperplasia (BPH) is the most common benign tumor in men. The etiology of BPH is still unresolved and multiple systems are likely to be involved. The effects of diabetes on urinary system are a risk factor for BPH. We then assessed the effects of diabetes on the parameters related to BPH, especially weight and volume. METHODS: This study was conducted on patients with BPH who underwent surgery during 2010-2013. The patients' demographic and clinical data including age, height, weight, history of diabetes, abdominal sonography, prostate-specific antigen(PSA), fasting blood sugar (FBS), triglyceride, and cholesterol, resected sample weight, and pathological diagnosis were extracted. RESULTS: The mean age of all 225 patients (35 (15.6%) diabetic patients and 190 (84.4%) non-diabetic patients) who entered the study was 71.5±8.7 years. The patients were divided in to 3 body mass index (BMI) groups: 48 (21.3%) were normal, 151 (67.1%) were overweight and 26 (11.6%) were obese. The mean weight of resected prostate was higher in diabetic patients (22.9±6.9 vs 21.7±14.3, P=0.02). The resected prostate weight had a significant relationship with BMI (P=0.001), prostate-specific antigen (PSA) level (P=0.001), and prostate volume sonography (P=0.001). No significant relationship was detected between resected prostate weight with age, FBS and triglyceride however, it is significant with cholesterol. CONCLUSION: We concluded that diabetes has a role in the development and progression of BPH with effect on prostate weight and volume. As well, BMI is a risk factor in BPH progression.

Unusual presentation of an abdominal foreign body: A case report.

BACKGROUND: Insertion of rectal foreign bodies intentionally or unintentionally is not unusual. CASE PRESENTATION: A 19-years-old unmarried male was admitted to our hospital due to a lump of left lower quadrant of abdomen. He denied sexual assault .The abdomen was soft on physical examination. Abdominal x-ray and CT scan showed a foreign body in lower abdomen and pelvis. The patient was operated and a slice of glass was extracted. CONCLUSION: In patients with rectal foreign body, the history is not always reliable and sexual assault may deny. The foreign object inserted in the rectum may migrate to peritoneal cavity without peritonitis.

Aryl hydrocarbon receptor gene transitions (c.-742C>T; c.1661G>A) and idiopathic male infertility: a case-control study with in silico and meta-analysis.

Aryl hydrocarbon receptor (AHR) is responsible for crucial events in male reproductive biology. Here, the association of the AHR transitions c.-742C>T and c.1661G>A with idiopathic male infertility was investigated in a case-control study, which is followed by a meta-analysis and a bioinformatic investigation. Blood and semen samples were obtained from a total of 135 idiopathic infertile men and 130 healthy controls. Participants were genotyped for the transitions using a PCR-RFLP method. A meta-analysis of five sets of data evaluated the association of c.1661G>A with male infertility, and using an in silico analysis, the possible molecular effects of the transitions predicted. Genotypes and alleles of AHR-c.-742C>T and c.1661G>A polymorphisms were not associated with the risk of male infertility significantly. However, the frequency of C/A haplotype was significantly associated with the increased risk of male infertility, and T/A haplotype was higher among controls significantly. Also, the frequencies of combined genotypes CT/GG, CT/GA and TT/GG were significantly associated with decreased risk of infertility. And, the meta-analysis showed that the AA versus GA/GG recessive model is associated with decreased risk of male infertility among the Iranian population. In silico analysis predicted that c.-742C>T does not alter the binding sites of the proposed transcription factors, but c.1661G>A poses a tolerable structural disturbance in AHR protein. In conclusion, these results showed that AHR c.-742C>T and c.1661G>A transitions separately could not be nominated as a risk or protective factor for male infertility. However, some combined models could affect infertility risk, especially among Iranian men.

Nephrolithiasis in elderly population; effect of demographic characteristics.

BACKGROUND: Kidney stone (nephrolithiasis) is one of the most common diseases. During the past several decades, its prevalence and incidence have increased markedly in elderly population. OBJECTIVES: This study was conducted to evaluate the risk factors for nephrolithiasis in elderly population. PATIENTS AND METHODS: This study was based on the Amirkola Health and Ageing Project (AHAP). Elderly people with kidney stones in every size, type and number were considered to be the case group and other subjects without a history of kidney stones served as control group. Demographic and anthropometric data, smoking, diabetes and metabolic syndrome (MetS), calcium (Ca), vitamin D, parathyroid hormone (PTH), uric acid and urine pH were compared in both groups. RESULTS: In this study, 1390 elderly people with the mean age of 69.37 ± 7.42 years were evaluated which 202 (14.53%) cases had renal stones. The patients with nephrolithiasis were younger (P = 0.010) and had higher uric acid and body mass index (BMI) levels (P = 0.041 and P = 0.006, respectively). Age <75 years, male gender and BMI ≥30 kg/m2 had a significant association with stone formation. The prevalence of diabetes, MetS and smoking in the patients with nephrolithiasis was lower than the subjects without it. CONCLUSIONS: This study suggests that male gender, obesity and age <75 years might be independent risk factors for the development of nephrolithiasis. Hence, low animal protein intake and weight reduction should be included as part of the counseling of senior stone-formers.