Clinical Correlation of Altered Molecular Signatures in Epileptic Human Hippocampus and Amygdala.

Widespread alterations in the expression of various genes could contribute to the pathogenesis of epilepsy. The expression levels of various genes, including major inhibitory and excitatory receptors, ion channels, cell type-specific markers, and excitatory amino acid transporters, were assessed and compared between the human epileptic hippocampus and amygdala, and findings from autopsy controls. Moreover, the potential correlation between molecular alterations in epileptic brain tissues and the clinical characteristics of patients undergoing epilepsy surgery was evaluated. Our findings revealed significant and complex changes in the expression of several key regulatory genes in both the hippocampus and amygdala of patients with intractable epilepsy. The expression changes in various genes differed considerably between the epileptic hippocampus and amygdala. Different correlation patterns were observed between changes in gene expression and clinical characteristics, depending on whether the patients were considered as a whole or were subdivided. Altered molecular signatures in different groups of epileptic patients, defined within a given category, could be viewed as diagnostic biomarkers. Distinct patterns of molecular changes that distinguish these groups from each other appear to be associated with epilepsy-specific functional consequences.

COVID-19 disrupts the blood-testis barrier through the induction of inflammatory cytokines and disruption of junctional proteins.

OBJECTIVE: Junctional proteins are the most important component of the blood-testis barrier and maintaining the integrity of this barrier is essential for spermatogenesis and male fertility. The present study elucidated the effect of SARS-CoV-2 infection on the blood-testis barrier (BTB) in patients who died from severe acute respiratory syndrome coronavirus 2 (COVID-19) complications. METHODS: In this study, lung and testis tissue was collected from autopsies of COVID-19 positive (n = 10) and negative men (n = 10) and was taken for stereology, immunocytochemistry, and RNA extraction. RESULTS: Evaluation of the lung tissue showed that the SARS-CoV-2 infection caused extensive damage to the lung tissue and also increases inflammation in testicular tissue and destruction of the testicular blood barrier. Autopsied testicular specimens of COVID-19 showed that COVID-19 infection significantly changes the spatial arrangement of testicular cells and notably decreased the number of Sertoli cells. Moreover, the immunohistochemistry results showed a significant reduction in the protein expression of occluding, claudin-11, and connexin-43 in the COVID-19 group. In addition, we also observed a remarkable enhancement in protein expression of CD68 in the testes of the COVID-19 group in comparison with the control group. Furthermore, the result showed that the expression of TNF-α, IL1ß, and IL6 was significantly increased in COVID-19 cases as well as the expression of occludin, claudin-11, and connexin-43 was decreased in COVID-19 cases. CONCLUSIONS: Overall, the present study demonstrated that SARS-CoV-2 could induce the up-regulation of the pro-inflammatory cytokine and down-regulation of junctional proteins of the BTB, which can disrupt BTB and ultimately impair spermatogenesis.

Claims about medical malpractices resulting in neonatal and maternal impairment in Iran.

BACKGROUND: Today even low incidence of complications for mothers or neonates during pregnancy, delivery or postpartum is unacceptable to the public and can result in claims because of greater expectation from patients and an increase in media coverage. The present study was conducted to investigate the reasons for medical malpractice claims on maternal and neonatal impairment, which are achieved in Iranian Legal Medicine Organization councils. MATERIALS AND METHODS: The present cross-sectional and retrospective study used convenience sampling to collect data of total claims from 31 provinces archived in the supreme council of the ILMO in 2 years. In this article, the medical malpractice claims on maternal and neonatal impairment during pregnancy, labour, delivery and early postpartum were reported. The data were collected through a validated researcher-made checklist and were analyzed in SPSS 16. RESULTS: Among total of 299 cases of impairment, cerebral palsy (33.34%), Erb's palsy due to shoulder dystocia (24.24%) and Down Syndrome (24.24%) were the main confirmed causes of malpractice for neonatal impairment and Retained Surgical Mass (20.5%), Salpingectomy and/or Oophorectomy Related to EP (17.2%), Hysterectomy (17.2%) and Episiotomy Related complication (17.2%) were the main confirmed causes of malpractice for maternal impairment. CONCLUSION: Considering this fact that medical malpractice was confirmed in a large proportion of some preventable and important complications, therefore, results of this study can be used for developing educational programs for related healthcare providers to prevent those complications.

Cell injury and receptor expression in the epileptic human amygdala.

Neuropathological findings in the amygdala obtained from patients with mesial temporal lobe epilepsy (MTLE) indicate varying degrees of histopathological alterations, such as neuronal loss and gliosis. The mechanisms underlying cellular damage in the amygdala of patients with MTLE have not been fully elucidated. In the present study, we assess cellular damage, determine the receptor expression of major inhibitory and excitatory neurotransmitters, and evaluate the correlation between the expression of various receptors and cell damage in the basolateral complex and the centromedial areas in the amygdala specimens resected during brain surgery on 30 patients with medically intractable MTLE. Our data reveal an increased rate of cell damage and apoptosis as well as decreased expression levels of several GABAergic receptor subunits (GABAARα1, GABAARß3, and GABABR1) and GAD65 in the amygdalae obtained during epilepsy surgery compared to autopsy specimens. Analyses of the expression of glutamate excitatory receptor subunits (NR1, NR2B, mGluR1α, GluR1, and GluR2) reveal no significant differences between the epileptic amygdalae and autopsy control tissues. Furthermore, the increased occurrence of apoptotic cells in the amygdala is negatively correlated with the reduced expression of the studied GABAergic receptor subunits and GAD65 but is not correlated with the expression of excitatory receptors. The present data point to the importance of GABAergic neurotransmission in seizure-induced cell injury in the amygdala of patients with MTLE and suggest several GABA receptor subunits as potential druggable target structures to control epilepsy and its comorbid disorders, such as anxiety.

Anthropometric measurements in Iranian men.

There is inevitable need for data regarding anthropometric measurements of each community's population. These anthropometric data have various applications, including health assessment, industrial designing, plastic & orthopedic surgery, nutritional studies, anatomical studies and forensic medicine investigations. Anthropometric parameters vary from race to race throughout the world, hence providing an anthropometric profile model of residents of different geographic regions seems to be necessary. To our knowledge, there is no report of bone parameters of the Iranian population. The present study was carried out to provide data on anthropomorphic bone parameters of the Iranian population, as a basis for future relevant studies. We calculated most of the known anthropometric parameters including skull, mandible, clavicle, scapula, humerus, radius, ulna, sacrum, hip, femur, tibia and fibula of 225 male corpses during a period of 2 years (2014-2016). Data expression was done as mean ± standard deviation. The results consist the first documented report on anthropometric bone measurement profile of Iranian male population, that can be considered a valuable source of data for future research on Iranian population in this regard.

Three years evaluation of retained foreign bodies after surgery in Iran.

BACKGROUND: Medical errors such as retained foreign bodies (RFB) during surgery are not well studied. To define risk factors associated with this type of error, we performed retrospective study. METHODS: We reviewed medical records for unintentional foreign object remaining in the body during surgery such as gender, age, surgery ward, and incident reports referred to several forensic medicine administrations as well as adverse effects of retained foreign bodies and methods for detection of them over a 3-years period from January 2008 through May 2011. RESULTS: Thirty eight patients were involved in the study to have retained foreign bodies (73% sponges and 27% other instruments including 7 (18.42%) cases of other bandages, 2 cases (5.26%) of scissor and 1 case (2.63%) of forceps). The general surgery ward was most commonly involved (47%) followed by the gynecology surgery ward (34%). Men (58%) were more involved with RFB than women (42%). CONCLUSION: Considering the most frequent type of retained foreign bodies and also more frequent involved surgery wards besides detection methods for RFB, a mixed of preventing protocols such as regular counting of devices, post-operative X-ray with radiopaque markers and exact evaluation of surgery site should be employed to reduce the occurrence of retained foreign bodies and its complications.

Frequency of lumbar intervertebral disc calcification and angiogenesis, and their correlation with clinical, surgical, and magnetic resonance imaging findings.

STUDY DESIGN: This study measured the frequency of lumbar intervertebral disc nucleus pulposus microscopic calcification and angiogenesis in adult patients undergoing discectomy compared to normal cadavers. OBJECTIVE: The results were compared to determine the relationship between disc microscopic calcification with disc degeneration type, histopathological angiogenesis, patients' age, gender, and duration of symptoms. SUMMARY OF BACKGROUND DATA: True frequency of microscopic calcification in normal or degenerated lumbar discs have not been fully defined nor linked to disc degeneration type and angiogenesis. Some studies demonstrated that angiogenesis and calcification are related to each other in several another tissues. METHODS: The frequency of microscopic calcification in specimens of disc nucleus pulpous obtained from 2 groups were measured: specimens were obtained during surgery from 90 consecutive patients of 15 to 50 years old suffering from disc herniation in single level of L4-L5 or L5-S1 between 2005 and 2006, 60 additional specimens of lumbar disc nucleus pulposus were obtained from normal cadavers of the same ages. Calcification was determined microscopically by Von Kossa staining and angiogenesis by H/E, and type of degeneration radiologically by Modic classification. RESULTS: Frequency of microscopic calcification was significantly higher in degenerated disc than normal cadaveric (54.4% vs. 6.7%) and was higher in Modic type III than type I (III: 95.0%, II: 57.4%, I: 13.0%), also prevalence of angiogenesis was significantly higher in patients than cadaveric discs (41.0% vs. 6.7%) and in calcified than noncalcified discs (59.2% vs. 19.5%) (P < 0.001). There was no relationship between disc calcification and patients' gender and level of discectomy. CONCLUSION: Disc nucleus pulposus microscopic calcification is a common event occurring in adult patients suffering from lumbar disc herniation. Mechanisms that link disc degeneration, angiogenesis, and calcification remain a focus for further researches that may be useful in future medical treatments before surgical treatment of lumbar disc herniation.