Association of interleukine-18 polymorphisms with susceptibility to prostate cancer in Iranian population.

Interleukin-18 (IL-18) is a multifunctional cytokine that augments interferon-γ production, promotion of the Th1 immune response and acts as an important immunomediator in the development of some cancers. The current study aimed to analyze the association of the five most common polymorphisms in the IL-18 gene with prostate cancer in the Iranian population. We examined a possible association of IL-18 -137G>C, -607C>A, -656G>T, +105A>C and +127C>T polymorphisms with prostate cancer occurrence by PCR-RFLP assay. Odds ratio (OR) and 95% confidence interval (CI) were used to assess the strength of the association between IL-18 polymorphisms and prostate cancer. Statistical analysis revealed that individuals carrying the mutant homozygote genotype of IL-18 -607C>A (OR=2.251, 95% CI=1.062-4.768, p=0.034) and -137G>C (OR=2.364, 95% CI=1.121-4.984, p=0.024) polymorphisms had an increased risk of prostate cancer. However, for IL-18 -656G>T, +105A>C and +127C>T polymorphisms, there were no differential distributions of their genotypes between patients with prostate cancer and healthy subjects. Our results indicated that the IL-18 -137G>C and -607C>A polymorphisms were significantly associated with an increased risk of prostate cancer in the Iranian population. Thus, these polymorphisms might be used as a molecular biomarker in the early diagnosis of prostate cancer.

Inflammatory and anti-inflammatory cytokines in the seminal plasma of infertile men suffering from varicocele.

Varicocele is one of causes of the declined sperm quality and low sperm production, which can lead to infertility in males. There are several experimental and epidemiological findings which support the idea that inflammatory mechanisms play an essential role in varicocele pathogenesis. Besides, in this pathological state, interleukin-37 (IL-37) as an anti-inflammatory cytokine is able to bind interleukin-18-binding protein (IL-18BP), and subsequently binds IL-18 receptor ß, inhibiting the pro-inflammatory activity of IL-18. To explore the interaction between IL-37 and IL-18 in infertility, we measured the amount of these cytokines in the seminal fluid of infertile men affected by varicocele. The seminal plasma levels of IL-37 and IL-18 were measured in 75 infertile men with varicocele and 75 healthy fertile controls (age range, 30-48 years) using enzyme-linked immunosorbent assay. The seminal levels of IL-37 and IL-18 were significantly increased in infertile men with varicocele when compared to fertile controls (p < .0001). Because of the essential role(s) of cytokines in inflammatory response of cell systems, it could be possible that sperm motility is reduced following increased IL-18, activated neutrophils and reactive oxygen species in semen of infertile patients with varicocele. Moreover, the results of this study indicated that interaction between IL-37 and IL-18Rß can lead to reduced inflammatory responses. It seems that IL-37 might be a potential biomarker and therapeutic target for male infertility.

The feasibility of regional anesthesia in the percutaneous nephrolithotomy with supracostal approach and its comparison with general anesthesia.

There are various approaches for the percutaneous nephrolithotomy (PCNL). Supracostal approach is a well known technique for doing of it. This approach is being done commonly under general anesthesia (GA). In this retrospective study, we evaluated the feasibility of supracostal PCNL under regional anesthesia (RA) and compared it with the same procedure under GA. Since March 2000 to March 2005, a total of 123 renal stone cases underwent PCNL with supracostal access in our center. GA was selected in 69 cases (56 %) (Group 1), spinal anesthesia (SA) in 45 cases (36.5 %), and epidural anesthesia (EA) in 9 cases (7.5 %) (Group 2). The operative time, success rate, hospital stay, and ensuing complications were compared between group 1 and group 2. There were no significant differences between groups 1 and 2 among surgical parameters, including age, stone area, anesthesia time, and hospitalization time (P > 0.05). There was no difference in the rate of complications or success rate between GA and RA cases (P > 0.05). Overall complete stone free rate, regardless of stone size, in relation to type of anesthesia was as follows: 88.4 % for GA, 88.9 % for EA, and 91.1 % for SA (P > 0.05). Conversion to GA was not needed in any patient with RA. The results showed that the supracostal PCNL with regional anesthesia was feasible but without evident advantages versus general anesthesia in this population, and possible advantages of the procedure in patients with pulmonary co-morbidities have still to be evaluated. The anesthesia related complications of RA were negligible and easily controllable.

Laparoscopic partial nephrectomy for tumours >4 cm compared with smaller tumours: perioperative results.

OBJECTIVE: The use of laparoscopic partial nephrectomy (LPN) in patients with tumours >4 cm remains to be further evaluated. We report our experience with LPN in tumours >4 cm compared with tumours ≤4 cm. MATERIALS AND METHODS: This is a retrospective study of data from all LPN patients operated from 2003 to 2008. Inclusion criteria were a single organ confined contrast enhancing mass/Bosniac III-IV cyst. Hospital admission records were used to extract operative and follow-up data. Patients were grouped into group A: ≤4 cm (32 patients, 53% of total), and group B: >4 cm (28 patients, 47% of total). RESULTS: A total of 60 patients (mean ± SD age, 47.4 ± 13.4 years; M/F, 36/24) were included. Mean ± SD tumour size was 31.5 ± 7.3 mm and 51.6 ± 10.9 mm in groups A and B, respectively. (P < 0.001) Malignant pathology was present in 22 (69%) and 16 patients (57%) in groups A and B, respectively. (P > 0.05) There was no statistically significant difference in age, gender, pre-operative creatinine, estimated glomerular filtration rate (eGFR), and other investigated pre-operative characteristics between study groups. (all P > 0.05) Nor any difference was observed regarding operative and pathologic (warm ischaemia time, operation duration, transfusion, positive margins, and malignant histology) as well as post-operative variables (re-hospitalization, post-operative complications, hospital stay, or eGFR changes). CONCLUSION: The results of this study supports the feasibility and comparability of operative and post-operative early complications for LPN when applied to tumours >4 cm in selected patients compared with tumours ≤4 cm.

Special position for the anaesthetic management of a patient with giant neck and back masses.

A neck mass is a risk factor for difficult airway during induction of anaesthesia particularly when accompanied with a giant back mass which limits positioning of the patient in the supine position. We report the management of a young woman with known recurrent neurofibroma scheduled for resection of her giant neck and back masses. Unfortunately, her dorsal thoracic mass was too huge to allow adoption of the supine position for induction of anaesthesia. In order to achieve a suitable supine position which is fundamental during airway management, we created a hole in the operating table to fit her giant back mass. Exhibition of this special operating table may help to achieve a suitable position and ease airway management which is not possible with routine tables in cases with giant posterior masses.

Lung function reference values in Iranian adolescents.

There is insufficient information about reference values for pulmonary volumes for Iranian populations. A study of lung function parameters was made on 302 non-smoking healthy Iranian students (152 male and 150 female). Lung function measures correlated strongly with height but not with body mass index. There were significant differences between some of the measured parameters and American Thoracic Society reference values for Caucasians (P < 0.05). Of note is the high functional residual capacity (110% higher) and low inspirational capacity (86% lower) in males compared with the reference values.

Lung function reference values in Iranian adolescents

There is insufficient information about reference values for pulmonary volumes for Iranian populations. A study of lung function parameters was made on 302 non-smoking healthy Iranian students [152 male and 150 female]. Lung function measures correlated strongly with height but not with body mass index. There were significant differences between some of the measured parameters and American Thoracic Society reference values for Caucasians [P < 0.05]. Of note is the high functional residual capacity [110% higher] and low inspirational capacity [86% lower] in males compared with the reference values