Medical Students\' Attitude Towards Research at the Completion of Basic Science Courses

Introduction: Assessing the attitude of medical students who has passed basic sciences, toward research and research activities in basic sciences, can provide a powerful basis for future interventions and improvement in their attitudes. In this study in Isfahan Medical School, the attitude of newcomer medical students toward research and specially research in basic sciences has been investigated at the completion of physiopathology courses.Methods: This is a descriptive cross-sectional study performed on all newcomer medical ‎students in physiopathology course after basic science courses in Isfahan ‎University of Medical Sciences in year 2010 (n=65). The instrument was a researcher made ‎questionnaire including 33 questions. The questionnaire was validated through face and content validity and its reliability was confirmed based on Cronbach’s Alpha (0.85). We used student T-test, Spearman and Pearson correlation coefficient for statistical analysis.Results: The mean of research understanding was 5.9± 1.49 out of eight. There was a significant positive relationship between previous research activities and the score of research understanding. There was also a significant relationship between interest toward research and doing research in clinical fields among students interested in research activities.Conclusion: Students showed a positive attitude toward research. However, they were more interested in clinical research rather than basic research and most students interested in research activities preferred clinical studies as their future activities. Offering MD-PhD dual degree training programs and recruiting physician scientist in them could introduce some career opportunities in this field and also train the demanding researchers for research centers in Iran medical research centers

Idiopathic thrombocytopenic purpura in women with breast cancer

The association of solid tumors with idiopathic thrombocytopenic purpura (ITP) is rare. However, there have been some case reports indicating an association between breast cancer and ITP. In this article four patients with breast cancer and ITP are mentioned. The diagnosis of breast cancer was based on the results of biopsy or surgical sample. The ITP diagnosis criteria were 1) exclusion of drug induced thrombocytopenia, 2) platelet count less than 140 × 109 /l with normal or increased number of megakaryocytes on bone marrow samples, and 3) absence of splenomegaly. In this case report an association of breast cancer and ITP is shown

Effect of fluid temperature in intravenous fluid resuscitation of hemorrhagic shock

<strong>BACKGROUND</strong>: Treatment of hemorrhagic shock is the major problem in emergency surgery. Fluid therapy is one of the first steps but, the conflict has been over the temperature used for the fluid injected to the patient. The aim of this study was to determine the effect of fluid temperature in intravenous fluid resuscitation of hemorrhagic shock.<br /> <strong>METHODS</strong>: In this experimental study, 3 groups of 10 rabbits underwent hemorrhagic shock class III (mean arterial pressure = 40 mmHg) by catheter on femoral artery. Within 25 minutes, ringer lactate solutes with controlled temperaturesof 15°C, 25°C and 37°C were injected through femoral venous line. They were followed for 72 hours.<br /> <strong>RESULTS</strong>: In the lowest, middle and the highest fluid temperature group, mortality rate was 90%, 10% and 40%, respectively. Statistically significant difference was seen between the 15°C and 25°C resuscitation groups (P<0.001).<br /> <strong>CONCLUSIONS</strong>: Our findings showed possible benefit of room temperature as the optimal fluid temperature for fluid resuscitation in hemorrhagic shock.<br /> <strong>KEY WORDS</strong>: Hemorrhagic shock, hypothermia, fluid therapy, rabbit, temperature.<br /&gt

MSH2 Loss in Primary Prostate Cancer.

Abstract Purpose: Inactivation of mismatch repair (MMR) genes may predict sensitivity to immunotherapy in metastatic prostate cancers. We studied primary prostate tumors with MMR defects. Experimental Design: A total of 1,133 primary prostatic adenocarcinomas and 43 prostatic small cell carcinomas (NEPC) were screened by MSH2 immunohistochemistry with confirmation by next-generation sequencing (NGS). Microsatellite instability (MSI) was assessed by PCR and NGS (mSINGS). Results: Of primary adenocarcinomas and NEPC, 1.2% (14/1,176) had MSH2 loss. Overall, 8% (7/91) of adenocarcinomas with primary Gleason pattern 5 (Gleason score 9–10) had MSH2 loss compared with 0.4% (5/1,042) of tumors with any other scores (P &amp;lt; 0.05). Five percent (2/43) of NEPC had MSH2 loss. MSH2 was generally homogenously lost, suggesting it was an early/clonal event. NGS confirmed MSH2 loss-of-function alterations in all (12/12) samples, with biallelic inactivation in 83% (10/12) and hypermutation in 83% (10/12). Overall, 61% (8/13) and 58% (7/12) of patients had definite MSI by PCR and mSINGS, respectively. Three patients (25%) had germline mutations in MSH2. Tumors with MSH2 loss had a higher density of infiltrating CD8+ lymphocytes compared with grade-matched controls without MSH2 loss (390 vs. 76 cells/mm2; P = 0.008), and CD8+ density was correlated with mutation burden among cases with MSH2 loss (r = 0.72, P = 0.005). T-cell receptor sequencing on a subset revealed a trend toward higher clonality in cases versus controls. Conclusions: Loss of MSH2 protein is correlated with MSH2 inactivation, hypermutation, and higher tumor-infiltrating lymphocyte density, and appears most common among very high-grade primary tumors, for which routine screening may be warranted if validated in additional cohorts. Clin Cancer Res; 23(22); 6863–74. ©2017 AACR.</jats:p

SULT2B1b Sulfotransferase: Induction by Vitamin D Receptor and Reduced Expression in Prostate Cancer

An elevated tumor tissue androgen level, which reactivates androgen receptor in recurrent prostate cancer, arises from the intratumor synthesis of 5 alpha-dihydrotestosterone through use of the precursor steroid dehydroepiandrosterone (DHEA) and is fueled by the steroidogenic enzymes 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD1), aldoketoreductase (AKR1C3), and steroid 5-alpha reductase, type 1 (SRD5A1) present in cancer tissue. Sulfotransferase 2B1b (SULT2B1b) (in short, SULT2B) is a prostate-expressed hydroxysteroid SULT that converts cholesterol, oxysterols, and DHEA to 3 beta-sulfates. DHEA metabolism involving sulfonation by SULT2B can potentially interfere with intraprostate androgen synthesis due to reduction of free DHEA pool and, thus, conversion of DHEA to androstenedione. Here we report that in prostatectomy specimens from treatment-naive patients, SULT2B expression is markedly reduced in malignant tissue (P < .001, Mann-Whitney U test) compared with robust expression in adjacent nonmalignant glands. SULT2B was detected in formalin-fixed specimens by immunohistochemistry on individual sections and tissue array. Immunoblotting of protein lysates of frozen cancer and matched benign tissue confirmed immunohistochemistry results. An in-house-developed rabbit polyclonal antibody against full-length human SULT2B was validated for specificity and used in the analyses. Ligand-activated vitamin D receptor induced the SULT2B1 promoter in vivo in mouse prostate and increased SULT2B mRNA and protein levels in vitro in prostate cancer cells. A vitamin D receptor/retinoid X receptor-alpha-bound DNA element (with a DR7 motif) mediated induction of the transfected SULT2B1 promoter in calcitriol-treated cells. SULT2B knockdown caused an increased proliferation rate of prostate cancer cells upon stimulation by DHEA. These results suggest that the tumor tissue SULT2B level may partly control prostate cancer growth, and its induction in a therapeutic setting may inhibit disease progression.open1