A Comparative 6-Month Clinical Study of Acellular Dermal Matrix Allograft and Subepithelial Connective Tissue Graft for Root Coverage

Objective: Different surgical procedures have been proposed for the treatment of gingival recessions. The goal of this study was to compare the clinical results of gingival recession treatment using Subepithelial Connective Tissue Graft and an Acellular Dermal MatrixAllograft.Materials and Methods: The present study was performed on 5 patients with 9 bilateral Miller`s class I or II gingival recessions. This included 15 premolars and 3 canines. In each patient the teeth were randomly divided in two groups of test (ADMA) and control (SCTG).Clinical parameters including recession height (RH), recession width (RW), keratinized gingiva (KG), clinical attachment level (CAL) and probing depth (PD) were measured at baseline, 2, 4 and 6 months after surgery and data analysis was performed using the Wilcoxon signed rank test.Results: The mean changes (mm) from baseline to 6 months in SCTG and ADMA were 2.22±0.83 and 1.77±0.66 decrease in RH, 2.55±0.88 and 2.33±0.86 decrease in RW,1.44±0.88 and 2.0±1.11 increase in KG, 2.33±1.22 and 2.11±0.6 decrease in CAL and finally 0.22±0.66 and 0.33±0.7 decrease in PD, respectively. The differences in meanchanges were not significant between the two groups in any of the parameters. The percentage of root coverage was 85.7% and 71.1% for the control and test group,respectively. The changes from baseline to the 6 month visit were significant for both groups in all parameters but PD.Conclusion: Alloderm may be suggested as an acceptable substitute for connective tissue graft considering the root coverage effect and KG width increase

Differential loading of the Argonaute complex in Epstein-Barr Virus (EBV)-infected cell lines derived from diffuse large B-cell lymphoma (DLBCL)

MicroRNAs sind essentielle post-transkriptionelle Regulatoren der Genexpression die an unterschiedlichen Prozessen wie Entwicklung, Signaltransduktion oder Wachstumskontrolle durch Bindung und Inhibition der Translation ihrer mRNA Ziel mRNAs beteiligt sind. Obwohl angenommen wird, dass ihre relative Expression in der Zelle das Ausmaß ihrer biologischen Funktion bestimmt, zeigt die Beladung der „Argonaute“ (Ago)-mRNA Komplexe mit miRNAs deren Relevanz besser an. In der vorliegenden Arbeit wurde die miRNA Beladung der Ago-Komplexe mit den miRNA Profilen der Gesamt-RNA zweier diffus-großzelliger B-Zell Lymphome (DLBCL) Linien nach Epstein-Barr Virus (EBV) -Infektion, verglichen. DLBCL ist ein hochmaligner Tumor, welcher in Aktivierte B-Zell (ABC-) und Germinal Center B-Zell (GCB-) DLBCL unterschieden wird. Etwa 10% aller DLBCLs sind mit dem onkogenen EBV, welches selbst 44 reife miRNAs exprimiert, infiziert. Die miRNA Profile aus Gesamtzellextrakten und des Ago2-Profils zweier DLBCL Linen wurden durch Hochdurchsatzsequenzierung (RNA-Seq) analysiert. In den Gesamt-Profilen konnten zwischen 713-851 humane miRNAs identifiziert werden, während die Ago2-Profile 1102-1372 humane miRNAs ergaben. Bei Anwendung eines 0.1% „cut-offs“ verringerte sich die Zahl der funktionellen miRNAs auf 56-62., welche jedoch immer noch 92-95% aller miRNAs-reads ausmachten. In Abhängigkeit von Latenztyp repräsentierten die viralen miRNAs 1.6% - 28% aller „reads“. In beiden Zelllinien hatte die EBV-Infektion den Verlust von miRNAs im Ago2-Komplex zur Folge. Die erhobenen Daten konnten für ausgewählte miRNAs durch RT-qPCR und im Northern Blot bestätigt werden. Auch die Analyse der Ago2-Komplexe der einzelnen Zellen ergab eine auffällige Umverteilung miRNAs zwischen Gesamt- und Ago2-assoziierten miRNAs. Zum Beispiel war die miRNA miR-423 in allen Zellen 6-8-fach im Ago2-Komplex angereichert, während die miR-142 im Ago2-Komplex depletiert vorliegt , was auf einen Funktionsverlust hinweist. Die hier erhobenen Daten werden zum weiteren Verständnis des Beitrags von miRNAs bei der Entstehung und Aufrechterhaltung von DLBCLs leisten.MicroRNAs are important post-transcriptional regulators of gene expression in all eukaryotic cells and play essential roles, i.e. in development, signal transduction or growth control by binding to and inhibiting the translation of their mRNA targets. While it is widely assumed that their overall level in a cell reflects their functional relevance, the loading and transfer of miRNAs to the “Argonaute” (Ago)-mRNA complex appears to give a more accurate indication of their activity in a cell. In this thesis, the miRNA loading of the Ago complex was compared with the total cellular miRNA profile of two cell lines derived from diffuse large B-cell lymphoma (DLBCL) in comparison with their Epstein-Barr Virus infected counterparts. DLBCL is a highly malignant tumor subdivided into Activated B-cell (ABC-) and Germinal Center B-cell (GCB-) subtypes. About 10% of DLBCL are infected with the oncogenic Epstein-Barr virus which itself encodes 44 mature miRNAs. The cellular and Ago2-bound miRNAs in two DLBCL lines were subjected to ultra-deep sequencing (RNA-seq). In the total profiles, 713-851 human miRNAs were detected while the Ago2-immunoprecipitation (Ago2-IP) resulted in 1102-1372 different miRNAs. When a 0.1% cut-off was applied which is considered to yield the functionally relevant miRNAs, only between 56-62 miRNAs were left. These, however, represented 92-95% of all reads. In the two EBV-infected counterparts, EBV-miRNAs represented between 1.6% - 28% of all reads depending on the viral latency type. In the case where EBV miRNAs accounted for 28 % of total reads cellular miRNAs were replaced from the Ago2-complex. The results could be confirmed for selected miRNAs by RT-qPCR and Northern blotting. Also within each cell line, various miRNAs were enriched or depleted from the Ago2 complex. For instance, mir-423-5p and mir-423-3p were highly enriched, by over 6-8-fold in Ago2-IP, compared to total cellular profile in all cell lines while miR142 was strongly depleted from the Ago2-complex indicating a functional loss in DLBCL. The data obtained will help to further understand the contribution of cell and viral miRNAs in induction and maintenance of DLBCL

Risk Assessment of Crisis Management in Response to Natural Disasters with an Emphasis on Earthquakes

The aim of this study was to explain the risks of the crisis management process in responding to natural disasters with the focus on earthquakes. This quantitative, descriptive, analytic study was conducted in Doroud City, Lorestan province, Iran in 2017. The society of the research comprises all members of the Doroud Crisis Management team, out of which 140 people were selected by stratified random sampling. In order to collect data, self-made questionnaires comprising 40 questions and 6 domains (structural, therapeutic, help and rescue, safety, hygiene, logistics)and based on the Likert Five Option Spectrum (extremely low=1, extremely high=5)were used. To ensure the validity of the questionnaires, they were assessed and verified by experts in the field. To assess the reliability, however, the Cronbach's Alpha Coefficient of 0.89 was applied. The data was analyzed by mean, standard deviation, and Independent T-test and variance analysis using SPSS21. The findings showed that safety with a mean and standard deviation of 4.91±0.68 was the highest and structure with a mean and standard deviation of 2.03±0.64 was the lowest domains under the assessment of crisis management. Also, training courses in therapeutic and hygiene domains, and work experience in therapeutic, help and rescue, security, logistics domains made a considerable difference (p=0.05). From the perspective of the sample under study, the domains of therapeutic and hygiene have the highest importance factor, logistics was allocated the lowest priority. Applying the proper assessment of different risk frameworks, the researchers reviewed each domain proportionate to the probability of an earthquake in the study area. This way by identifying the potential hazards and risks in view of important and effective domains, the dangers could be prioritized and management programs could be implemented

Characterization of CD147, CA9, and CD70 as Tumor-Specific Markers on Extracellular Vesicles in Clear Cell Renal Cell Carcinoma

Extracellular vesicles (EVs) are secreted by healthy and tumor cells and are involved in cell–cell communication. Tumor-released EVs could represent a new class of biomarkers from liquid biopsies. The aim of this study was to identify tumor-specific EV markers in clear cell renal carcinoma (ccRCC) using cell lines and patient-derived tissue samples. EVs from ccRCC cell lines (786-O, RCC53, Caki1, and Caki2) and patient tissues were isolated via ultracentrifugation. EVs were characterized using transmission electron microscopy, nanoparticle tracking analysis, and Western blotting using exosome and putative tumor markers (epithelial cell adhesion molecule (EpCAM), carbonic anhydrase 9 (CA9), CD70, CD147). The tumor markers were verified using immunohistochemistry. CA9 was expressed in Caki2 cells and EVs, and CD147 was found in the cells and EVs of all tested ccRCC cell lines. In tumor tissues, we found an increased expression of CA9, CD70, and CD147 were increased in cell lysates and EV fractions compared to normal tissues. In contrast, EpCAM was heterogeneously expressed in tumor samples and positive in normal tissue. To conclude, we developed an effective technique to isolate EVs directly from human tissue samples with high purity and high concentration. In contrast to EpCAM, CA9, CD70, and CD147 could represent promising markers to identify tumor-specific EVs in ccRCC

“HEXAL Model” How It Can Collaborate With Health Service Providers and Travel Medicine

Introduction: Nowadays the trend to travel abroad has extremely grown. This is while, paying attention to travelers’ health is an incredibly important issue. Many organizations try their best to provide health services during travelers’ trips. Meanwhile, the biggest and most effecting health care providers all around the world are hospitals. Regarding this fact, a theory has been presented to help these organizations coordinate and direct much more effectively in compared to the past. It is noticeable to mention that this theory can help health care providers to gain a more sustainable position in order to develop medical tourism in their centers.Methods: A theory has been presented in this research with different dimensions. The major aspects of this model have been designed according to the relationships which exist in families. These relationships include: parents, children and others. Each of these aspects have been divided into two segments which are female and male. These aspects play their roles in three different dimensions.Results: According to the results this study, it can be mentioned that there are 6 relationships in regards to the HEXAL Model in health service providers. These relationships include mother, father, sister, brother, step sister and other relationships. It can be also said that each of these dimensions have different responsibilities in both health care providers and travel medicine.Conclusion: By using this model, health service providers can collaborate much more effectively. As a result, medical tourists and even other tourists can experience much more satisfying trips throughout their lives

A Comparison of Service Quality in Teaching and Non-teaching Hospitals: The Gap Analysis

Introduction: Service quality is a judgment that the customer compares his/her expectations by this judgment, with the perception of the received services. The purpose of this study was to compare service quality in teaching hospitals with non-teaching hospitals in Kerman city. Methods: This cross-sectional study has been done on 166 hospitalized patients and the standard SERVQUAL questionnaire with an approved validity and reliability was used. Data analysis was performed using SPSS software version 19. Results: The results show that the service quality from the patients’ perception in non-teaching hospitals is more than the teaching hospitals (p=0.002). Most of the service quality gap is in the tangibility dimensions and also in providing amenities for patients and their companions. Conclusion: Teaching setting of the hospital typically can cause poor subjectivity in patients about the quality of services provided and it is recommended that authorities identify factors causing these kind of thinking and solve them. Also the negative scores indicate a need for improvement in all aspects, especially the tangibility dimensions having the maximum gap

Medical Tourism Attraction of Tehran Hospitals

Introduction: Today the market of medical tourism is growing as one of the competitive and profitable industries in the world. The aim of this study was to determine medical tourist attraction in Tehran hospitals. Methods: This is a descriptive study which was carried out in 8 hospitals of Tehran in 2012. 195 people from the managing boards of these hospitals participated in the study. A questionnaire was designed to gather data. The validity of the questionnaire was confirmed by professors and administrators and reliability was calculated 80% by Cronbach's alpha. The data was analyzed using SPSS. Findings: The total amount of medical tourist attractions in Tehran hospitals is moderate (51%) and also average number of foreign patients admitted to hospitals and average income for hospitals is also moderate. Conclusion: According to the results it seems media advertising is the most effective in attracting medical tourists. Furthermore, the advertisement of the capabilities of hospitals alongside marketing could help attract more medical tourists

The Capabilities of Iranian Hospitals in Attracting Medical Tourists; Based on Joint Commission International: A Case Study of Shiraz Hospitals

Introduction: Medical tourism is one of the competitive and income industries in world and has the ability to attract tourists in the health sector and international markets are totally dependent on international accreditation. This study has been done to evaluate the capabilities of active public and private hospitals in Shiraz regarding attraction of tourists’ base on accreditation standards. Methods: This is a descriptive-analytic and cross-sectional study which performed on four hospitals which were active in medical tourism in 2012. A checklist of international accreditation standards based on Joint Commission International (JCI) was applied for collecting data. Data were analyzed using descriptive analytic statistical tests. In descriptive statistics, frequency tables and standard deviation were used for scoring the hospitals. Independent student (T-test) was used to compare the mean of public and private hospitals in attracting medical tourists. Results: Hospital No.3 in the Patient-Centered Standards and Health Care Organization Management Standards was in the best position whilst hospital No.2 in the Patient-Centered Standards was in the worst state and hospital no.1 in Health Care Organization Management was in the worst position. Also there was a significant difference between public and private hospitals in attracting medical tourists according to Joint Commission International (sig=0.01). Conclusion: Shiraz hospitals have good ability to attract medical tourists; these abilities are very good in most cases and in some cases there is a need to improve. Having recognized the strengths and weaknesses of these hospitals can use SWOT analysis model, which is used in medical tourism program of some countries, for improving their abilities in attracting medical tourists

Contextual Effects of Ethnicity, Gender, and Place on Depression; Case Study of War Related Stress for Kurdish Women

Contextual factors such as ethnicity, gender, place, and their intersections determine the social condition that populations and individuals live in. As a result, environmental stressors that shape exposures, and also resilience and vulnerabilities are specific to the population. This emphasizes the role of the intersection of such contextual factors in studying psychosocial causes of depression. The aim of this case study is to review the role of war related stress as a unique environmental cause of depression among Kurdish women who live in the Middle East. First, we reviewed the literature on the direct effects of ethnicity, gender, place, and their intersections on depression. Then we discussed the contextual (indirect) effects of these factors in modifying the effect of (resilience and vulnerability to) risk factors of depression. Then we reviewed the evidence highlighting the role of war related stress as a unique social cause of depression among Kurd women. We hope this paper provides an example of how social causes of depression depend on intersections of ethnicity, gender, and place. We argue that depression should be seen as a condition, with population specific causes and consequences. We also believe that ethnicity, gender, and place help clinicians and public health officials to better approach depression within populations. Contextual factors should not be undermined in approaching depression across population groups. In this view, context not only determines the exposure to the risk and protective factors, it also changes the vulnerability and resilience to them. Thus we need to better understand how ethnicity, gender, place, and their intersections modify separate, additive, and multiplicative effects of risk and protective factors on depression

Evaluation of IL-17A and IL-17F genes polymorphism in Iranian dyspeptic patients

Helicobacter pylori (H.pylori) colonize the gastric mucosa of approximately 50 of the world's population that involved in chronic gastritis. The relationship between Hp colonization and gastric inflammation is widely accepted. Polymorphisms in inflammation related genes such as cytokines were thought to partly determine the outcome of Hp infection and progression of gastritis. Interleukin IL -17A and IL-17F are inflammatory cytokines expressed by a novel subset of CD4+ Th cells, play important function in inflammation. Aimed: we evaluate association of IL-17A G197A and IL-17F A7488G polymorphisms with gastritis, Polymorphonuclear (PMN) and Monoculear (MN) infiltration in related to Hp. Methods: According to rapid urease test, PCR 16srRNA, urea and histological examination of biopsies, patients were classified Hp-infected and Hp-uninfected. The histological severity of gastritis was graded from normal to severe based on the degree of MN cell and PMN leukocyte infiltration, chronic gastritis and chronic active gastritis. Polymorphism in IL-17A G197A and IL-17F A7488G were evaluated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: AG, GG, AG/AA carriers of IL-17A G197A and AA, GA, GG, GA/GG carriers of IL-17F A7488G polymorphisms were not associated with MN infiltration, PMN infiltration, chronic gastritis and Chronic active gastritis in Hp-infected and Hp-uninfected groups (p > 0.05). AA genotype of IL-17A G197A was related to chronic gastritis and PMN infiltration in Hp-uninfected group. Conclusion: IL-17A G197A substitution may be a risk factor for development gastritis in Hp-uninfected patients, also affect the pathway MN cell production pathways