Publications by authors named "Mohammad Javad Ashraf"

54 Publications

Five Years Pathological Evaluation of Corneal Regrafts: A Study from Southern Iran.

J Ophthalmol 2020 4;2020:2546923. Epub 2020 Nov 4.

Associate Professor, Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: Corneal regrafts sometimes needed to restore the transparency after graft failure. The aim of the study is five years epidemiologic and histopathological evaluation of corneal regrafts.

Methods: In this cross-sectional study, all corneal regrafts during 5 years (2012-2016) were assessed in the Khalili Ophthalmology Center at Shiraz city. Demographic data including age, area of residence, primary disease, type of graft, cause of regraft, interval between primary and subsequent grafts (IPSG), associated eye diseases or surgeries, and systemic diseases were recorded. Also, microscopic findings of corneas were reviewed.

Results: Among a total of 1190 corneal grafts, 76 of them (6.38%) were regrafts. The most common type of grafting was penetrating keratoplasty (PK). The shortest IPSG was observed in fungal keratitis. Main causes of graft failure were endothelial dysfunction, infection, immunologic rejection, technical problems, and recurrence of primary disease, respectively. The most common histopathological finding in failed grafts was severe endothelial cell loss (89.8%). Also, more than half and one-third of cases had Descemet membrane changes and stromal ingrowth, respectively.

Conclusion: Endothelial cell loss was the major cause of failure in our study. Also, recurrence rate in infective cases, especially fungal keratitis, was very high. Considerable presence of histopathological changes such as doubling of Descemet membrane and retrocorneal fibrous ingrowth need further investigations. Perhaps, modification in techniques of corneal grafting and assessment of donor tissue and recipient bed along with any need for longer medical treatment are the basis for future studies in order to increase graft survival.
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http://dx.doi.org/10.1155/2020/2546923DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803222PMC
November 2020

Orbital mucormycosis in immunocompetent children; review of risk factors, diagnosis, and treatment approach.

BMC Infect Dis 2020 Oct 19;20(1):770. Epub 2020 Oct 19.

Shiraz University of Medical Sciences, Namazi Hospital, 7193711351, Zand Ave, Shiraz, Iran.

Background: Orbital mucormycosis is a rare but potentially severe and troublesome invasive fungal infection that could be occurred even in healthy individuals. The initial clinical presentation is similar to bacterial pre-septal or septal cellulitis, especially in early stages.

Case Presentation: Herein, we describe the successful management of a series of five cases presenting with orbital mucormycosis in previously healthy children.

Conclusions: Orbital mucormycosis is extremely rare in healthy children and maybe life-threatening when diagnosis delayed given a similar clinical presentation with bacterial septal cellulitis. Intravenous antifungal therapy with amphotericin B and timely surgical drainage is live-saving.
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http://dx.doi.org/10.1186/s12879-020-05460-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574198PMC
October 2020

Association of Conjunctival Dysplasia (Squamous Intraepithelial Neoplasia) with Melanosis (Microscopic Non- Proliferative Melanin Pigmentation).

J Curr Ophthalmol 2020 Jul-Sep;32(3):244-248. Epub 2020 Jul 4.

Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: To determine the association between conjunctival epithelial dysplasia (squamous intraepithelial neoplasia) and its melanosis (microscopic non-proliferative melanin pigmentation) in conjunctival biopsies.

Methods: In this retrospective case series, histopathological slides from all conjunctival biopsies obtained in Khalil Hospital affiliated with Shiraz University of Medical Sciences for a period of 6 years (April 2009-July 2015) were reviewed. After considering the exclusion criteria (non-melanotic pigmentation, melanocytic proliferations, and squamous cell carcinoma), conjunctival biopsies were divided histopathologically into two groups of dysplastic and non-dysplastic. Then, the slides were reviewed by one ophthalmopathologists and one general pathologist. Melanin pigmentation was recorded in both groups as 0, 1+, 2+, and 3+. The data were analyzed, and the groups were compared.

Results: Overall, 685 cases with a mean age of 47.78 (±17.74) years were included in this study. Dysplastic and non-dysplastic groups comprised 135 (19.7%) and 550 (80.3%) specimens, respectively. Seventy-six percent (76%) of the specimens in the dysplastic group versus 40% in the non-dysplastic group had melanosis ( = 0.001). However, the degree of dysplasia (1+, 2+, and 3+) was not statistically correlated with the degree of melanosis (1+, 2+, and 3+) ( = 0.393).

Conclusion: Our results demonstrated that melanosis is a common finding in conjunctival epithelial dysplasia and might indicate an association with conjunctival epithelial dysplasia.
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http://dx.doi.org/10.4103/JOCO.JOCO_40_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382514PMC
July 2020

Expression of Paxillin in Benign and Malignant Salivary Gland Tumors.

J Dent (Shiraz) 2019 Dec;20(4):249-254

Dept. of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Statement Of The Problem: Paxillin is a major cytoskeletal protein aberrantly deregulated in various human cancers and involved in tumor growth and invasion. However, the clinicopathological and prognostic significance of paxillin in salivary gland tumors (SGTs) is still unclear.

Purpose: This study was conducted to evaluate the relationship between paxillin expression and clinicopathological features of patients with SGTs.

Materials And Method: In this retrospective study, 50 paraffin-embedded tissue samples which were histologically confirmed as benign (pleomorphic adenoma, PA) or malignant (mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma, ACC) SGTs, and 19 specimens from those with normal salivary gland (NSG) as a control group were assessed for paxillin expression using the immunohistochemistry. The paxillin expression in our samples was scored based on the extent and intensity of immunoreactivity and compared with histological type, clinical stage, and distant metastasis.

Results: High paxillin expression was identified in 66% of SGTs whereas all patients with NSG showed low expression (< 0.0001). Although the expression of paxillin in patients with benign and malignant tumors is similar, there is a significant difference between patients with PA, MEC, and ACC with that of the NSG (< 0.0001). Paxillin expression was not correlated with clinicopathological features of patients.

Conclusion: High expression of paxillin was observed in tumoral tissues compared with the controls that establish an important role of paxillin in SGTs but its prognostic role was unclear and need further evaluation.
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http://dx.doi.org/10.30476/DENTJODS.2019.44909DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6890811PMC
December 2019

Atypical Memory and Regulatory B Cell Subsets in Tumor Draining Lymph Nodes of Head and Neck Squamous Cell Carcinoma Correlate with Good Prognostic Factors.

Head Neck Pathol 2020 Sep 5;14(3):645-656. Epub 2019 Nov 5.

Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Research on the role of B cells in the development and modulation of antitumor immunity has increased in recent years; however, knowledge about B cell phenotype and function in tumor draining lymph nodes (TDLNs) is still incomplete. This study aimed to investigate changes in the phenotypic profile of B cells in TDLNs of head and neck squamous cell carcinoma (HNSCC) during disease progression. Mononuclear cells were isolated from TDLNs and stained with antibodies for CD19 and other B cell-related markers and analyzed by flow cytometry. CD19 B cells comprised 38.6 ± 8.9% of lymphocytes in TDLNs of HNSCC. Comparison of metastatic and non-metastatic LNs disclosed no significant differences in the frequencies of B cell subsets including antigen-experienced, naïve, switched, unswitched, atypical memory, marginal zone-like B cells, and B cells with regulatory phenotypes. The percentage of atypical memory (CD27IgMIgD) B cells was significantly higher in patients with tongue SCC with no involved LNs (p = 0.033) and correlated inversely with the number of involved LNs. The frequency of CD24CD38 B cells was significantly higher in non-metastatic LNs of patients with grade I compared to grade II (p = 0.016), and the percentage of CD5 B cells decreased as tumors progressed from stage III to IV (p = 0.008). Our data show that in TDLNs of HNSCC, the frequency of B cells with atypical memory and regulatory phenotypes was significantly associated with good prognostic factors; however, their function remains to be investigated.
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http://dx.doi.org/10.1007/s12105-019-01095-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413970PMC
September 2020

Evaluation of Glypican-3 expression in benign and malignant salivary gland tumors.

J Oral Biol Craniofac Res 2019 Jan-Mar;9(1):63-66. Epub 2018 Sep 6.

Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

Introduction: Glypican-3 (GPC3) is involved in regulation of cell proliferation and morphogenesis. It is abundant in embryonic tissue, but limited in most adult tissues. GPC3 deletion or mutation can disturb the balance between cell apoptosis and proliferation, which may result in tumorigenesis. This study aimed to investigate the GPC3 expression in salivary gland tumors (SGTs) and the adjacent non-neoplastic tissues.

Methods: This study reviewed 50 samples of salivary tumors from the archive of Khalili Hospital, Shiraz, Iran, including 17 cases of pleomorphic adenoma (PA), 16 cases of mucoepidermoid carcinoma (MEC), and 17 cases of adenoid cystic carcinoma (ACC); as well as a control group of 23 cases of normal salivary gland tissues. GPC3 expression was investigated through immunohistochemistry.

Results: GPC3 expression was significantly higher in malignant tumors (MEC and ACC) than in PA, and higher in PA than in the normal salivary glands (P < 0.001). The expression intensity was moderate to strong in malignant tumors and weak to moderate in benign tumors. No strong positivity was observed in normal salivary gland tissues (P < 0.001). Nor was any association detected between the GPC3 expression and intensity with the clinicopathologic parameters.

Conclusion: Although GPC3 overexpression was observed at the protein level in SGTs, and its expression was not related with the clinicopathologic factors, the potential use of GPC3 for diagnostic, therapeutic, and prognostic purposes requires further investigations.
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http://dx.doi.org/10.1016/j.jobcr.2018.09.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6170252PMC
September 2018

Conjunctivitis as a manifestation of Wegener's Granulomatosis.

J Curr Ophthalmol 2018 Sep 13;30(3):268-272. Epub 2017 Dec 13.

Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: To report a case of prolonged conjunctivitis as the manifestation of Granulomatosis with polyangiitis (GPA).

Methods: A 37-year-old man presented with prolonged conjunctivitis which had persisted for one month. He was taking medication for his conjunctivitis without any response. A slit-lamp examination revealed conjunctivitis and scleritis in the right eye. Conjunctivitis, 360-degree peripheral corneal thinning, corneal perforation, and scleritis were seen in the left eye.

Results: Emergency penetrating keratoplasty was performed to treat the patient's corneal perforation. After a consultation with the Internal Medicine Department, the patient was suspected of having GPA with positive cytoplasmic anti-neutrophil cytoplasmic antibodies (C-ANCA). Functional endoscopic sinus surgery was performed to treat right maxillary sinusitis, and a biopsy of the maxillary sinus mucosa was obtained. The pathology report showed granuloma and vasculitis with severe acute and chronic inflammation and few eosinophils; thus, the diagnosis was confirmed.

Conclusion: Because prolonged conjunctivitis occurs only rarely in association with systemic disease, ophthalmologists should be aware of this potential, particularly in patients with GPA.
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http://dx.doi.org/10.1016/j.joco.2017.11.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127366PMC
September 2018

Expression of CDK6 in Oral Squamous Cell Carcinomas

Asian Pac J Cancer Prev 2018 Apr 25;19(4):1013-1016. Epub 2018 Apr 25.

Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Email:

Background: CDK6 is the key factor in regulation of the cell cycle and essential for passage into the G1 phase. It also plays an important role in the development of various tumors. In this cross-sectional study expression of the CDK6 protein in oral squamous cell carcinoma (OSCC) and healthy oral mucosa of controls was assessed to determine relations with malignant transformation and clinicopathologic factors. Method: A total of 60 samples, 45 from OSCCs and 15 from healthy tissue, underwent immunohistochemistry for CDK6. Nuclear and cytoplasmic staining of keratinocytes was considered as positive and the percentages of positive cells were calculated. Results: Expression of CDK6 was detected in 55.6% of OSCC samples (25 cases) and 13.3% of controls (2 cases), the difference being significant. Mean percentage of CDK6 stained cells was 24.2±29.3 in the OSCC cases and 4.33±2.1 in the control group, again statistically significant. No relationship was detected between CDK6 expression and clinicopathologic factors. Conclusion: Overexpression of CDK6 observed in OSCC points to a role for this protein in oral carcinogenesis.
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http://dx.doi.org/10.22034/APJCP.2018.19.4.1013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031802PMC
April 2018

Papillary Carcinoma of Thyroid with Nasal Cavity Metastases: A Case Report.

Iran J Med Sci 2018 Jan;43(1):90-93

Department of Ear, Nose, Throat, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Papillary thyroid carcinoma (PTC) is one of the most commonly diagnosed types of differentiated carcinoma of the thyroid. It is stated that lung is the most common site of metastasis followed by bone. The incidence of paranasal sinus (PNS) metastasis is fairly uncommon in case of thyroid carcinoma. To the best of our knowledge, no case of metastatic PTC to nasal cavity has been reported. In this case report, we present the first case of papillary carcinoma of the thyroid with nasal cavity metastases in a 55-year-old female. The patient underwent surgical treatment and the mass was completely removed and sent for pathology. The pathology report revealed that it was metastatic papillary cell carcinoma. Surgical approach is usually difficult in view of the cosmetic and functional concerns, but may be considered in selected cases. As described herein, this rare type of metastasis was successfully removed and the patient was symptoms free after 1-year follow-up.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5776001PMC
January 2018

Overexpression of CDC7 in malignant salivary gland tumors correlates with tumor differentiation.

Braz J Otorhinolaryngol 2019 Mar - Apr;85(2):144-149. Epub 2017 Dec 26.

Shiraz University of Medical Sciences, School of Dentistry, Department of Oral and Maxillofacial Pathology, Shiraz, Iran.

Introduction: Cell division cycle-7 protein is a serine/threonine kinase that has a basic role in cell cycle regulation and is a potential prognostic or therapeutic target in some human cancers.

Objectives: This study investigated the expression of cell division cycle-7 protein in benign and malignant salivary gland tumors and also its correlation with clinicopathologic factors.

Methods: Immunohistochemical expression of cell division cycle-7 was evaluated in 46 cases, including 15 adenoid cystic carcinoma, 12 mucoepidermoid carcinoma, 14 pleomorphic adenoma, and 5 normal salivary glands. Cell division cycle-7 expression rate and intensity were compared statistically.

Results: The protein was expressed in almost all tumors. The intensity and mean of cell division cycle-7 expression were higher in malignant tumors in comparison with pleomorphic adenomas (p=0.000). The protein expression was correlated with tumor grades (p=0.000).

Conclusions: The present study demonstrated cell division cycle-7 overexpression in malignant salivary gland tumors in comparison with pleomorphic adenomas, and also a correlation with tumor differentiation. Therefore, this protein might be a potential prognostic and therapeutic target for salivary gland tumors.
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http://dx.doi.org/10.1016/j.bjorl.2017.11.004DOI Listing
May 2019

Evaluation of the Ki-67 and MCM3 Expression in Cytologic Smear of Oral Squamous Cell Carcinoma.

J Dent (Shiraz) 2017 Sep;18(3):207-211

Otolaryngology Research Center, Dept. of Otorhinolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.

Statement Of The Problem: Squamous cell carcinoma (SCC) is the most frequent oral cancer whose 5-year survival rate is 80% for early-detected lesions and nearly 30-50% for advanced lesions. Early detection of oral cancers and precancerous lesions can improve the patient's survival and decrease the morbidity.

Purpose: This study aimed to evaluate and compare the Ki-67 and MCM3 expression in cytologic smear of oral SCC (OSCC).

Materials And Method: We examined 48 oral brush biopsies including 28 OSCC and 20 healthy non-smoking samples. Immunocytochemistry staining was performed for Ki-67 and MCM3 by using an EnVision-labeled peroxidase system, and labeling index (LI) was calculated.

Results: Out of 28 OSCC cases, 27(96.4%) cases contained MCM3 positive cells and 22(78%) cases contained Ki-67 positive cells. All normal mucosa were Ki-67 and MCM3 negative. MCM3 and Ki-67 LI were significantly higher in OSCC than normal mucosa (< 0.001). MCM3 LI was significantly higher than Ki-67 LI in OSCC group (< 0.001).

Conclusion: Immunocytologic evaluation of Ki-67 and MCM3 can be used for early detection of OSCC. Furthermore, MCM3 may be a more sensitive cytologic biomarker than Ki-67 in SCC patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634361PMC
September 2017

Expression of Human Kallikreins 4, 8, 10, 11 and 13 in Pleomorphic Adenomas and Mucoepidermoid Carcinomas.

Iran J Pathol 2016 ;11(4):334-344

Kerman Dental and Oral Diseases Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.

Background: In cancers of prostate, breast, oropharynx, lung, hypopharynx and skin, human tissue kallikreins has been demonstrated as a main role in these problems. There are many research works in which some human tissue kallikreins are expressed in salivary glands. In the present study, the main goal was to determine expression of human tissue kallikreins 4, 8, 10, 11 and 13 in pleomorphic adenomas and mucoepidermoid carcinomas.

Methods: Sixty-six specimens (45 cases of pleomorphic adenomas and 21 cases mucoepidermoid carcinomas) were selected for final analysis by immunohistochemistry. For doing association test, clinical parameters obtained from the patients' medical charts, which included age, gender were used and the nonparametric tests employed for statistical analyses.

Results: The expression of human kallikreins 4, 8, 11 and 13 was more prominent in benign and malignant tumors compared to that in normal tissues and the difference was significant. In addition, the expression of human kallikreins 4, 8, 10 and 11 in malignant tumors was more than that in benign tumors, with statistically significant differences.

Conclusion: The differences in the levels of human kallikreins 4, 8, 11 and 13 suggest that kallikreins may benefit in determining tumor behavior of salivary gland tumors.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563931PMC
January 2016

Long-lasting chondromyxoid fibroma of the zygoma: A rare case report and review of literature.

J Educ Health Promot 2017 9;6:78. Epub 2017 Aug 9.

Department of Otolaryngology, Clinical Pathology Division, Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Chondromyxoid fibroma (CMF) is a benign tumor which usually occurs in skeletal long bones. Its presence in zygoma is extremely rare. The patient was a 47-year-old female, with chief complaint of painful swelling in the left side of zygoma since 1 month ago after a long-lasting painless swelling for about 15 years. Computed tomography scan showed an osteolytic lesion, in the body of left zygomatic bone with lobulated and well-demarcated margins. During surgery, the mass was completely excised and the histological feature of the tumor was in favor of CMF. CMF is benign tumor and complete resection is the treatment of choice.
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http://dx.doi.org/10.4103/jehp.jehp_33_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561685PMC
August 2017

Chemokine and chemokine receptor patterns in patients with benign and malignant salivary gland tumors: a distinct role for CCR7.

Eur Cytokine Netw 2017 Mar;28(1):27-35

Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

To explore the molecular mechanisms involved in pathophysiology of malignant and benign salivary gland tumors (SGTs), we investigated main tumor-inducing chemokines and chemokine receptors, CXCL12/CXCR4/ACKR3 (CXCR7), CXCR3/CXCL10, CCR5/CCL5, CCL21/CCR7, CCL2, CCR4, CXCR5, CCR6, and CXCL8 in tumor tissues. Parotid tissues were obtained from 30 patients with malignant and benign SGTs. Quantitative real-time polymerase chain reaction (qRT-PCR) was employed to determine the mRNA expression pattern of the mentioned chemokines/chemokine receptors and immunohistochemistry (IHC) was performed to verify the expression of CCR7. Expression levels of CCR7 and CCR4 transcripts were higher in the tumor tissues of malignant cases in comparison to benign ones (p = 0.03 and 0.02). Immunohistochemistry analysis confirmed that the protein level of CCR7 concurred with the mRNA expression. CCL2 gene transcripts were observed with a higher expression in patients with tumor-free lymph nodes (LN) and early stages, whereas CCR7 transcript was higher in LN and late stages of the disease. A significant inverse correlation was found between CXCL10 transcript and tumor size in benign cases. The mRNA expression of CCR7, CCR4, CXCR3, CCL21, CCL5, and CXCL12 was significantly higher in mucoepidermoid carcinoma in comparison to pleomorphic adenoma subtypes (p < 0.05). On the basis of the present study, it was determined that malignant and benign SGTs exhibit a distinct pattern of chemokines and chemokine receptors, which are probably associated with known biological and clinical behaviors of these tumors. Significant increased CCR4 and CCR7 expression in malignant SGTs might play a central role in malignant transformation that introduces them as new targets for cancer immunotherapy.
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http://dx.doi.org/10.1684/ecn.2017.0388DOI Listing
March 2017

The Healing Effect of Conditioned Media and Bone Marrow-Derived Stem Cells in Laryngotracheal Stenosis: A Comparison in Experimental Dog Model.

World J Plast Surg 2017 May;6(2):190-197

Stem Cell Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Differences in causes, severities, areas of stenosis, and the association with swallowing and phonation of larynx and trachea can result into Laryngotracheal stenosis (LTS).This study evaluated the healing effect of bone marrow stem cells (BMSCs) in experimentally induced LTS dog model.

Methods: Seven dogs were enrolled. BMSCs were isolated from proximal humerus and shoulder of a dog and cultured in media containing alpha minimal essential medium, fetal bovine serum, penicillin and streptomycin, and L-glutamine. BMSCs were characterized morphologically, by RT-PCR, and osteogenic induction. Karyotyping was undertaken for chromosomal stability. Mechanical trauma to laryngeal mucosa was identically conducted by Tru-cut punch forceps in right and left vocal folds. Two milliliter of conditioned media or BMSCs (2×10) were injected in the right site of the tissue and the left side was considered as control after LTS induction. The larynx was visualized 2, 4 and 6 weeks after treatment. Six weeks post-treatment, the larynges were evaluated histologically.

Results: BMSCs were adhered to culture flasks, spindle shape and positive for mesenchymal marker and negative for hematopoietic markers. Osteogenic induction was verified by Alizarin red staining. Karyotype was normal. A complete epithelialization and minimal chronic inflammatory cell infiltration were noted in submucosa of both left (control) and right (cases) vocal folds. The healing effect of conditioned media and BMSCs in comparison to the control group was more prominent.

Conclusion: As thickness of fibrosis in cases were less than control group, conditioned media and BMSCs were shown to be good choices in healing of LTS.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506354PMC
May 2017

Optic nerve glioma with complete intraocular extension.

J Curr Ophthalmol 2016 Dec 3;28(4):228-231. Epub 2016 Aug 3.

Pathology Department, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: To present a rare presentation of optic nerve glioma (ONG) with total intraocular extension.

Methods: A 44-year-old man with a history of loss of vision since childhood and recent development of progressive disfiguring proptosis was referred.

Results: The vision in the affected eye was no light perception, and a proptosis of about 2-3 mm was present. Computed tomography and Magnetic Resonance Imaging (MRI) of brain/orbit showed a fusiform enlargement of the left optic nerve and total filling of vitreous cavity by a mass with high signal intensity in T2-weighted MRI. There was no extension into the intracranial cavity. The patient also had no signs of neurofibromatosis. Histopathology confirmed the diagnosis of ONG of the left orbit with extension into the globe and filling vitreous cavity.

Conclusion: ONG may extend to the vitreous cavity with no simultaneous intracranial involvement.
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http://dx.doi.org/10.1016/j.joco.2016.07.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093854PMC
December 2016

Correlation between Female Sex Hormones and Electrodiagnostic Parameters and Clinical Function in Post-menopausal Women with Idiopathic Carpal Tunnel Syndrome.

J Menopausal Med 2016 Aug 30;22(2):80-6. Epub 2016 Aug 30.

Department of Physical Medicine and Rehabilitation, Shiraz Burn Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Objectives: To investigate the role of sex-hormonal changes in idiopathic carpal tunnel syndrome (CTS) among post-menopausal women through measuring estrogen receptor (ER) expression in their transverse carpal ligament (TCL) and serum estrogen level, as well as determine the correlation between these factors and electrodiagnostic parameters and Boston score.

Methods: Biopsy samples of TCL were collected from 12 postmenopausal women who had undergone surgery for severe idiopathic CTS; control specimens were collected from 10 postmenopausal women without CTS who had undergone surgery for the other hand pathologies. To determine the distributions of ER in TCL, histological and immunohistochemical examinations were performed. Serum estrogen level was also measured. Electrodiagnosis and Boston questionnaire were used for CTS severity and determination of the patients' function.

Results: ER expression in TCL and serum estrogen level were not significantly different in the case group compared to the control group (P = 0.79 and P = 0.88, respectively). Also, there was no correlation between ER expression or serum estrogen level and electrodiagnostic parameters or Boston score.

Conclusions: Sex hormones cannot still be considered as the etiology of idiopathic CTS in postmenopausal women. The role of other factors such as wrist ratio and narrower outlet in females compared to the males should be considered along with hormonal changes.
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http://dx.doi.org/10.6118/jmm.2016.22.2.80DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016508PMC
August 2016

Effects of Steroids and Curcumin on Prevention of Laryngeal Stenosis Secondary to Trauma.

Iran J Otorhinolaryngol 2016 Jul;28(87):249-54

Stem cell and Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Introduction: The aim of this study was to compare the preventive effects of corticosteroids and curcumin on subglottic stenosis in an animal model.

Materials And Methods: Twenty-one male German Shepherd dogs were used for this study. After standardized trauma to the subglottic area, the dogs were divided into three groups. Group A received curcumin (450 mg/ day) for 15 days; Group B received beclomethasone (2 puffs/day, 50 µg/dose) for 15 days; Group C received saline spray only. At 6 weeks after the injury, the larynx specimens were examined histopathologically to assess epithelialization, inflammation, and fibrosis.

Results: Complete epithelial covering of the steroid-treated group was significantly less than that of the control group. Despite inflammation and fibrosis, there was no significant difference between the steroid and control groups. In the curcumin-treated group, there was no significant difference between the groups.

Conclusion: Topically applied steroid decreases epithelialization after induced subglottic injury. It is recommended that further studies be conducted in order to investigate the effects of the two drugs on airway stenosis prevention.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4994983PMC
July 2016

Therapeutic Effect of Intrastromal Voriconazole, Topical Voriconazole, and Topical Natamycin on Fusarium Keratitis in Rabbit.

J Ophthalmol 2016 19;2016:8692830. Epub 2016 May 19.

Poostchi Eye Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz 7134845794, Iran.

Purpose. Evaluating the therapeutic effect of topical and intrastromal voriconazole and topical natamycin on Fusarium keratitis. Methods. 24 rabbits were selected. The stroma of their corneas was inoculated with suspension of Fusarium solani species complex. Seven days after injection they were divided into 4 groups randomly: the first group was treated with topical voriconazole (TV) 1% for one week, the second one with one-time intrastromal injection of voriconazole (ISV) 50 microgram/0.1 mL, and the third group with topical gel of natamycin (TN) for one week, and the last one did not receive any antifungal treatment. Finally the eyes were enucleated and sclerocorneal buttons were sent for histological and microbiological examinations. Results. After treatment the ISV group and TN group showed significantly lower clinical score and colony forming units than the control group (P = 0.040 and P = 0.026, resp.), but there was statistically no significant difference between control and TV groups (P = 0.249) or between ISV and TN groups (P = 0.665). In pathological evaluation, fewer chronic inflammations were reported in 2 of the 3 buttons from TV group and 3 of the 3 buttons from ISV and TN groups in comparison with the control group. Conclusion. Intrastromal injection of voriconazole seems to be effective in treatment of Fusarium keratitis as much as topical natamycin and these are more effective than topical voriconazole.
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http://dx.doi.org/10.1155/2016/8692830DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889827PMC
June 2016

MTA1 Expression in Benign and Malignant Salivary gland Tumors.

Iran J Otorhinolaryngol 2016 Jan;28(84):51-9

Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

Introduction: Salivary gland tumors (SGTs) are important parts of human neoplasms. The most common SGT is pleomorphic adenoma and the most common malignant SGTs are mucoepidermoid carcinoma and adenoid cystic carcinoma (ACC). Metastasis-associated genes 1 (MTA1), a member of the nucleosome remodeling and histone deacetylation complex, is one newly discovered gene which recruits histone deacetylation, causing ATP-dependent chromosome remodeling, and regulating transcription. MTA1 had been shown to be overexpressed in malignant tumors with the enhancement of invasion and metastasis.

Materials And Methods: Fifty-six samples of salivary gland tumors from the Khalili Hospital archive, including 20 cases of pleomorphic adenoma, 17 cases of mucoepidermoid carcinoma, 19 cases of ACC, and 23 cases of normal salivary gland tissues were chosen for immunohistochemical analysis of MTA1.

Results: MTA1 expression in the malignant tumors was significantly higher than that in pleomorphic adenoma (P<0.001), and higher in pleomorphic adenoma than the normal salivary glands(P< 0.001). In total, 69.6% of normal salivary gland tissues showed MTA1, but all cases of salivary gland tumors were positive for MTA1. High nuclear expression of MTA1 was detected in 83.3% (30/36) of the malignant salivary gland tumors and 45% (9/20) of pleomorphic adenoma, while low MTA1 expression was seen in all of the normal salivary gland tissues. No statistically significant correlation was found between MTA1 protein expression and any clinicopathological features (P>0.05).

Conclusion: Our findings demonstrate that MTA1 was significantly overexpressed in malignant salivary gland neoplasm in comparison to a lower level in benign pleomorphic adenoma, suggesting that MTA1 protein might be involved in carcinogenesis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735617PMC
January 2016

Twist Expression in Pleomorphic Adenoma, Adenoid Cystic Carcinoma and Mucoepidermoid Carcinoma of Salivary Glands.

Turk Patoloji Derg 2016 ;32(1):15-21

Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, SHIRAZ, IRAN.

Objective: Twist is an important transcription factor that induces epithelial-mesenchymal transition and therefore plays an important role in tumor progression. There are a few studies on Twist expression in salivary gland carcinomas. The aim of this study was to evaluate and compare the expression of Twist in the most common benign and malignant salivary gland tumors and to determine whether its expression was correlated with any tumor characteristics.

Material And Method: In this retrospective cross-sectional study, 45 cases including 11 cases of normal salivary gland, 12 pleomorphic adenomas, 12 adenoid cystic carcinomas and 10 mucoepidermoid carcinomas were enrolled. The mean and intensity of Twist expression were evaluated immunohistochemically and were compared using statistical analysis.

Results: The expression of Twist was higher in malignant salivary gland tumors in comparison with normal glands and benign tumors (p= 0.03). It was also higher in pleomorphic adenomas in comparison with normal tissue. Adenoid cystic carcinomas and mucoepidermoid carcinomas showed no significant difference in Twist expression (p= 0.50). There was no correlation with the size, stage or grade of tumor.

Conclusion: The findings showed that Twist might play a role in the formation of salivary gland neoplasm and also may affect malignant transformation and tumoral invasion. The exact mechanism of this marker and the possibility of using it as a therapeutic target require further investigation.
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http://dx.doi.org/10.5146/tjpath.2015.01343DOI Listing
January 2017

Synthetic Fiber "Teddy Bear" Conjunctival Granuloma; a Case Report.

J Ophthalmic Vis Res 2015 Jul-Sep;10(3):342-4

Department of Pathology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: To report the clinicopathologic features of a case of conjunctival synthetic fiber granuloma.

Case Report: A 6-year-old girl presented with a slow-growing red nodule in the right inferior conjunctival sac with no history of surgery or trauma. Histopathological examination revealed foreign body type granulomatous inflammation around birefringent fibers of variable colors consistent with synthetic fiber granuloma.

Conclusion: This is the first case report of synthetic fiber (teddy bear) conjunctival granuloma from Iran. Despite its scarcity, ophthalmologists should consider this type of granuloma in the differential diagnoses of childhood conjunctival lesions especially when the lesion is unilateral and inferior.
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http://dx.doi.org/10.4103/2008-322X.170342DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687271PMC
January 2016

Salvia officinalis L. induces alveolar bud growing in adult female rat mammary glands.

Avicenna J Phytomed 2015 Nov-Dec;5(6):560-7

School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Objectives: In traditional medicine Salvia officinalis (sage) has been used as menstrual cycle regulator. In the present study the effects of sage extract on breast tissue were examined.

Materials And Methods: Fourteen female rats were divided into two groups: 1) Distilled water-treated rats (Con) that were gavaged with 1ml distilled water and 2) Saliva officinalis hydroalcoholic extract (SHE)-treated rats that were gavaged with 30mg/kg/body weight of sage extract for 30 days. The estrus cycle changes were monitored by daily examination of vaginal smear. Whole mounts of right pelvic breast were spread on the slide and stained by carmine. The number of alveolar buds (ABs) type 1 and 2 and lobules of mammary gland were scored. Tissue sections of left pelvic mammary gland were prepared and its histomorphometrical changes were measured. Blood samples were taken from dorsal aorta and estradiol and progesterone concentrations were measured using radioimmunoassay.

Results: Estrous cycles decreased significantly in SHE-treated animals. The number of alveolar buds and lobules in mammary gland whole mount of SHE-treated group were higher than the Con group. The number and diameter of ducts in histological section of mammary gland in SHE-treated group increased as compared to the Con group.

Conclusion: Sage promotes alveologenesis of mammary glands and it can be used as a lactiferous herb.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678501PMC
December 2015

Conjunctival Lesions; a Histopathologic Review in Fars Province, Iran.

J Ophthalmic Vis Res 2015 Apr-Jun;10(2):98-101

Department of Pathology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: To determine the prevalence of various types of conjunctival lesions, at a tertiary ophthalmic center in Fars Province, South of Iran.

Methods: Histopathologic slides and medical records of conjunctival lesions submitted to the pathology department of Khalili Hospital, Shiraz, Iran were reviewed from April, 2009 to July, 2013. The histopathologic diagnoses were categorized into benign, pre-malignant, and malignant lesions. The prevalence of various types of conjunctival lesions was calculated.

Results: Histologic sections of 631 conjunctival lesions were reviewed. Benign lesions were most prevalent (81.8%), followed by premalignant (10.8%) and malignant (7.4%) lesions. Pterygia were the most common benign lesions (69.2%), intraepithelial dysplasia constituted most cases of premalignant lesions (94.1%), and squamous cell carcinoma was the most frequent malignant lesion (93.6%). Benign lesions were the most common type of lesions in all age groups, however the prevalence of malignant lesions increased significantly with age (P < 0.001).

Conclusion: Benign lesions were the most common conjunctival lesions with pterygia on top of the list, while intraepithelial neoplasia and squamous cell carcinoma were the most common premalignant and malignant lesions, respectively. Conjunctival malignant lesions were more prevalent with older age.
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http://dx.doi.org/10.4103/2008-322X.163774DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4568625PMC
October 2015

Caveolin-1 overexpression in benign and malignant salivary gland tumors.

Tumour Biol 2016 Feb 1;37(2):1863-9. Epub 2015 Sep 1.

Shiraz University of Medical Sciences, Shiraz, Iran.

Caveolin-1, a tyrosine-phosphorylated protein, is supposed to have different regulatory roles as promoter or suppressor in many human cancers. However, no published study concerned its expression in benign and malignant salivary gland tumors. The aim of this study was to evaluate and compare the expression of Cav-1 in the most common benign and malignant salivary gland tumors and evaluate its correlation with proliferation activity. In this cross-sectional retrospective study, immunohistochemical expression of caveolin-1 and Ki67 were evaluated in 49 samples, including 11 normal salivary glands, 15 cases of pleomorphic adenoma (PA), 13 adenoid cystic carcinomas (AdCC), and 10 mucoepidermoid carcinomas (MEC). The expression of Cav-1 was seen in 18 % of normal salivary glands and 85 % of tumors. The immunoreaction in the tumors was significantly higher than normal tissues (P = 0.001), but the difference between benign and malignant tumors was not significant (P = 0.07). Expression of Cav-1 was correlated with Ki67 labeling index in PAs, but not in malignant tumors. Cav-1 expression was not in association with tumor size and stage. Overexpression of Cav-1 was found in salivary gland tumors in comparison with normal tissues, but no significant difference was observed between benign and malignant tumors. Cav-1 was inversely correlated with proliferation in PA. Therefore, this marker may participate in tumorigenesis of salivary gland tumors and may be a potential biomarker for cancer treatments.
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http://dx.doi.org/10.1007/s13277-015-3968-zDOI Listing
February 2016

Elastofibroma of the Face: A Case Report.

J Dent (Shiraz) 2015 Mar;16(1 Suppl):73-5

Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran, Oral and Dental Disease Research Center, Kerman University of Medical Sciences, Kerman, Iran;

Elastofibroma is a rare neoplasm that characteristically occurs in subscapular area in response to microtrauma. There are some reports of this tumor in other sites of the body but, up till now, there has been no report of elastofibroma in the face. A 20-year-old man presented with a slow growing painless mass in the face without any history of trauma. Histopathologic examination revealed a soft tissue mass composed of eosinophilic fibers admixed with aggregation of fat cells, capillary blood vessels, and fibroblasts. Elastic stain and Masson's trichrome stain confirmed the nature of elastic and collagen fibers. It was a case of elastofibroma in the face.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476114PMC
March 2015

Evaluation of Minichromosome Maintenance-3 (MCM3) in Oral Squamous Cell Carcinoma.

J Dent (Shiraz) 2015 Jun;16(2):87-92

Post Graduate Student, Dept. of Oral & Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran;

Statement Of The Problem: The expression of minichromosome maintenance-3 (MCM3) proteins and their diagnostic value in oral mucosal dysplasia and squamous cell carcinoma (SCC) is not well known.

Purpose: This study was conducted to evaluate the usefulness of minichromosome maintenance 3 (MCM3) as a biomarker for diagnosis of oral premalignant lesions and SCC.

Materials And Method: In this study, 31 oral SCC, 20 dysplastic epithelium and 20 controls were selected and immunohistochemical staining was done for MCM3. ANOVA, Tukey HSD, Mann-Whitney and Kruskal-Wallis tests were used to compare the groups and the correlation between different grades.

Results: There was increasing trend of MCM3 from control to dysplastic epithelium and from dysplastic epithelium to SCC both in suprabasal layers and in total epithelial layers. MCM3 expression was elevated with increasing the grade of dysplasia, but there was no statistically significant difference (p= 0.93). The expression was also increased in high grades of SCC compared to lower grades.

Conclusion: MCM3 can be used as a useful biomarker in the diagnosis of premalignant lesions and oral SCC.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445857PMC
June 2015

Primary tuberculosis of the vallecula and pyriform sinus: a case report and review of literature.

Iran J Otorhinolaryngol 2015 Mar;27(79):171-5

Department of Pathology,Shiraz University of Medical Sciences, Shiraz,Iran.

Introduction: Tuberculosis (TB) is a relatively prevalent infectious disease caused by a bacterium called mycobacterium tuberculosis. It primarily involves the lungs, but it can also affect other organs causing a variety of symptoms.

Case Report: In this report, a rare case with primary involvement of pyriform sinus and vallecula due to tuberculosis in a 74-year-old woman who complained of odynophagia for 6 months, is reported. There were no clinical or radiological pulmonary findings.

Conclusion: The authors point out the epidemiological importance of tuberculosis and the need for more suspicion when dealing with uncommon lesions to make an early diagnosis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409963PMC
March 2015

Fine-needle aspiration cytological diagnosis of neck masses.

Acta Cytol 2015 11;59(1):68-76. Epub 2015 Feb 11.

Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Fine-needle aspiration (FNA) is a simple, safe, inexpensive, and acceptable method for diagnosing masses, especially at superficial areas. Therefore, we decided to evaluate the accuracy of FNA cytological diagnosis in nonthyroidal, nonsalivary gland neck masses and compare the results with histopathological diagnosis.

Materials And Methods: In this retrospective study, all cases with FNA cytological diagnosis of nonthyroidal, nonsalivary gland neck masses from April 2009 to July 2013 were retrieved. The procedure was done by pathologists, and all cytological and histopathological slides of the existing 46 cases were reviewed by 3 pathologists. The values of sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated.

Results: SN, SP, PPV, NPV, and accuracy in this study were 79, 100, 100, 73, and 86%, respectively. We had 6 false-negative and no false-positive cases.

Conclusion: The FNA procedure is a reliable method as the first step for the diagnosis of nonthyroidal, nonsalivary gland neck masses. To increase the diagnostic value of cytology, careful examination of all cytological slides, repetition of the FNA procedure and good history taking are helpful.
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http://dx.doi.org/10.1159/000371412DOI Listing
August 2015

The Healing Effect of Licorice on Pseudomonas aeruginosa Infected Burn Wounds in Experimental Rat Model.

World J Plast Surg 2014 Jul;3(2):99-106

School of Veterinary Medicine, Shiraz University, Shiraz, Iran;

Background: Burn is still one of the most devastating injuries in emergency medicine while improvements in wound healing knowledge and technology have resulted into development of new dressings. This study was undertaken to evaluate the healing effect of licorice in Pseudomonas aeruginosa infected burn wounds of experimental rat model.

Methods: One hundred and twenty female Sprague-Dawley rats were randomly allocated to 4 equal groups. Group A received silver sulfadiazine ointment, Group B received 10% licorice extract and Group C was considered as control group and received gel base as the base of medication. Group D did not receive any medication and just underwent burn injury. A standard 3rd degree burn wound was produced by a hot plate with similar size about 20% of total body surface area (TBSA) and at identical temperature. After 24 h of burn production, 10(8) colony forming units (CFU) of toxigenic strains of P. aeruginosa (PA 103) were inoculated subcutaneously into the burnt area. After 3, 7, 14, 21 and 28 days of therapy, the animals were sacrificed and burn areas were macroscopically examined and histologically evaluated.

Results: Decrease in size of the burn wounds, in inflammation and re-epithelialization were poor in groups B-D. Infection to P. aeruginosa was still visible in groups B-D but was absent in Group A. The mean histological score, tensile strength, maximum stress, yield strength and stiffness in groups B-D were lower compared with Group A.

Conclusion: Licorice extract in 10% concentration was shown not to be effective in healing of P. aeruginosa infected burn wounds.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236996PMC
July 2014