Archives of Iranian Medicine
Volume:2 Issue: 1, Jan 1999

Background-To determine if there is an association between immunoproliferative small intestinal disease and Helicobacter pylori infection.Methods-This is a retrospective study of 66 cases of immunoproliferative small intestinal disease in whom 21 had endoscopic biopsies of the stomach, compared with 42 patients with non-ulcer dyspepsia. Biopsies from the antrum and fundus were assessed for presence of H. pylori by histology.Results-Chronic active gastritis was found in 8 (38%) of patients with immunoproliferative small intestinal disease and 35 (83%) of patients with non-ulcer dyspepsia. H. pylori infection was found in 6 (29%) of patients with immunoproliferative small intestinal disease compared with 33 (79%) of patients with non-ulcer dyspepsia.Conclusions-In this patient population we failed to find an association between H. pylori infection and immunoproliferative small intestinal disease.

Background- A large number of Iranian soldiers suffered penetrating CNS injury with consequent seizures during the Iran-Iraq war. Methods- Patients suffering from seizure attacks due to head injuries in the Iran-Iraq war and residing in the province of Isfahan were recruited and extensively investigated. Results- A total of 153 patients were studied; 121(79.5%) suffered from generalized seizures of which 110 patients were tonic clonic type. The type of injury was penetrating in 132 (86%) of the patients. Nighty-five percent of the patients had abnormal CT scans and almost half of the patients harbored intracranial foreign bodies with metallic density. Analysis showed that there was no significant correlation between the size of the lesion and the occurrence of seizures. The presence of metallic particles in the brain had no impact on the frequency of the seizures either. Conclusion- Due to the relative abundance of penetrating head injuries in the former soldiers of the Iran-Iraq war and the diverse nature of its complications including seizure attacks, this issue merits further investigation and attention.

Background-Omeprazole is widely used in various gastric, acid-related disorders and undergoes rapid and extensive metabolism in the liver.Methods-The pharmacokinetics of omeprazole and its metabolites were studied in nine young healthy volunteers following oral administration of two 20 mg capsules. The concentration of omeprazole and its metabolites, omeprazole sulfone and hydroxy-omeprazole, were determined in plasma by a rapid and selective method using solid-phase extraction followed by HPLC analysis.Results-The maximum concentration of omeprazole was reached at least 1 hour after oral dosing. Significant inter-subject variability was observed within pharmacokinetic parameters of omeprazole and its metabolites in volunteers. Four subjects exhibited much higher plasma levels of omeprazole compared to the others. Analysis of serum showed the existence of another metabolite of omeprazole which has not been previously reported.Conclusion-1) The inter-individual variations in omeprazole metabolism reported in different populations was also observed in Iranian volunteers. 2) Another metabolite of omeprazole appears to exist which requires further characterization.

Background-Malignant cell-lines derived from oral squamous cell carcinoma (SCC) express messenger RNA for transforming growth factor alpha (TGF-a) and parathyroid hormone-like proteins (PTHLP) in culture. The purpose of the present study was to determine the precise immunohistolocalization and tissue distribution of these bioactive peptides in paraffin-embedded sections of normal and diseased oral mucosa and to relate them to their cell-lines occurrences reported in the literature. Methods-Formalin fixed paraffin embedded sections of twenty-two primary oral squamous cell carcinoma, 18 benign and dysplastic oral epithelial lesions and 15 specimens of normal buccal mucosa were included in the study. Expression of TGF-a and PTHLP was determined immunohistochemically. Results-A detectable level of TGF-a and PTHLP was found in normal and benign oral mucosa. A higher level of expression was demonstrated in dysplastic oral lesions and the greatest staining level was found in oral SCCs. Malignant epithelial cells at the peripheral margins of the invading tumors demonstrated strong positive staining for both antigens. Conclusions-The in situ expression of TGF-a and PTHLP by normal and diseased oral mucosa was detectable immunohistochemically in formalin fixed paraffin embedded sections of oral mucosa and their occurrences were not altered by fixation methods used to process these tissues. Secondly, the expression of TGF-a and PTHLP was a reflection of dysplasia and loss of differentiation in oral epithelial cells. Thus, the immunohistochemical determination of these bioactive peptides may be valuable as an adjunct to conventional histology for detection of potential malignancies in histological examination of oral mucosal diseases.

Background-Garlic has been reported to reduce cholesterol and other serum lipids. The beneficial effects of garlic powder supplementation is however, a matter of controversy.Objective-To investigate the lipid-lowering effect of dried garlic supplimentation in hypercholestrolemic patients.Methods-The effects of dried garlic powder tablets (Garlet7) on the serum lipid and lipoprotein levels were studied in 93 primary hypercholesterolemic subjects over a period of 12 weeks. In a placebo-controlled, randomized, double-blind parallel trial, patients were randomized into four groups and were given 1200, 2400, and 3600 mg/day of Garlet. Serum lipid and lipoprotein levels were measured at the beginning and at the end of the study. No dietary intervention was implemented during the trial. A two-day diet recall with Food Frequency Questionnaire (FFQ) was obtained at the baseline and at the end of the study. No significant changes were demonstrated in nutrient components and calorie intake between and within each group during the trial.Results-The serum cholesterol and LDL-cholesterol in the treatment group, who received 2400 mg/d of Garlet, was reduced by 21.2 mg/dL (8.2%, p<0.001), and 20.4 mg/dL (11.7%, p<0.002), respectively, during the 12-week study period. The serum triglyceride in the those who received 1200 mg/d, decreased by 28.1 mg/dL (11.8%, p<0.009), by the end of the trial. Serum HDL-cholesterol was not altered significantly.Conclusion-Garlic powder supplementation has some beneficial effects on the known atherosclerotic risk factors including serum cholesterol, triglyceride and LDL-cholesterol. Furthermore, it was found that the efficacy of garlic was not linearly dose dependent.

Background_ High prevalence of human T-Cell lymphotropic virus type I (HTLV-1) infection and disease has been identified in northeastern Iran. Objective_This study was conducted to determine the phylogenesis of the HTLV-1 in this highly prevalent area. Methods_DNA in six patients was obtained form peripheral blood. Mononuclear cells from four patients with ATL and one with TSP/HAM and another asymptomatic HTLV-1 seropositive patient were studied. Amplified long terminal repeats (LTRS) were analyzed for restriction fragment length polymorphisms. Phylogenetic analysis by PCR technique and primers LTR1 and LTR2 were used and compared with HTLV-1 form patients with other molecular strains. Results_The results show that genotype classification of HTLV-1 is of cosmopolitan subtype. Conclusion_The results suggest that the introduction of the HTLV-1 virus into the Northwest of Iran must have occurred over the past several centuries.

A 70-year-old woman presented with gradual painless blurring of vision in both eyes for approximately ten years. Her medical and family history were unremarkable. Her visual acuity was counting fingers at 0.5 meter in the right eye and hand motion in the left. The anterior segments were notable only for the presence of early nuclear cataracts. The fundus of both eyes revealed the pathognomonic appearance of rail-road tracks in the retinal pigment epithelium. The linear tracks were especially numerous in the mid-periphery. There was fibrous macular proliferation in the left eye and severe macular degeneration in the right. Fluorescein angiography revealed numerous hyperfluorescent tracks with no leakage. There was early hyperfluorescence in the macula of left eye with late staining. This is the first report of bilateral Ophthalmomyiasis interna posterior in Iran.

Pancoast''s syndrome is almost exclusively caused by malignant apical lung tumors invading structures of the thoracic outlet. Signs of this syndrome include A: Apical lung mass which may be associated with soft tissue infiltration or rib destruction B: Severe pain in the shoulder or arm C: Ipsilateral Horner syndrome D: Ipsilateral weakness and atrophy of arm muscles. Non-neoplastic causes of Pancoast''s syndrome are very rare. Herein we present a case of Pancoast''s syndrome of echinococcal origin in a 20-year-old woman with right shoulder and arm pain, weakness and paresthesia of 8 month duration. On physical examination a right-sided Horner syndrome, muscle atrophy and skin scaling in right arm were evident. Chest X-ray showed opacity of the right lung apex with destruction of posterior arch of the second rib and upper border of the third rib. A CT scan of the chest revealed bone destruction and soft tissue density of the cystic mass. With the impression of Pancoast''s syndrome the patient underwent thoracotomy. Daughter cysts were seen and the pathologic examination confirmed the diagnosis. Horner syndrome and shoulder pain subsided gradually after operation. Rare non-neoplastic causes of Pancoast''s syndrome include tuberculosis, fungal and bacterial infection as well as the echinococcal cyst. Hydatid cyst, though a rare cause of Pancoast''s syndrome must be considered in endemic area including Iran.

Elastofibroma dorsi is a rare pseudo-tumor that results from repeated trauma, almost exclusively in the connective tissue between the edge of the scapula and the chest wall. It is a degenerative benign neoplasm occurring usually in elderly women with the clinical appearance of a malignant tumor. Elastofibroma is very rarely reported in literature. Herein we report on a 70-year-old woman with two plaques of elastofibroma presenting in two unusual sites of body; one on the right breast with an unusual shape and another over the back, on the same side.