مجله پزشکی کوثر
سال ششم شماره 2 (پیاپی 20، تابستان 1380)

this research the effects of axotomy on the spinal cord histology of neonatal rats were studied. 40 rat pups of both sexes were operated under ice-induced anesthesia within 5 days of birth. Via hypothermia and under sterile conditions, the right sciatic nerve was transected at mid-thigh level. The left side was used as a control. Operated rats were sacrificed at 3,5,7,10 and 14 days of axotomy. All animals were perfused and killed with an overdose of ether. After routine processing and embedding in paraffin, transverse serial sections were taken at 8 mm from the lumbar spinal cord and stained with cresyl violet and Hematoxylin and Eosin. Moreover, the spinal cord was processed for semithin sections by perfusing the animals with 2.2% glutaradehyde in phosphate buffer, postfixed 1% osmium tetroxide and dehydrated in graded acetone followed by epoxy and resin. Slices 500-800 mm thick were cut and stained with Tolidine blue. Slides were studied by superimposing an ocular grid and counting vital and nonvital motoneurons. Comparisons between counts on the right and left sides of operated animals were made. ANOVA was used to evaluate the significance of the differences between the results obtained in different periods and the neuronal loss on the operated side was determined by student t-test. Quantitative studies confirm the death of motoneurons on operated side. Mean survival rates of motoneurons in all groups was lower on the operated side and this difference was significant (P>0.01). Furthermore the mean number of live motoneurons 10 days after surgery was lower than other groups (P>0.01).There was a relation between loss of motoneurons and increase of dead cells. Microscopic observation showed nuclear changes and cytoplasmic vesicles in the spinal motoneurons. Scattered cells with a dense cytoplasm with piknotic nuclei were seen. These cells represented characteristic apoptotic features. Some motoneurons showed changes such as nuclear condensation and peripheral displacement. In conclusion, axotomy resulted in apoptotic cell death of motoneurons as well as progressive definitive time-course reduction of cell number after axotomy with a peak cell loss at day 10.

The aim of this study was to assess the effects of hip position on H reflex amplitude. This study was carried on 30 healthy female subjects. Their ages ranged from 20 to 40 years. In this experiment, after placing the recording electrodes on the soleus muscle of the dominant leg, the lower limb from hip joint was randomly positioned in 150, 400 flexion, 200 abduction and 200 extension. H reflexes in five stages of stimulus intensity and maximum M wave (Mmax) were recorded by stimulation of tibial nerve in the popliteal fossa. In addition, latency of H reflexes in five stages, latency of maximum M wave and H/M ratio in four position were also recorded. In this study, knee joint was extended and ankle joint was fixed in 900 (neutral position) by a metal plate which was designed at the end of the bed. The lower limb, was also fixed by a sling in the femoral region. Paired t-test and ANOVA were used to determine significant differences between variables. Results were as follows: amplitude of H reflex in five stages of stimulus intensity and H/M ratio were decreased from 150 flexion (control position) to 400 flexion and increased from control position to 200 extension. In 200 abduction, amplitude of H reflex was decreased only in third, forth and fifth stages of experiment. H/M ratio was also decreased but not singnificantly. Amplitudes of Mmax weren’t differed in all positions which indicating test procedure were the same. The effects of hip position on H reflex amplitude and H/M ratio could explained by changing the activity of muscular and skin receptors and Golgi tendon organs and their effects on motor neuron pools. Positioning of the hip joint causes change in activity and excitability in motor neuron pools in spinal cord. These changes are due to genetic background and type of activity can decrease (inhibition) or increase (excitation) motor neuron activity in spinal cord.

Chronic toxoplasmosis often is associated with a protective immunity against re-infection. The object of this study was to determine the efficacy of immunity against reinfection with the RH strain of Toxoplasma. Mice with chronic toxoplasmosis were injected through IP with the RH strain. All died 3-5 days after infection. This result indicates that the immune responses in chronic infection with toxoplasma can not protect this animal against acute toxoplasmosis with the RH strain. If this situation applies to in human toxoplasmosis, infection of pregnant women is dangerov because if a pregnant women is infected with a different toxoplasma strain prior to pregnancy, the fetus may be infected with congenital toxoplasmosis.

The problem of drug dependence still remains unsolved. In the present study the effects of the essence of anisum pimpinella on the expression and acquisition of conditioned place preference (CPP) induced by morphine in mice were investigated. Male albino Swiss-Webster mice (20-25gr) were used. The Carr and White method was applied for the induction of CPP. Intrapretoneal (IP) injection of morphine (5mg/kg) induced CPP significantly. However, injection of essence (0.125-0.5 ml/kg; IP) induced conditioned place aversion (CPA). Although administration of essence before the test had no effect on morphine action. Co-administration of the essence (0.25ml/kg) with morphine in the training days reduced the morphine effect. Pre-treatment of animals with bicuculline a GABAA receptor antagonist (1.5mg/kg) diminished the effect of the essence on morphine induced CPP but this result was not found for CGP35348 (GABAB receptor antagonist). These results show that the essence of the anisum pimpinella may reduce morphine effects via a GABAergic mechanism.

Laser-Doppler flowmetry (LDF) was used to measure changes in regional cerebral blood flow (rCBF) following morphine and naloxone administration in morphine-dependent anesthetized rats. Morphine (10 mg/kg; i.p.) administration reduced rCBF in control, sham-operated and morphine-dependent rats, but the depressant effect of morphine in morphine-dependent animals was less than that of controls and sham-operated groups. While naloxone (0.5 mg/kg; s.c.) had no considerable effect on rCBF in control and sham-operated groups, it increased rCBF in morphine dependent ones. The depressant effect of morphine in the naive group and the enhancing effect of naloxone in morphine-dependent animals were not seen after local application of lidocaine upon the recording site. This study may provide a framework to study the cellular and molecular mechanisms responsible for coupling neuronal electrical activity with regional alteration in blood flow during precipitation of morphine withdrawal.

Multiple therapeutic combinations have been tested to determine the ideal regimens for eradication of Helicobacter Pylori as the major factor in peptic ulcer diseases with different results depending on geographic area. Our aim was to evaluate the effectiveness of currently prescribed anti H. Pylori regimens in Tehran-Iran. We enrolled 415 subjects (242 males, 173 females, age 11-82 years) with documented H. Pylori infection of the stomach from outpatients of the gastroentrology department of Shariati Hospital. In all patients H. Pylori infection was identified by rapid urease test and or histology. Patients were then treated by different H. Pylori regimens (Triple or quadriple) on an intention to treat basis. One to six months after completion of therapy C 14 urea breath test (C14-UBT) was performed for assessment of eradication. Overall success rate of all regimens were 37%, patient compliance (usage of< 80% drugs) were satisfactory (94%) and was identical for all regimens. The results of this intention-to - treat study was comparable with controlled (perprotocol) studies. The regimen containing amoxicillin + furazolidone was more successful than that of amoxicillin + metronidazole (83.3% vs 66.2%, P>0.05). Only the regimen containg amoxicillin + aetronidazole + omeprazole was superior to H2 receptor antagonists (86.6% Vs 66.2%, P>0.05). The most successful antibiotic combination was tetracycline + furazolidone (100% success rate) which warrants more evaluation in a separate study. Successful eradication rate was identical in groups 1 and 2 evaluated 1-3 months and 3-6 months after completion of therapy respectively (73.6% vs 71.1%, P<0.05). Conventialy there was no significant difference between intention-to-treat therapy with reported preprotocol eradication rate. The best drug regimen in this study was bismuth + tetracycline + furazolidone + acid secretory inhibitors. Replacement of metronidazole by furazolidone was effective in improving eradication rate. In assessment of success of eradication, results of 3 months versus 6 months after therapy were almost similar and comparable.

One of the most common post - op complications in PACU is nausea and vomiting. this is more common in special surgical procedures like OBGYN surgeries or laparoscopic surgeries, Where complications are mostly encountered. Different therepeutic regimens have been used for this condition; among which Metoclopramide is the first choice. Cases of this study were subdivided into 3 groups, all of which were pregnant women below 30 years, undergoing cesarean section. None of the cases had confounding conditions like vertigo, pre - op nausea, etc. Samples were distributed in the 3 group randomly. The first group received 10 mg metoclopramide, stat, post - operatively; the second and the third groups received promethazine 25mg and dihidrobenzpoeridole 2.5 mg, along with a 10 mg dose of metoclopramide, respectively. All patients were checked both in the PACU and 8 hours after surgery, regarding nausea and vomiting. No significant difference was noted among the 3 groups regarding the symptoms.

FNA is a safe and simple method which can differentiate benign and malignant nodules in thyroid. In this retrospective study attempts were done to determine the accuracy of preoprative fine-needle aspiration biopsy (FNA). We compaired the FAN biopsies from 95 patients (70 female and 25 male) with their permenant pathology. They divided in two groups; in the first group, there were 64 (67%) patients with diagnostic report (50 benign and 14 Malignant), and the second group consist of 31 (33%) patient with suspicious report. In the first group, there were seven (19%) mistake in diagnosis with FNA, 3 false negative and 4 fase positive; and in the second group, there were six (19.4%) malignant and 25(80.6%) were benign. The sensitivity and the specificity of FNA in this study were 78% and 92% respectively. The positive predictive value was 73% and negative predictive value was 94 %.

This study compares the results of kidney transplanation in multiple renal arteries kidneys with that of single arteri kidneys from living donors. In the years 1995-1999 twelve kidney transplantations with double renal arteries have been done. Twelve transplants with single renal arteri operated right before or after the study cases were chosen as controls. Immediate diuresis after the operation in both groups was 100%. Normal perfusion in post operative isotope scans was seen in all patients, and no thrombosis was observed in either group. The average blood pressure in the study group was 135/85mmHg before operation and 125/75mmHg 3 month post operation with significant decrease in both systolic (P=0.031) and diastolic (P=0.023)pressure. The average creatinine level 6 months after operation was 1.58mg/dl in the study group and 1.54mg/dl in the control group without any significant difference (p=0.89).Apparently kidneys with multiple renal arteries do not have any significant disadvantages on graft function.

Scurvy is result from ascorbic acid deficiency. Many years ago, scurvy occurred in epidemics due to lack of vitamin C in the diet. Of course these epidemics still occur in some parts of the world especially in refugee camps and in populations that subsist mainly on donated creal grains.The incidence of this disease has been less in recent years, but it is seen sporadically in some living on a monotonous diet. we present a case who had been on a restricted diet without fruits and vegetables due to chronic dyspepsia and gastric ulcers and had taken Omeprazol and Bismuth for 3 years. He had ecchymotic patches on his skin and referred to the dermatology clinic. On examination, corkscrew hair with perifollicular purpura on his skin was noticed. Vitamin C deficiency was suggested and for two weeks he was given 1000 mg vitamin C orally per day and the mucocutaneous lesions disappeared.

When Iranian forces started the libration process of the occupied Land of Iran, the medical personel were recruited to the fronts and the nearest field hospitals, emergency care, and first aid camps. The field hospitals were at frist, prefabricated later replaced by metal-made constructions and concrete ones, to become more resistance aganist air and ground bombardments. These constructions were the first bases of the field hospitals. Later 173,823 cases were admitted there, and at least 7718 cases were operated there (1). These cases consist 21 percent of the total 32/534 cases under going surgical operations. 30 percent of these operations were laparotomies, and 1288 chest tubes were inserted. The Fatematazzahra (a.s.) hospital, located in Abadan Ali-ebne - Abitaleb in north Abadan, and Imam Hossein (a.s.) hospital in the Khorramshahr road were the most effective field hospitals. If field hospitals were deficient, more than 50 percent of the cases would have died to transportation shortages or would have had considerable morbidities. Casualty deployment was the lowest ever (as low as 3 hours). This was 72 hours in the World War II, 12 hours in the Vietnam war and only 1 hour in Faw.