فهرست مطالب

Acta Medica Iranica
Volume:42 Issue: 5, Sept-Oct 2004

  • تاریخ انتشار: 1383/09/11
  • تعداد عناوین: 17
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  • F. Asadi Jamnani, M. Doosti, M. Zahraei, M. Ghazi, Sh. Ahmadian Pages 311-318
    Liver secretes a large range of very low density lipoprotein (VLDL) particles of different sizes and Svedberg flotation rates (Sf). In plasma VLDL is converted to low density lipoprotein (LDL)which in turn plays an important role in the development of atherosclerotic diseases; however,triglyceride (TG) rich VLDL1 has been shown to be more deleterious than cholesteryl ester (CE) rich VLDL2. There is evidence that the liver intracellular pool of CE and TG can regulate secretion of VLDL. To study the effect of CE pool on VLDLl and VLDL2 secretion, guinea pig liver was perfused with Krebs- Henseleit buffers containing lovastatin, progesterone and lovastatin plus progesterone. Perfusate pools of VLDL1 and VLDL2 were separated by cumulative flotation ultracentrifugation, confirmed by electron microscopy, and in each pool TG, CE and total lipid were measured. Progesterone had no significant effect on total lipid analysis in either VLDL1 or VLDL2 pools while lovastatin lowered the total lipid by 20% in VLDL1 and 41% in VLDL2 based on percent 90 minute point. Lovastatin decreased TG by 21% and CE by 20% in VLDL1 while it decreased TG by 39% and CE by 56% in VLDL2, based on percent 90 minute point slope change. On the other hand, while lovastatin plus progesterone lowered TG by 22% and CE by 23% in VLDL1, it lowers TG and CE by 39 and 64% in VLDL2, respectively. CE has an important role in the lipidation process and secretion of VLDL2 particles in normal guinea pig liver perfusion system.
  • M.J. Zibaeenezhad, A. Amanat, A. Alborzi, A. Obudi Pages 319-324
    The possibility that infectious agents may trigger a cascade of reactions leading to inflammation, atherogenesis and vascular thrombotic events has recently been raised. Chlamydia pneumoniae is an infectious agent that has received the most attention with respect to coronary artery disease (CAD). To determine the relationship between C. pneumoniae and CAD, a case control study was conducted on 167 subjects (81 women and 86 men) who underwent coronary angiography at cardiac catheterization laboratories of our hospital. We measured IgG and IgA antibodies to C. pneumoniae antigens by ELISA method in baseline serum samples from 109 cases (mean age 57 years) who had at least one coronary artery lesion occupying 50% or more of the luminal diameter on coronary angiography and from 58 matched controls (mean age 50 years) who had documented normal coronary arteries. The prevalence of IgG and IgA antibodies to C. pneumoniae showed no case-control differences for IgG (82.6% vs 74.1%) or IgA (23.5% vs 16.7%). These results suggest that C. pneumoniae is not associated with documented CAD. More studies are needed to clarify the possible different effects of C. pneumoniae on atherosclerosis.
  • F. Kazerouni, E. Javadi, M. Doosti, B. Larijani Pages 325-330
    Low density lipoprotein (LDL) subclass pattern B is characterized by predominance of small dense LDL. Subjects with pattern B tend to have higher triglyceride (TG) and lower levels of high density lipoprotein cholesterol (HDL-C). Small dense LDL is associated with increased risk of coronary disease. In this study, effect of non-insulin dependent diabetes mellitus (NIDDM) on LDL size, plasma TG and HDL-C were assessed in Iranian patients. LDL size was determined by non-denaturing gradient polyacrylamide gel electrophoresis in 81 NIDDM and 81 healthy subjects (age 50 to 70 yrs). TG and HDL-C were measured by analytical kits. Fifty nine percent of diabetics and 27% of controls showed LDL pattern B. LDL size was significantly lower in diabetics than controls (25.1± 1.5 vs 25.8± 2.8 nm, P<0.001). Diabetics had significantly higher triglyceride than controls (187.8 ± 90 vs 145.6 ± 69 mg/dl, P<0.001) and lower HDL-C (47.5± 12 vs 57.1± 14 mg/dl, P<0.001). LDL size correlated negatively with TG (r = -0.281, P<0.05). Diabetics showed 2-fold increase in frequency of pattern B which may explain increased risk of coronary disease in these patients.
  • F. Asgarani, M. Mahdavi, Mazdeh, M. Lessan, Pezeshki, Kh. Makhdoomi A., M. Nafar Pages 331-337
    Although protein-calorie malnutrition is common among the hemodialysis patients and is associated with increased rates of morbidity and mortality, assessment of nutritional status of these patients is frequently ignored in many dialysis centers. Malnutrition can be estimated using a semiquantitative scale, subjective global assessment (SGA) but subjective nature of this scale restricts its reliability. In this study, we evaluated the malnutrition status in 71 hemodialysis patients by a recently developed, fully quantitative scoring system, dialysis malnutrition score (DMS) instead of conventional SGA and compared the results with laboratory and anthropometric measurements of malnutrition. Consequently, this revealed that DMS significantly correlated with the anthropometric measurements and an important laboratory parameter, serum transferrin level. The conventional SGA had only significant correlation with anthropometric measurements. These results confirmed the role of SGA as a reliable method in assessment of malnutrition, but it must be performed by a physician or trained nurse and is time consuming. Regarding these limitations, we suggest DMS as an alternative method for SGA in assessment of nutritional status of hemodialysis patients.
  • A.Sh. Zafarghandi, N. Zafarghandi, N. Baghaii Pages 338-342
    Induction of labor is one of the most common procedures during pregnancy. Various methods for cervical ripening and labor induction have been described in the obstetrics literature; but the role of corticosteroids in the process of labor is not entirely understood. This study challenged the possible role of corticosteroids in induction of labor by extra-amniotic injection through an inflated intracervical Foley balloon catheter. This randomized trial was conducted on 44 women with a single pregnancy, intact membranes, and an unfavorable cervix. They were randomly assigned to receive either 20 mg of dexamethasone in saline solution (study group, n=22) or saline solution only (control group, n=22) administered extra-amniotically through an intracervical inflated Foley balloon catheter. Eighteen (81.8%) patients in the study group and 20 (90.9%) in the control group entered the active phase of labor and were delivered vaginally. The mean time intervals between induction of labor to the active phase and between induction of labor to delivery were significantly shorter in the study group compared with those of the control group (3.3±2.1 hours vs. 9±4.7 hours, P<0.01, 5.7±3.4 hours vs. 6.9±4.7 hours, P<0.01, respectively). There was no maternal or fetal complication in study or control group. The intracervical Foley balloon catheter with extra-amniotic corticosteroids was more efficient in reducing the induction-to-delivery interval for termination of midtrimester pregnancies than the same Foley catheter with saline solution only. Cervical ripening with extra-amniotic corticosteroids possesses the advantages of simplicity, low cost, and lack of systemic or serious side effects.
  • M. N. Tahmasebi, Sh. Jalali Mazlouman Pages 343-349
    This study was performed to evaluate the results of 14 years of application of Ilizarov method in treatment of infected non-unions of tibia and femur in patients with severe trauma and battlefield wounds. Seventeen patients with long bone nonunion (14 were with infected nonunion of tibia out of whom two were associated with tibial bone defects and 3 with infected non-union of femur) were admitted for the study. After preliminary debridement (in infected cases with draining fistulae) and preparation for external fixation, ring fixator was introduced and compression alone or compression and distraction (in atrophic non-unions) were enforced on fragments to induce union. Bone transfer was used in cases with bone defects. All cases resulted in complete union and had infection controlled. The mean time of union was 8 months in tibial infected non-unions and 10 months in infected femoral nonunions. In cases with bone defects, the mean union time was 12 months. In selected cases of infected tibial and femoral non-union, Ilizarov is an efficient method of treatment, especially with bone transfer in cases with bone defects. The application of this method in battle-field wounds has resulted in noticeable outcomes. Patient’s tolerance was low in cases of femoral Ilizarov, but this is the method of choice for tibial infected non-unions, taking into account the lack of the need for long-term antibiotic use
  • J.N. Saraji, M. A. Hassanzadeh, M. Pourmahabadian, S. J. Shahtaheri Pages 350-354
    Musculoskeletal disorders (MSDs) are important causes of work incapacity and loss of work days. MSDs are major problems in almost all countries and increasingly can be found in service industries such as maritime sector. This study aimed at evaluation of MSDs symptoms among crew of tugboats, dredgers, pilot boats and barges by using Nordic Musculoskeletal Questionnaire (NMQ) and also determination of work-related MSDs risk factors by application of Ovako Working Analysis Posture System (OWAS). The result showed that 28.4% of body postures rated in action category 3 and 4 of OWAS. It seems that OWAS cannot be used as a determination method of risk factors for all jobs. Also, the best and sometimes the only way to correct awkward postures is correction of worker''s back position.
  • H. Soltanghoraiee, M. Jamali Zavarehii, M.A. Broomand Pages 355-358
    Breast cancer is common and is considered second cause of cancer related mortality in females. Regarding importance of breast cancer, more investigation in this field is recommended. For many years investigators believed that neoplasms were not innervated but new findings have proved otherwise. This descriptive study was carried out to compare number of nerve fibers in benign, malignant and normal breast tissue. Of each group several slides were reviewed and 3608.50 mm2 of malignant tumors (ductal carcinoma), 3641 mm2 of benign tumors (fibroadenoma) and 2331.25 mm2 of normal breast tissue (mammoplasty) were assessed. Numbers of nerve fibers were compared and a significant increase in nerve fibers was found in malignant tumors compared with benign tumors and normal breast tissue. Accuracy of hematoxylin and eosin method were examined by immunohistochemistry staining (neurofilament) method and affirmed. These results reveal that malignant tumors of breast have more nerve fibers than normal breast tissue or benign tumors.
  • A. A. Momen, J. Melendrez Pages 359-362
    Several previous studies of adults have reported that the amplitudes of the sural and superficial radial nerve (SN and SRN) action potentials are larger with antidromic than with Orthodromic recordings. However, this difference has not been documented in children. This study evaluated the amplitudes of SN and SRN sensory nerve action potentials (SNAPs), obtained with antidromic and orthodromic recordings in children with and without neuropathy, and compared these data with similar findings in adults. The SNAPs of SN or SRN or both of 10 neurologically normal children, 6 children with neuropathy and 7 healthy adults were studied with surface stimulation and recording. The position of the stimulating and recording electrodes for the orthodromic recordings were the reverse of that for the antidromic recordings. Peak to peak SNAP amplitudes were measured and analyzed. The mean of the SRN SNAP amplitude was significantly higher with the antidromic than the Orthodromic technique for the first and third groups (P<0.05). The mean SN SNAP amplitude was higher in the three groups, but the difference was not statistically significant because of the small number of subjects. This difference became significant when the data for the children and normal adult groups were combined and reanalyzed (P<0.05). Consistent responses were obtained with both techniques. However, the antidromic technique was superior to the orthodromic technique because of the greater amplitude of responses. We recommend the use of the antidromic technique for its greater amplitudes, ease of use and potential reduction of discomfort to the patient.
  • M. Zarabian, F. Salehipour, S.N. Ostad Pages 363-366
    Avulsion is one of the most serious emergencies in dental office. In the event of any problem, the tooth should be stored in a medium that supports the periodontal ligament cell viability. In other clinical situations, preserving media, growth factors and mitogenic products may be useful in repairing the traumatized tissues. It has been previously reported that levodopa (L-dopa) accelerates healing by increasing the growth hormone level. In this study, the local effect of L-dopa, as a mitogen, on human periodontal ligament fibroblast (HPLF) cells was evaluated. Samples from impacted or semiimpacted wisdom or canine teeth, which were devoid of inflammation, were taken. The cells obtained from this tissue were cultured in an appropriate medium. The passage numbers between 3-6 were taken for further experiments. The viability of HPLF cells, which were treated by L-dopa, was evaluated by trypan blue dye exclusion and neutral red assay. Results indicated that low concentration of L-dopa produces significant increase of these cells compared to control group. These results confirmed previous studies about direct action of L- dopa on the viability of HPLF cells. On the basis of this study and previous reports, presence of L-dopa in preserving media may be useful in increasing the self-life transferring HPLF cells.
  • A. Jamal, P. Pooransari, R. Ansari Pages 367-370
    Severe nausea and vomiting associated with weight loss, ketonemia, and electrolyte imbalance in pregnancy is called hyperemesis gravidarum (HG). Its cause is unknown but there are some hypotheses like hormonal mechanisms, psychological and emotional factors and Helicobacter pylori infection. The aim of this study was to find an association between (HG) and H. pylori infection. For this purpose in a prospective study from Aug. 2001 to Feb. 2002, the serum antibodies against H. pylori in 39 patients with HG was compared with IgG titers of 55 asymptomatic pregnant women at the same gestational age as controls. Venous blood was taken after the patients had given their written consent. Specific serum antibodies (immunoglobulin IgG) directed against H. pylori was measured by fluorescent enzyme-immunoassay. IgG titers less than 15 was considered negative, IgG titers more than 20 were regarded positive and IgG titers between 15-20 were considered as suspicious and required repeating the test after 2-4 weeks. Chi square, Mann Whitney and Student t test were used for statistical analysis of the data. Positive serum IgG concentrations were found in 26 of the 39 hyperemesis patients (66.7%) compared with 23 of 55 controls (41.8%). The difference was statistically significant(P<0.015). The mean IgG titers in hyperemesis group were 25 compared to 10.5 in control group(P<0.05). It seems that H. pylori infection is significantly associated with HG.
  • N. Izadi Mood, S.N. Jazayeri, Z. Eftekhar Pages 371-374
    The 1991 Bethesda System for cervical/vaginal cytology reporting has defined adequacy criteria, including unsatisfactory designation. Most laboratories in USA and a few laboratories in Iran have implemented these criteria, but only few studies about clinical implications have been performed. All unsatisfactory Papanicolaou (Pap) smears taken between August 2000 and March 2002 were retrieved from the file of cytologic reports of Mirza Koochak Khan Hospital''s Department of Pathology. Of 4,598 total Pap smears 204 (4.4%) were unsatisfactory (corresponding atypical rate of 2.5% and a SIL/carcinoma rate of 0.97%). About 20.2% of unsatisfactory Pap smears were from patients with a history of epithelial abnormalities. The majority (71 of 204 specimens; 35%) of follow-up Pap smears or biopsies occurred within 6 months,12% within 6-12 months,1% within 12-18 months and 1% after 18 months. Approximately 59% had no follow-up. The first repeat Pap smear or histologic specimen in 83 patients with follow-up was negative in 71 (85%), unsatisfactory in 2(2.4%), epithelial cell abnormality in 11 (13.2%) and atypical squamous cells of undetermined significance in 4(4.8%). Nonmalignant conditions contributing to the unsatisfactory smears on histologic specimens (23%) included cervicitis, endocervical polyp and endometritis. Majority of patients with unsatisfactory Pap smears were followed up within 6 months. A significant number(13.2%) of those with follow-up had eventual diagnosis of epithelial cell abnormality. Benign pathologic conditions also contributed to unsatisfactory smears. These patients were more likely to have a history of abnormalities. Unsatisfactory specimens are associated with benign as well as preneoplastic/neoplastic conditions. Clinical correlation should be the first step in delineating the cause of the unsatisfactory diagnosis.
  • St. Esfahani, A. Madani, N. Ataei, An. Tehrani, P. Mohseni, Z. Ghanbari Pages 375-378
    Source: Acta Medica Iranica, 2004;42(5):375-378. One of the complications of end-stage renal disease (ESRD) is sensorineural hearing loss (SNHL). Despite large number of studies on adults ESRD patients, there are only a few reported surveys regarding SNHL in children. To determine the prevalence of SNHL in children with ESRD and its relationship with sex of patients, presence of hypertension, history of ototoxic drugs administration and duration of dialysis, we evaluated 30 children and adolescents suffering from ESRD who were under hemodialysis therapy with standard pure-tone audiometry. The ages of children were 5-17.5 years (mean 12 years). Patients with Alport’s syndrome and other hereditary or congenital syndromes involving the ears were excluded from the study. SNHL was detected in 9 patients (30%); 3 children had unilateral and 6 had bilateral SNHL (15 ears). In all of these 15 ears SNHL was in high frequencies (4000-8000 Hz). In 10 ears (66%) also there was SNHL in middle frequencies and in 7 ears (46.6%)there was hearing loss in all frequencies (250-8000 Hz). The severity of SNHL was mild in 7, moderate in 9, severe in 13 and profound in 3 ears in at least one frequency. There was no significant relationship between SNHL and sex of patients, presence of hypertension, history of ototoxic drugs administration and duration of dialysis (P values were 0.8107, 0.3217, 0.69, 0.087, respectively). SNHL is common in children and adolescents with ESRD and must be considered in rehabilitation of these children; the etiology of this impairment is not clear.
  • T. Mashhoodi, S. Zahedi, Asl, Ar. Sarkaki Pages 379-382
    It has been shown in some investigations that cardiovascular events are the main causes of death in hemodialysis patients. The exact etiology is unknown but some of the articles have reported a relation between aluminium ions in the dialysis solution and cardiovascular disorders. To determine the probable effect of aluminium on vasculature function, in vitro effects of aluminium ion on vasoconstriction induced by KCl (30 mM) or phenylephrine (10 µM) were investigated using isolated rat aorta. AlCl3 (1-4 mM) decreased both KCl and phenylephrine induced contractions in a dose dependent manner (P<0.01). Complete inhibition of the contractions occurred using the higher doses of aluminium. Results of this study suggest that because of inhibitory effects of aluminium on vascular contractions, the probable cardiovascular dysfunction must be considered in aluminium intoxication.
  • N. Khadem, Sh. Jalali Mazlouman Pages 383-389
    It seems that endometriosis plays an important role in female factor infertility but a clear causal relationship has yet to be established. This case-control study was conducted to determine and compare the frequency and severity of endometriosis in 100 infertile women and 120 fertile multi-para women as control group. Descriptive statistics, Student t test and Chi square test were used in analyzing data. Endometriosis was diagnosed in 38% of infertile versus 11.6% in fertile women (P=0.002). The mean age of women with endometriosis was 27.9±6.1 years; maximum prevalence of endometriosis was observed at 26 years of age. The mean duration of infertility was 4.3±1.9 years in women with endometriosis and 4.6±1.2 years in women without endometriosis. The prevalence of endometriosis in study population was comparatively higher than what has been reported in studies from other countries. There was a significant relation between endometriosis and infertility. Diagnostic time interval had no relation with infertility and severity of endometriosis. Age-related factors did not have any effect on fertility in women with endometriosis. Our study demonstrates a meaningful relation between endometriosis and infertility. Endometriosis may have a higher prevalence in Iranian population.
  • M. Vaziri, M. Banazadeh, M. Hashemi Pages 390-392
    Primary lymphomas of the lung are rare and usual radiographic findings are adenopathy, effusion, multiple lesions, solitary lesion or diffuse lesion. This paper presents a case of primary malignant tumor of the lung with a very rare radiological presentation. A 20-year-old male patient was admitted to our hospital due to fever, chills, productive cough and later development of hemoptysis. Weight loss of 6 kg during a five month period was also noted. Physical examination was normal. Chest X-ray showed a right lower lobe mass with obliteration of diaphragmatic contour. Chest CT scan revealed cavitation in the mass. Laboratory tests and bronchoscopy were also normal. Surgical resection of the mass via right lower lobectomy revealed the pathological diagnosis of intermediate grade mixed large and small cell lymphoma. Cavitation in this uncommon tumor of the lung is very rare and has been reported very infrequently.
  • F. Ghaemmaghami, H. Ayatollahi, B. Daneshbodi, F. Ardalan Pages 393-396
    Ovarian mixed germ cell tumors consisting of endodermal sinus tumor and immature teratoma are very rare and have been reported only in a few case reports. Here we report a rare mixed germ cell tumor of ovary which was consisted of endodermal sinus tumor and immature teratoma components with an unusual intraabdominal location. Patient was a 21 years old girl with the chief compliant of abdominal pain. Ultrasound and CT scan showed a lobulated cystic mass. Laparotomy was performed and due to unusual localization, in which tumor was localized as a tumoral bridge between two ovaries, we performed maximal fertility sparing surgery by preserving ovaries, tubes and uterus. After surgery, 4 courses of chemotherapy with bleomycin, etoposide, and cis-platinum were done. Alfa feto-protein became negative after 3 courses of chemotherapy and she was under observation and in good health during follow up period.