Tanaffos Respiration Journal
Volume:1 Issue: 2, Spring 2002

The potential ability of the immune system to recognise tumour tissue and to be able to help with the treatment of cancer has been suspected for a very long time. However, it is only in the last few years that the full anti-tumour potential of the immune system is beginning to be appreciated. This is due to a rapid growth in the understanding of the cellular and molecular biology of both cancer and the immune system. Tumour immunology is now poised to offer a number of different strategies for prevention and the induction of immune mediated rejection of tumours. These developments have been the subject of a number of comprehensive and extremely informative recent reviews. The present article aims to highlight particular aspects of the recent developments in tumour immunology and immune therapy that are likely to be of interest to readers of Tanaffos. In particular the case for immune therapy of cancer is examined and a number of different immune therapy strategies that are currently under active investigation are described. For a more thorough analysis of the subject the reader is referred to a number of particularly informative recent reviews, and the references therein, that have been listed at the end of this article.(Tanaffos 2002;1(2): 7-14)

Measurement of antimycobacterial antibody may be used as an accurate diagnostic tool in childhood tuberculosis. This study was conducted to evaluate the value of IgG, IgA, and IgM levels against A60 antigen by using ELISA method for diagnosis of tuberculosis. 238 children aged from 6 months to 18 years old, divided into 4 groups; group A(n=51),patients with documented diagnosis of tuberculosis; group B (n=75), patients who had close contact with TB patients; group C (n=51), patients with lung diseases other than tuberculosis; group D(n=40), healthy children. Serums of 4 different groups of patients were studied. Group A consisted of 22 smear positive, 24 smear negative, and 5 extrapulmonary tuberculosis patients. Sensitivity for bacteriologic study in smear positive cases was 51.2%. The mean levels of IgG, IgA, and IgM were significantly high in group A compared to other groups. IgM anti-A60 antibody had 70.6% sensitivity and 62% specificity for tuberculosis. Among the smear negative tuberculosis patients IgM anti-A60 had a sensitivity of 62.1%. Sensitivity of IgM anti-A60 in group B was 53.3%. The sensitivity of combined use of IgG and IgM was 70.6% in group A. The sensitivity of serologic diagnosis of A60 antigen is higher than bacteriologic findings (77.3% vs. 51.2%). A60-ELISA test is a simple and rapid diagnostic method, which can facilitate the diagnosis of tuberculosis. (Tanaffos 2002; 1(2): 15-19)

Hemodialysis patients are at risk of acquiring tuberculosis, which is most often due to reactivation of the infection. As a result, screening for tuberculosis is recommended in hemodialysis patients. In this study, the rate of response to cutaneous PPD along with tetanus and diphteria toxoid antigens have been evaluated to define in hemodialysis patients. This clinical trial was conducted on 67 chronic hemodialysis patients in Labbafi Nejad Hospital during March- May 2001. PPD, tetanus and diphtheria toxoid solutions, with 1/10 dilution were administered by Manteaux technique and the induration was evaluated 48-72 hours, 7 and 9 days after. Of 64 patients, 18.8% had positive PPD tests and 26.6% had negative anergy tests through the first evaluation. The degree of constancy in the results of PPD and anergy tests during the three-time evaluation period were 23.4% and 18.7%, respectively, and the degree of induration was increased or decreased among the rest. Hemodialysis patients are at the increased risk for acquiring tuberculosis. Thus, negative cutaneous PPD results should certainly be revised and evaluated using anergy tests and repetitive readings of the test results. Attention must be paid to the “Delayed Type Hypersensitivity” (DTH) phenomenon presenting for the first time in the analysis of cutaneous test results. Finally, it is recommended to reconsider the value of cutaneous PPD test and its method of analysis in hemodialysis patients. (Tanaffos 2002; 1(2): 21-26)

Tuberculosis is a common infection among HIV positive patients. It causes a lot of obstacles in diagnosis, and it can significantly affect the course of HIV infection. Between March 1997 and April 2001, we evaluated the rate of clinical tuberculosis among 638 HIV positive patients in Kermanshah province in IRAN. The study population was consisted of HIV infected patients who had been received anti tuberculosis drug regimen. Medical records of the patients were reviewed for age, gender, marital status, clinical presentation, infection source, and treatment outcome. Clinical tuberculosis was observed in 73 (11.4%) HIV- infected patients, 80.9% of whom were smear-positive, 10.9% were smear-negative, and the remaining 8.2% revealing to have extra-pulmonary tuberculosis. The patients were adapted to anti tuberculosis treatment with a cure rate of about 80%. The prevalence rate of clinical tuberculosis is high but underestimated, and it seems to be due to vulnerability of our patients to tuberculosis in the setting of intravenous drug usage as a major underlying factor for HIV among infected individuals and also residence in prisons due to illegal drug consumption. (Tanaffos 2002; 1(2): 27-33)

Exercise is one of the most prevalent predisposing factors of bronchospasm. Its symptoms may be merely due to physical activities. Clear understanding of exercise-induced bronchospasm is essential to eliminate complications and achieve more effective treatment. The study population consisted of Tehran soccer-players. In this clinical trial, four soccer clubs were selected by cluster random sampling. The means of data collecting included history taking, physical examination, and the performance of spirometry tests at rests as well as 5 and 12 minutes after exercise. One hundred soccer players were enrolled in this study with the mean age (±SD) of 20± 4.26 years old. The mean values of FEV1±SD measured at 5 minutes before as well as 5 and 12 minutes after a ten-minute continuos exercise were 4.15± 0.44, 4.13 ± 0.5, and 4.12 ± 0.49 liter respectively. These differences seem to be age related.12 minutes after exercise, 6 players have shown reduced FEV1 (15-17%) in respect of resting value (4.78 ± 0.52 vs. 3.57 ± 0.33). The prevalence of exercise-induced bronchospasm was 6% in our study, comparable to 3-11% reported of others. The lower prevalence of exercise- induced bronchospasm in our study may be due to older study group, negative history of allergy and pulmonary diseases in our cases. (Tanaffos 2002; 1(2): 35-39)

Information on the magnitude of the problem of childhood asthma in rural areas of Iran and the factors influencing its occurrence is inadequate. This study was carried out to measure the prevalence of asthma among school-aged children in Zarinshahr and factors, which determine its occurrence. A questionnaire-based study carried out in 33 randomly selected school classes in Zarinshahr. The age of participants ranged from 6 to 13 years. Overall, 1309 questionnaires were returned. The prevalence rates of asthma diagnosed previously, asthma ever in life, current asthma, nocturnal symptoms and exercise induced cough were1.2%, 14.7%, 5.9%, 11.3%, and 19.4%, respectively. Allergic rhinitis and allergic chronic cough were presented in 1.9% and 2.4% of the children. A positive family history of similar disorder, early childhood respiratory infection, paternal smoking and keeping cats at home were significant factors influencing the development of asthma, while children’s gender and parental education did not. (Tanaffos 2002; 1(2): 41-46)

As any cardiac involvement may worsen the prognosis of mediastino-pulmonary tumors, this study was designed to evaluate the function and anatomy of heart by ehocardiography in this group of patients. Medical records of 76 patients were reviewed for age, sex, type of malignancy, and cardiac consultation report. The patients underwent transthoracic echocardiography. Moreover, descriptive statistical methods were used for data analysis. The study population included 58 males and 18 females, with the mean (±SD) age of 50.70 ± 15.14. 71 out of 76 cases had normal LV function, 2 revealed to have severe pulmonary hypertension, and 9 had significant pericardial effusion. Furthermore, intra and extracardiac masses were observed in 5 patients. Severe mitral regurgitation and tricuspid regurgitation were also reported. Echocardiography is a useful noninvasive approach to determine cardiac involvement in the patients suffering from thoracic malignancies. (Tanaffos 2002; 1(2): 47-50)

Pulmonary carcinoid tumor is a low-grade malignant neoplasm comprised of neuroendocrine cells. The aim of this study was to determine the clinical features; radiological and bronchoscopic findings, as well as treatment in patients. The hospital records of 21 patients with pulmonary carciniod tumor, who admitted to NRITLD between 1995 and 2001, were evaluated. 19 patients had typical and 2 had atypical carcinoid tumor. Male to female ratio was 1.1. The mean age ± SD was 39.33±16.31.Cough (80.9%) was the most common presenting symptom. 16 patients had abnormal chest radiography. The diagnosis was made using bronchoscopy and biopsy. Most of the tumors arose in main bronchi. Surgery with or without endobronchial laser therapy was the treatment of our patients. Lobectomy (47.3%) was the most common procedure. surgery with or without laser therapy has a favorable outcome in pulmonary carcinoid tumors.(Tanaffos 2002; 1(2): 51-56)

Angiomyolipoma (AML) is uncommon outside the kidney, and it rarely occurs in mediastinum. This article presents a case of posterior upper mediastinal AML with a review of the literature on angiomyolipoma. A 56-year-old woman was referred to our hospital with 8-month history of cough and chest pain. Radiology showed a mass in the posterior upper mediastinum. Left thoracotomy was done for surgical removal of the tumor. Pathologic findings revealed an AML tumor in the left paravertebral and posterior upper mediastinal regions with massive infiltration of the intercostal nerves and subtle invasion of the adjacent thoracic spinal canal. This case is the third reported AML of posterior upper mediastinum. To prevent misdiagnosis, it is suggested that AML could be considered for the differential diagnosis of mediastinal tumors.(Tanaffos 2002; 1(2): 57-63)