Iranian Journal of Medical Sciences
Volume:27 Issue: 2, Jun 2002

b-Thalassemia major is a serious medical problem. Growth retardation is commonly seen in poly-transfused b-thalassemia patients. The exact mechanism of short stature in children with thalassemia major is not well understood, however, it is believed to be multi-factorial. To study the growth state and its relationship to growth hormone (GH) deficiency in b-thalassemia patients. The extent of growth and growth hormone deficiency were evaluated in 150 patients aged 10-22 years (84 males, 66 females) residing in Shiraz. The age, sex, height, weight and serum ferritin levels were recorded using a questionnaire. Growth hormone secretion was determined with L-Dopa provocative test in 138 b-thalassemia patients. Short stature was present in 64% of patients (63.6% of girls, 69% of boys). Growth hormone deficiency was present in 57.5% of 138 patients, (53.5% of boys, 46.5% of girls). Short stature was found in 83.5% of GH deficient and 74.6% of GH sufficient (p=0.22) subjects. There was no difference between the height of GH deficient and GH sufficient patients (p=0.297). Age at the start of chelating therapy, height deficiency and serum ferritin levels did not differ in GH deficient compared to GH sufficient patients. This study suggests that growth retardation and GH deficiency are common in thalassemic patients and that height deficiency may not be related to GH reserve with the current testing methods for measurement of GH reserve.

Hepatitis B is an important infectious disease. Since several years ago, mass vaccination against this viral infection has become as part of routine vaccination schedule of Iran. However, some healthy neonates, children and adults fail to generate a protective antibody response after vaccination. To investigate distribution of HLA class-I and class-II antigens in healthy Iranian neonates vaccinated with recombinant hepatitis B vaccine. HLA-typing was performed on peripheral blood lymphocytes isolated from 25 responder and 23 nonresponder (anti-HBs < 10 IU/L) healthy neonates, using the standard microlymphocytotoxicity method. Anti-HBs antibody was quantitated by sandwich ELISA. The frequency of HLA-DR7 (p<0.01), DQ2 (p<0.02) and DR13 (p<0.05) was significantly higher in the nonresponder neonates compared to the responder group. The DR1 and DQ3 antigens were over-represented (p<0.05) in the responder vaccinees, implying positive association with the anti-HBs antibody response. Statistical analysis revealed increased frequencies of B7-DR7-DR53-DQ2 and DR13-DR52-DQ2 haplotypes in the nonresponder neonates (p<0.05). We found a significant association between lack of antibody response to recombinant hepatitis B vaccine and expression of certain HLA class- II antigens in healthy Iranian neonates.

Cigarette smoking has several known detrimental effect on cardiovascular system. QT dispersion (QTd) is among the important predictors of cardiac death. To assess the acute effect of smoking of a single standard cigarette on QT and QTc (corrected QT) dispersion, hence on the risk of ventricular arrhythmias in healthy smokers and nonsmokers. 111 healthy men with a mean±SD age of 32.5±10.2 years and with normal ECGs were included in this study. Two standard 12-lead ECGs were recorded for each subject; one baseline at least one hour after last smoking and the other, 7-10 minutes after smoking of a single standard filtered cigarette. The mean QT and QTc dispersion before and after smoking in different age groups in nonsmoker and smokers with different backgrounds of smoking habits were compared. In the baseline ECG, the mean±SD QTd and the mean±SD QTc dispersion were 47±15, and 53±16 ms, respectively. These values increased to 57±16, and 60±16 ms, respectively in the second ECG (p<0.001). A significant rise in QTd was consistent in all age groups of non-smokers and smokers with different smoking backgrounds. Smoking of even a single cigarette in both smokers and non-smokers can lead to a rise in QTd.

Early diagnosis of appendicitis is important during pregnancy. Unlike omentom, cecum and appendix are not likely to be displaced by the growing uterus, so the concept of position change of the appendix during pregnancy is questionable. To determine the anatomical location of appendix during pregnancy. In a prospective study from October 1995 to March 1999, 291 women of reproductive age were evaluated for the location of appendix. They were divided into 3 groups, A: 165 pregnant women (37-40 weeks of gestation) who underwent elective cesarean section, B: 26 pregnant women (19-39 weeks of gestation) with acute appendicitis, who underwent appendectomy, and C: 100 non-pregnant women with acute appendicitis who underwent appendectomy serving as the comparison group. The location of appendix was considered as normal if it fell within ± 2 cm variation from McBurney’s point, otherwise, it was considered as a position change. In group A, 26 out of 165 (15%) and in group B, 6 out of 26 (23%) women had change in the position of appendix. In the control group, 17% had change in position. There were no significant differences between group A and B as compared with the control group (group C). In group B, there was no relation between the height of the fundus and the point of tenderness. The location of appendix does not change significantly during the pregnancy in most women.

There are multiple methods for acceleration of bone healing. Bone marrow has been shown to contain osteoprogenitor cells. To determine the effect of percutaneous bone marrow injection on bone healing. 15 mature, 2-kg-weighing white New Zealand rabbits from both sexes were randomized into 3 groups: Group I: Only osteotomy of right radius was performed and a 5 mm bony defect was made. Group II: Same as group I, with the defect filled by bonegraft, taken from the iliac crest. Group III: Same as group I plus percutaneous bone marrow injection 5 days after the operation. 45 days post-operation, the rabbits were sacrificed. The radii of both forelimbs were isolated and tested by tensile testing machine. There was a significant difference between groups I and III (p<0.001) for toleration of maximum load and bending stiffness. No significant difference was observed between groups II and III for these parameters. Bone marrow injection has an effect on bone healing comparable to bone grafting. This technique is non-invasive and simple without any significant complication.

There are also reports from other parts of the world indicating the presence of significant association of H. pylori infection and hyperemesis gravidarum, a bothersome condition that affects pregnant women. To test the hypothesis that whether H. pylori infection is associated with hyperemesis gravidarum among Iranian H.P carriers. From November 1999 to February 2001, we enrolled 54 pregnant women with hyperemesis gravidarum and 53 asymptomatic pregnant women (control group) in a prospective study. Using a specific serum IgG against H. pylori, the seroprevalence of H. pylori infection was determined in both study and control groups. Serologically positive H. pylori infection was detected in 44 (82%) out of 54 patients with hyperemesis gravidarum and 29 (55%) out of 53 asymptomatic pregnant women. The prevalence was significantly (p<0.01) higher in those with hyperemesis gravidarum than those in the control group. The mean±SD of the IgG titer in the study group (69.7±77.5) was significantly (p<0.01) more than that of the control group (34.5±47.8). H. pylori infection may cause hyperemesis gravidarum.

Despite demonstration of molecular and biochemical changes induced by heat shock on Leishmania, the immunological importance of such changes has not been elucidated. Studying the effect of two excretory factors prepared under heat shock and ambient temperature from Leishmania major on Balb/c splenocytes function. The parasites were cultured at 25°C and then subjected to heat shock by overnight incubating at 35°C. Both 25°C (R25) and 35°C (R35) supernatants were collected and used for biochemical analysis and as culture media for T cell activation. The protein profile of two supernatants was studied by SDS-PAGE. Splenocytes of Balb/c mice were stimulated by concavalin-A in the presence of RPMI, R25 and R35. Consequently, CD25 expression was studied by means of flow cytometry and the production of IFN-γ and IL-4 was determined by ELISA. SDS-PAGE analysis showed distinct protein profile for R25 and R35. Significant decrease in IFN-γ and IL-4 production by cells cultured in R35 was noticed (p<0.001). CD25 expression was also down-regulated (p<0.01). In contrast, cytokine production in the supernatants of the cells cultured in R25 demonstrated suppression on IL-4 (p<0.01) but not on IFN-γ production. In parallel, CD25 expression was not down-regulated in the presence of R25 medium. The data suggest that heat shock-induced excretory factor of L. major is capable of inhibiting T cell function by decreasing IFN-γ production and down-regulating CD-25 expression which might be involved in the induction of immunosuppression in this susceptible murine strain. Furthermore, we suppose that the supernatant of L. major culture in ambient temperature have an intrinsic ability to promote Th1 response.

Monoclonal antibody technology allows identification of amastigote-specific antigen in human tissue biopsies and search for a suitable vaccine candidate, which may induce a long lasting immunity. Production and partial characterization of seven monoclonal antibodies against Leishmania tropica promstigotes. Seven murine monoclonal antibodies of the IgG isotype were produced against the stationary stage promastigotes of Leishmania tropica. Extensive cross reactivity was found within 4 reference strains and isolates from the patients. Non-Leishmanial antigens were not recognized by any of the antibodies. One antibody recognized a diffuse band 64 to 86 kDa, and the other 6 recognized 1, 2, or more bands in immunoblotting of soluble antigens of promastigotes. The reaction of these 7 antibodies with the soluble extracts of 4 reference strains of Leishmania and 10 isolates from patients was studied. Although these antibodies were not suitable for identification purposes, the characterization of shared epitopes may be considered in studying the antigenic structure of these organisms. Further experiments may confirm the idea that some of these epitopes are suitable vaccine candidates.

Faba bean toxicity (favism) is a common condition observed in our region. To develop a short and simple technique involving the use of riboflavin-deficient rats to test in vivo faba bean toxicity. Methods/ Sprague Dawley rats were maintained on a riboflavin-deficient diet and their vitamin B2 status was monitored by the assay of erythrocyte glutathione reductase (EGR). Their blood was found to be sensitive enough as early as 5 weeks of eating the deficient diet. Initially RBC preparations from the riboflavin-deficient rats were used to test the toxicity of different concentrations of divicine (0.0-13.5 mM). It was found that an increase in divicine concentration resulted in an appreciable drop in reduced glutathione (GSH) of RBC. The assay procedure was then used to test the effectiveness of certain detoxification treatments of faba beans. A high correlation (r= 0.9) was noted between residual vicine (the main favism factor) concentration and the toxicity index (TI) of treated samples indicating the suitability of the above procedure for toxicity assay. It is recommended to use blood from Sprague Dawley rats that have been fed a riboflavin-deficient diet for about 5 weeks or longer, in the bioassay of toxicity of faba beans and their isolated favism principles

Environmental pollution plays a destructive role in the daily life of industrialized communities and due to their negative impact on the society they are always under close investigation. Besides wellknown pollutants substantial, all major international health organizations consider noise pollution as an important health problem. In this study, we have used an animal model to study the effects of noise exposure on is hematological survey (CBC) and red cell indices. Forty male Winstar rats were randomized into two groups of test and control. Animals in the test group were exposed to a 20 dB unmodulated sinusoidal noise with a frequency of 1100 Hz for 120 days, while animals in the control group were kept in normal condition. By the end of the study, a blood sample was taken from each animal in both groups and a complete blood count was performed.In animals in the test group as compared to those in the control; 1) there was significant (p<0.001) increase in the number of red blood cells, white blood cells, hemoglobin, and hematocrit; 2) there was significant (p<0.001) decrease in mean corpuscular volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC). It was then concluded that noise exposure affects blood cells.

Autonomic disturbance can leads to blood flow changes that can be studied by various methods. To assess the blood flow changes in patients with severecarpal tunnel syndrome by laser Doppler flowmetry.Ten patients with severe unilateral carpal tunnel syndrome confirmed by electrodiagnostic examination enrolled in this study. Patients comprised one man and nine women with mean age of 37 years, an average duration of symptoms for 29 weeks.Unaffected hand and little finger of affected hand were used as control. Skin blood flow was measured in neutral, flexed and extended positions of hands. There was significant reduction of skin blood flow of median nerve territory as compared to control (unaffected hand) (p<0.05). There was also significant (p<0.05) reduction of blood flow of median nerve territory as compare to ulnar nerve territory of affected hand except in extended position. Circulatory disturbances are seen in hand skin of CTS patients. This change depends on the type and severity of CTS. This study showed a reduction of skin blood flow in severe form of CTS.

Schizophrenia is a psychiatric disorder that impairs several intellectual functions, including attention processes. To investigate attention deficit in a group of patients with schizophrenia. Thirty patients with schizophrenia hospitalized in three psychiatric wards in Shiraz and Isfahan and 30 normal healthy subjects matched for age, gender and years of education underwent the following tests: A computerized Continuous Performance Test (CPT), Stroop color-word test and Wisconsin Card Sorting (WCS) test. In the tests performed, patients with schizophrenia preformed poorer than control subjects. The acute/chronic classification did not predict differences in attention processes among subtypes of schizophrenia, while positive/negative classification predicted differences observed among the patient groups. The subtypes of schizophrenia (paranoid, undifferentiated and residual) had the same performance in CPT, while they were significantly different in error scores of (WCS) and reaction time in response to Stroop stimuli in incongruent color-word condition. The paranoid patients preformed better in contrast to other subtypes on attention related tasks. The results of the present study suggest that CPT is a valuable test for differentiation of schizophrenia disorder in general, while Stroop test and WCS may have better diagnostic value for differentiating subtypes of the disorder.

It is known that vanadyl compounds are capable of alleviating hyperglycemia in streptozotocin induced diabetic rats. To examine the effect of vanadyl sulphate (VS) on spermatogenesis of male rats. Male rats (n=10) were administered 32 mg/kg/day of VS orally and 50 mEq/l NaCl (as drinking water) for one month. Meanwhile, 11 male rats, the control group, received vehicle only; 50 mEq/l NaCl as drinking water. At the end of the study, blood testosterone level as well as spermatogram of rats in both groups were determined. The animals were sacrificed and their testes and epididimes were then studied under light microscope. In VS treated group, blood testosterone level, and sperm count were significantly decreased by 51% (normal = 2.83±0.7 ng/ml, p<0.001), and 80% (normal = 565´106/ml, p<0.05), respectively, as compared to the control group. However, sperm motility, shape, and histology of testes and epididymides were not different from those of the control group. Vanadyl sulphate has detrimental effects on spermatogenesis.