فهرست مطالب

  • Volume:1 Issue: 1, 2000
  • تاریخ انتشار: 1379/08/11
  • تعداد عناوین: 7
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  • A. Amanat Page 2
    The main line of treatment of achalsia is reducing the LES pressure, which may be achieved by medical, endoscopic or surgical therapies. Medical therapy (including Nitrates, Ca- channel blockers, Anticholinergics, Theophylline and b 2 - agonists) is indicated in patients with mild symptoms, as a temporary measure before a more definitive form of therapy, surgically high-risk patients and those not responding to botulinum toxin injections. Botulinum toxin, a potent inhibitor of the release of acetylcholine from nerve terminals, is indicated in patients at high risk for complications with balloon dilation or myotomy. It needs to be repeated at roughly annual intervals. Balloon (Pneumatic) dilation is considered the treatment of choice for most patients of achalasia. In a 7 years follow-up study, 50-75% success rate was seen with single dilation. The major complication of pneumatic dilation is esophageal perforation. Sclerotherapy is an effective alternative to the pneumatic dilatation. The margin of error between too short myotomy (persistent dysphagia) and too long myotomy (post -op reflux) is very narrow 2. Best strategy is a long myotomy to prevent residual dysphagia accompanied by a fundoplication procedure to prevent GE reflux, however, the most common open procedure is an anterior myotomy through a thoracotomy or laparoscopy. Instances of post myotomy severe esophagitis, strictures, Barrett metaplasia and adenocarcinoma associated with Barrett metaplasia have all been observed.
  • A. Borhan Haghighi Page 7
    Chronic meningitis is chronic inflammation of the meninges with characteristic neurological syndromes, lasting more than 4 weeks, and associated with persistent inflammatory response (CSF pleocytosis). It may present by meningoencephalitis, meningomyeloradicalitis, cranial nerve palsy, optico-chiasmatic arachnoiditis, meningovascular syndromes and hydrocephalus as isolated, or combined forms. Etiologic causes include infectious (bacterial (TB, Brucella, syphilis), viral, fungal, protozoal and helminthic), neoplastic (carcinomas, lymphomas, leukemias, primary CNS tumors, etc.), chemical, drug induced, vasculitic and granulomatous disorders (SLE, Behcet''s syndrome, primary CNS angitis, sarcoidosis, etc.). Approach to these patients includes epidemiological features, assessment of associated involved organs (e. g., mucocutaneous system, eye, lymph nodes, liver and spleen, pulmonary tract, etc.), CSF studies (including microbiologic, immunologic, cytologic, etc.), Imaging studies, leptomeningial biopsy and finally empirical therapy.
  • M. Moghadammi Page 13
    The main etiologies of fever in a post- transplant patient are infection (the most common cause), allograft rejection, drug hypersensitivity and malignancy. In respect of infectious diseases, the post- transplant period is divided into first month (mostly pyelonephritis [by the usual organisms facialiated by immunosuppression and increased rate of reflux, which usually leads to renal failure] and pneumonia), second to sixth months (CMV is the most important organism, others include: listeria(most common cause of bacterial CNS infection in these people), nocardia, salmonella, mycobacteria and pneumocystis carinii) and after the sixth month (which kidney function determines whether the infection is like the general population pattern or not. For the later, chronic viral infections (e. g., EBV, CMV and HIV) are the most common. pneumocystis carinii is less likely after the sixth month.) Rejection should be considered in patients with fever and organ dysfunction. Drug fever may be associated with beta-lactam antibiotics, sulfonamides, amphothericin B, a number of immunosuppressive agents (e.g., OKT3 and azathioprin). Most agents produce fever following 7-10 days of administration. The most common malignancies seen in these patients are skin tumors and lymphoproliferative disorders.
  • Sh. Ghotbi, M. Beheshti, Et Al Page 17
    In the 1950, Lederberg and Talmage observed that each clone of B-lymphocytes produces one type of antibody, so antibodies should have a monoclonality nature. 25 years later, in the 1975, Knhler and Kilstein used hybridation of corresponding cells to produce monoclonal antibodies (McAb). Today monoclonal antibody is belived as a powerful tool for diagnosis and treatment and too many other purposes in the biologic sciences specially medicine. The aim of this review article i''s to describe some aspects of McAb production and application.
  • M. Masoompur Page 22
    68 year old man, case of operated colon adenocarcinoma, referred due to generalized weakness. History is unremarkable except for diarrhea and physical exam just showed hypoactive bowel sounds and hypoactive deep tendon reflexes. The only pertinent point in laboratory data is hypokalemia. Finally, magnesium supplement leaded to complete recovery
  • K. B. Lankarani Page 25
  • M. J. Kaviani Page 26