نشریه دانشور پزشکی
پیاپی 80 (اردیبهشت 1388)

Pulmonary alveolar microlithiasis is a rare condition characterized by a diffuse bilateral filling of the majority of alveoli by calcific concretions called calcospherits. The etiology and pathogenesis are obscure. Osteopetrosis is a heterogenous group of heritable conditions with defect in bone resorption by osteoclasts. We report a case of pulmonary alveolar microlithiasis associated with osteopetrosis, which was diagnosed incidentally by high density bones and generalized osteosclerosis in chest x-ray. Association of these two diseases has not been reported before and because of their unknown etiology and presence of hypercalcemia as a probable etiologic factor or predisposing factor and relationship with genetic factors, we report the case.

Sexual activity during pregnancy and outcome of delivery is main problem of social and medical society and there is a different consequence in several studies. This study was performed to determine effect of coitus on outcome of pregnancy. This study has been done cross sectional method in the year of 2007 on 278 pregnant women whom hospitalize for delivery in Shahed University hospital and Desyani hospital in Gorgan. The group was chosen from those who had the criteria and no had medical contra indication for coitus during pregnancy. In this study correlation between gestational age position of coitus premature rupture of membrane (PROM) preterm labor, duration of induction duration of labor and type of delivery and infantal outcome and sexual activity during pregnancy has been defined separately. No correlation between gestational age, preterm labor, duration of induction duration of labor and type of delivery and infantal outcome and sexual activity. There was correlation between sexual activity during 1-7 days before labor and PROM (p=0.04) and there was correlation between supine position and preterm labor (p=0.04) and gestational age (p=0.01). No correlation between PROM, preterm labor during of induction and during of labor with sexual activity (penile - vaginal and stimulation) during of pregnancy. In this study, we did not found significant correlation between sexual activity and outcome of delivery. Coitus during 1-7 days before delivery may increase incidence of PROM and supine position may increase incidence of preterm labor

Aging is a universal process that results in physiologic decline of organ systems. The effect of aging on esophageal motor function and the level of functional decline that could be responsible for symptoms are controversial. Dysphagia is a common symptom and is frequently blamed on "presbyesophagus" or considered the result of a stroke and therefore is not evaluated.

The aim of this study was to determine if esophageal manometric findings and most common motility disorder in older patients with dysphagia differ significantly from younger patients.

Consecutively performed manometry studies (n=218) were reviewed and among patients with dysphagia (n=102) two groups were chosen for the study; those ≥ 65 years (n=22) and those ≤ 40 years (n=81). Presenting symptoms, manometric findings, and diagnosis were compared between two groups.

There were 59% women in the older group and 51.8% women in the younger group. The mean age of older group was 70 years (± 5.4) and the mean age in the younger group was 27.3 years (± 7.5). No significant difference was found between two groups in the symptoms of heartburn and chest pain. Lower esophageal sphincter (LES) resting pressure (20.8 vs 31.1, p<0.003) and residual pressure (6.2 vs 11.2, p<0.03) were lower in older patients than younger patients. LES percent of relaxation was higher in the older group (76.3 vs 63.4, p<0.02). There was no significant difference between two groups in regard to percent of aperistalsis. Older patients were as likely to have a normal study as younger patients. Frequency of non specific esophageal motility disorder (NEMD) in older patients was significantly more than younger patients (45% vs 7%; p<0.001) and frequency of achalasia was less than younger patients (36% vs 68%; p<0.008).

Failure of esophagus does not appear to be an inevitable consequence of aging. When older patients present with dysphasia, esophageal manometry frequently yields a specific diagnosis to help explain their symptoms.

As apoptotic cell death plays an important role in natural development and many pathologic conditions such as cancer and neurodegenerative diseases, understanding of its molecular mechanisms can be useful in designing new therapeutic strategies. In present study following induction of apoptosis in spinal motoneurons, expression of neurotrophic factor BDNF, and its receptors TrkB and p75 has been investigated. In this study, twenty of three days old neonates of Sprague-Dawley rats were randomly divided into control and experimental groups. In all animals of experimental group the left sciatic nerve was transected in the mid-thigh level. 21 days following axotomy in both groups the animals were sacrificed and the L4-L6 spinal cord segments were used for cell count and immunohistochemical studies to assess the number of survived motoneurons and the expression of BDNF, TrkB and p75. In both groups the intact right side of spinal cord was considered as internal controls. Following transection of sciatic nerve, the number of related spinal motoneurons decreased by 58.89% and 55.84% compared to intact side and control group, respectively. The percentage of BDNF-positive and p75-positive motoneurons increased, but the percentage of TrkB-positive neurons has been decreased significantly. The findings of this study indicates the different effects of BDNF on cell fate which are receptor-mediated, its binding to TrkB results in survival of neuron whereas its binding to p75 activates the apoptotic mechanism.

R heumatoid arthritis is one of the most common chronic diseases of unknown causes leading to significant disability especially in adult patients. The depression can considerably affect the patients’ quality of life. Background & Objective In this study, 190 patients who had referred to rheumatology and internal wards of Tehran hospitals were randomly selected. The data were collected using a questionnaire which consisted of 3 parts. The data were collected using a questionnaire which consisted of 3 parts: demographic, disease characteristics, quality of life and Beck depression. All analyses carried out through SPPS statistical software. The data were than analyzed by descriptive and inferential statistical procedures (Chi square). The result showed that quality of life was high to moderate in half of the subjects (50%) and was low in the others (50%). With respect to life quality, results showed approximately, 50% of the studied patients evaluate high and moderate their life quality from the physical, socio-economic, mental, sleep and rest and general health dimensions and 50% of others were low. Intensity of depression was severe. There was a meaningful relationship between intensity of depression and quality of life (p<0.001). The result showed that studying the quality of life in patients with rheumatoid arthritis can result in plans to take appropriate measures in order to prevent depression and improve the quality of life

The preferred Selection of the anterior cervical discectomy alone, with iliac crest bone graft fusion and using the PEEK cage is still in controversial in degenerative disc disease. The aim of this study is comparing them on radiographic and clinical results. The all consecutive patients in the three hospitals in Tehran between the 2000 up to the 2003 years were selected and located in ACD, ACDF and PEEK cage groups and at least undergoing 18 months follow up after the surgery, and finally, data were analyzed by using the SPSS program. 31 patients were located in the ACD, 37 in the ACDF, and 35 in the PEEK cage group. The clinical improvement range (Modified PROLO Scale) was 1.53±1.18. The patient's satisfaction mean was 8.23±2.12 according to the G.S.I that in the PEEK cage group was more than other groups. At the end of follow up fusion was achieved in 94.05% of the patients that there was not any significant difference between the groups. But in multilevel involvement, the difference was meaningful and it was more in the groups with fusion rather than the group of ACD. The most complications were related to the ACDF and the least to the PEEK cage group. Height of foramen was decreased in the ACD and ACDF groups, and increased in the PEEK cage group. Fusion is necessary in multilevel involvement. PEEK cage fusion appropriately increases foramen height better than others and has less complications and similar clinical results, satisfaction rate and easy radiographic follow up. Therefore, utilizing this technique is better and suggested if the patient's selection has been done exactly.

Agents of chemical war specially sulfur mustard and their pulmonary complications of chemical devotees, creating very worries for family specially spouses and have had negative impact on wellbeing and quality of life's spouse of caregiver and chemical devotee. S0, carry out of studies related to spouses of chemical devotees for maintaining and improving for quality of life's them, seem be necessary. This study carried out to determine relationship between quality of life and some of individual's characteristics in spouses of chemical devotees involved with pulmonary complications of sulfur mustard in Tehran (2006). The study is a descriptive–analytic research that were selected 100 spouses of chemical devotee is restricted by 20-60 years with mean of age in 36/81 years by sampling randomly. The instruments of data collection were included: Demographic, standard scale of caregiver quality of life (created by Ferrell & Grant) questionnaires for assessment of domains in quality of life (Physical, Psychological, Family-Social-Financial), That carried out to way of interviewing and complement of self report form in workshop, their houses and devotees foundation centers. The finding of descriptive statistical was shown that less than one third (19%) of samples in domains of physical, zero percent in domain of psychological and 49% in domain of social have had score quality of life. So, statistical tests (Fisher & chi-squared) were shown an inverse correlation between the educational level (p<0.02) and percent of devotee (p<0.04) with their score of quality of life. Also, a direct correlation and positive impact of correlation was observed between job and quality of life of samples (p<0.01). According to the upper finding, the research hypothesis, that there is a correlation between quality of life's spouses of chemical devotees with some of individual's characteristics, related to educational level, percent of devotee and job situation job was confirmed, but disproval with other's individual characteristics.

Several indices have been introduced to estimate arterial stiffness that based on changes in brachial blood pressure. But because of the error resulted by the substitution of brachial blood pressure instead of the other central arteries, such as carotid, it will be very important to present elastic parameter based on the mechanical models without any emphasis on brachial blood pressure. In this study, estimation of pulse wave velocity of large arteries is used as an index for arterial stiffness. At first a suitable dynamic model is introduced for pulsatile blood flow in arteries based on Navier-Stokes equations in fluid mechanics. Then, according to the theory of elasticity, equations governing arterial wall is described and coupled to the equations of fluid flow. Attained system of equations is completed by clinical information that obtained from Doppler ultrasound images from carotid artery of healthy male subject. For this purpose Doppler ultrasound images were recorded and saved in computer and then center-line blood velocity, arterial wall thickness, the period of a cardiac cycle and arterial radius measured by offline processing. The results from analytic solution of completed equations showed that the PWV for this healthy subject is 2 m/s. By applying this method, non-invasive and clinical evaluation of arterial stiffness by Doppler ultrasound measurement of common carotid artery without any measurement of local blood pressure will be possible.

The widespread use of β -lactam antibiotic has lead to the development of resistance to this group of antibiotics in bacterial pathogens due to β -lactamase production. This study was undertaken to determine the AmpC β -lactamase production in pathogens isolated from hospitalized patients at selected university hospitals of Tehran. Non-repeat clinical isolates (154) from clinical specimens of selected hospital were taken. Disk agar diffusion and minimum inhibitory concentration (MIC) with β -lactam antibiotic included Ceftazidim, Ceftriaxon and Cefepim and Clavulanic acid as a β -lactamase inhibitor for detection of extended spectrum β -lactamase (ESBLs) producing organisms w ere done. In addition, the susceptibility of these organisms to Cefoxitin was examined. All isolates were examined by Multiplex PCR method for finding the different kind of gene family encoded AmpC β -lactamases Isolates had divided in three group included of P+, P+C+, P+C- based on ESBLs phenotypic test criteria with 57.15% (n=88), 53.9% (n=83) and 3.25% (n=5) respectively. Isolates that their result became P+C+ and P+C- were selected and the Multiplex PCR for them were done. The results of molecular testing showed that 5.7% of isolates, in the other hand 5 strains of E. coli were positive for AmpC β -lactamase. This is the first report of AmpC β -lactamase producing bacteria from Iran. If the type of β -lactamase produced by the pathogen could be detected along with antibiogram before administrating the β -lactamase drug to the patient therapeutic failure might be avoided. Because of significance of these organisms in produce nosocomial infection and in order to prevent them from spread, we need to more study for showing the actual prevalence of them.

Transformation of plasmid DNA into bacterial competent cells is a key technique for molecular cloning. Transformation can be achieved using either chemical or physical methods, e.g., electroporation. The rate of success in these methods depends on experience and attention to method’s details. Therefore, the higher the efficiency and quality of a transformation method, the more the rate of success in that experience would be. The aim of the present study was to design a simple and rapid molecular transformation method, to achieve the efficiency without the need for special expensive apparatus. In our improved method after preparation of bacterial cell’s pellet, it was resuspended in new Competent/Transformation Solution (CTS); the suspension was mixed with 1 µl (0.1ng) of plasmid DNA and incubated for 5-30 minutes at 4°C. Then 10 µl of 1 M glucose was added to it and cells were grown at 37°C with shaking for 1 hour. After incubation, the cells were spread on selective medium plates containing 100 mM CaCl2 by standard methods. This method does not necessary to heat shock and it is more efficient than classical transformation methods (107 transformants/µg). Our procedure represents a simple and convenient method for simultaneous Escherichia coli preparation and its transformation.

Food restriction has a protective effect against damaging agents and prevents cardiovascular disorders. This study was conducted to evaluate the effect of food restriction on contractile reactivity of male rats using isolated tissue setup. Male Wistar rats were randomly divided into one control and three experimental groups. Control group received normal rat regimen for 6 weeks. The group with full restriction and non-isolation received 1/3 of the food regimen. The group with full restriction and isolation received 1/3 of the food regimen. The experimental group with two-week food restriction and non-isolation received 1/3 of the food regimen only for two weeks. After 6 weeks, contractile reactivity of aortic rings to KCl and noreadrenaline was determined. Although two-weeks food restriction did not produce any significant change in aortic contractile response to KCl and noreadrenaline as compared to control group, but full restriction with or without isolation increased this response relative to control group (p=0.041 and p=0.027, respectively). Short-term food restriction did not have any significant effect on maximum contractile response and subchronic restriction can increase this response to KCl and noreadrenaline.