فهرست مطالب

Medical Journal Of the Islamic Republic of Iran
Volume:26 Issue: 1, Spring 2012

  • تاریخ انتشار: 1391/02/17
  • تعداد عناوین: 8
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  • Noushin Jalayer Naderi, Shams Shariat Tarabghan, Mohsen Merati, Mahdi Ashouri, Ali Majidi, Mohammad Javad Kharazi Fard Page 1
    Background
    An enchondroma is a benign and a well-differentiated chondrosarcoma is an invasive chondroid tumor with high recurrence potential. In spite of biologic differences, these two tumors have very similar histopathologic appearance. It has been shown that the biologic nature of the connective tissue around benign and malignant tumors varies in the number of mast cells. The aim of this study was to study the histopathologic distinction of enchondroma and well-differentiated chondrosarcoma using the density of the mast cells in fibrotic capsule.
    Methods
    Twelve enchondroma and 15 well-differentiated chondrosarcoma were collected from Pathology department of Cancer Institute and Central Pathology department of Imam Khomeini Hospital in Tehran. 3 micron paraffin embedded tissue sections were stained by toluidine blue for mast cells counting. Mast cells were counted in fibrous capsule of all cases. Mast cells counts were accomplished in 10 high power fields. The average number of mast cells in 10HPF was determined as an index for each lesion. Mann-Whitney U test was used for statistical analysis.
    Results
    Mean index in enchondroma and well-differentiated chondrosarcoma groups were 0.1±0.12 and 0.31±0.33 respectively, showing a significant difference between number of mast cells in the fibrotic capsule in these two lesions (p=0.028). Comparison of the corresponding points in ROC curve, showed a cut-off point = 0.15, with positive predictive value of 61%, negative predictive value 71%, specificity of 33.3% and sensitivity of 66.7%, (p=0.025).
    Conclusion
    Average density of the mast cells in the surrounding fibrotic capsules of enchondroma and well-differentiated chondrosarcoma along with other criterions, could be a beneficial factor for histologically differentiation between these two lesions.
  • Ali Ghafouri, Omran Abbas Salehi, Seyed Ali Keshavarz, Saeed Hosseini, Abolfazl Shojaifard, Zhamak Khorgami Page 7
    Background
    Today, early diagnosis of upper gastrointestinal (GI) tract malignancies and their surgical resection is becoming more feasible. One of the important side effects in upper GI tract malignancies is malnutrition which has direct relationship with postoperative complications. Nonetheless, there is no easy regimen of nutrition for these patients especially for the first week after operation. Accordingly we present a simple method for improving feeding such patients via tube jejunostomy. The aim of this study was to investigate the impact of early enteral feeding (EEF) on postoperative course after complete resection of upper gastrointestinal tract malignancy and reconstruction.
    Methods
    Between September 2005 to September 2008, 60 consecutive patients (22 female, 38 male) with upper GI tract malignancies who had undergone complete resection and reconstruction enrolled in this study. The patients randomly divided equally in two groups of control and EEF. Control group was treated with traditional management of nil by mouth and intravenous fluids for the first five postoperative days and then with liquids and enteral regular diet when tolerated. In EEF group the patients were fed by tube jejunostomy from 1st postoperative day and assessed for nutritional status before surgery and 5 days after surgery. Both groups were monitored on the basis of weight gain, clinical and paraclinical parameters and postoperative complications.
    Results
    Sixty patients were randomly divided to two equal groups. Surgical procedures were similar in two groups and no significant difference in demographic and basic nutritional status were found. On 5th postoperative day serum albumin was 4.2±0.4 g/dl in EEF and 3.6±0.3 g/dl in control group (p= 0.041). Also serum transferrin was 260.8±2.5 mg/dl and 208±1.8 mg/dl in EEF and control group respectively (p<0.001). Moreover, hospital stay was shorter in EEF group (7.7±3.1 vs. 14±2.5 days, p=0.009).There were four (13.3%) anasatomotic leakages in control group and one (3.3%) in EEF group (p=0.353). Also there was six (20%) wound infection in control group and three (10%) in EEF group (p=0.472).
    Conclusion
    The EEF by tube jejunostomy can be an effective method of feeding patients in postoperative days of resection of GI malignancies. Postoperative hospital stay would be shorter and the level of laboratory parameters especially serum transferrin is higher in EEF in comparison with control group. It also may reduce postoperative complications such as wound infection and enterocutaneous fistula.
  • Mahtab Rahbar, Kaykhosro Mardanpur, Ramin Tavafzadeh Page 12
    Background
    This study was to determine the sensitivity, specificity, positive predictive value (PPV), negative predictive values (NPV) and agreement between two methods of the stained gastric imprint cytology smears and stained gastric specimen biopsy mucosal methods for detection of H. pylori.
    Methods
    Air-dried imprint smears of gastric biopsies from 330 patients were stained by the Grunwald- Giemsa method in the endoscopy suite and examined for H. pylori, providing results within minutes. The grade of H pylori infection was documented. The same biopsy was processed and stained with H&E and Grunwald- Giemsa stains, and reviewed by two different pathologists blind to the imprint cytology results.
    Results
    Ninety-four of the 238 patients were male with a mean age of 46 (±16.4) years. Based on histology, the H. pylori prevalence was very high at 77.87% and according to cytology H.Pylori prevalence was high at 75.45% in this region our country. The sensitivity and specificity of imprint cytology in the detection of H. pylori were 96.88% and 90.12%, respectively. The PPV and NPV were 96.88% and 90.12%, respectively. The agreement between two diagnostic methods was 95.26% which confirms reliability of imprint cytology method for ion of H.pylori detection.
    Conclusion
    Gastric imprint smears stained with Grunwald-Giemsa method is a rapid and cost effective method in addition to histology for detecting H. pylori in patients undergoing upper gastrointestinal endoscopy and biopsy. It does not require any additional biopsy.
  • Ali Zare Mirzaie, Maryam Abolhasani, Bina Ahmadinejad, Mahshid Panahi Page 17
    Background
    Myocardial infarction is the major cause of morbidity and mortality in industrialized countries. Platelet count and the mean platelet volume (MPV), a simple and reliable indicator of platelet size which correlates with platelet activation, might associate with troponin in acute chest pain.
    Methods
    We analyzed MPV of 851 patients who were admitted to Rasoul-e-Akram Hospital with acute chest pain during the year 2010. Two blood samples were taken from each patient within 4 hours of their arrival for routine hematology, including platelet count and MPV, and cardiac troponin T. Also, electrocardiograms of the patients were recorded. Association of MPV and platelet count with troponin was observed.
    Results
    The patients in troponin positive group, who had also ischemic electrocardiographic changes, had higher MPV values than non- acute coronary syndrome (ACS) patients with normal cardiac troponin T levels (9.9 vs 9.5 fl with p< 0.001). In troponin negative group, the mean of platelet count was higher than that in the positive group (221683 vs 198814/μl with p< 0.001).
    Conclusion
    MPV and platelet count are inexpensive laboratory tests which can be measured in association with other laboratory biomarkers in patients presenting with acute chest pain. This could help to lower hospitalization rates and also avoid misdiagnosis and having complications of patients with ACS.
  • Najmosadat Atefi, Mehrdad Majedi, Shadi Peyghambari, Shadi Ghourchian Page 22
    Background
    The relationship between Lichen Planus (LP) and diabetes was studied previously, but the re-sults were in conflict. The aim of this study was to find the prevalence of diabetes mellitus (DM) in patients with LP among Iranian patients.
    Methods
    In this study, 80 patients with LP were enrolled. They referred to dermatology clinic of our hospital during one year. A self-designed checklist for the study included duration of the disease, the pattern of the dis-tribution of lichenoid lesions and fasting blood sugar (FBS).
    Results
    From 80 patients with LP, 16 (20%) had diabetes. Also, 14 patients (17.5%) had impaired fasting glucose. The mean age of diabetic patients was significantly higher than non-diabetic group (p=0.039). In addi-tion, the duration of LP in patients with DM was significantly higher than non-diabetic patients (p=0.024).
    Conclusion
    In our study, we saw a high prevalence of DM among patients with LP. Comparing our findings with the overall prevalence of DM in Iran, there was a significant difference between the prevalence of DM among patients with LP and the overall prevalence (p=0.001). Regarding our findings screening for FBS in pa-tients with LP is required in Iran.
  • Maryam Fayazi, Shohreh Noorizadeh Dehkordi, Mehdi Dadgoo, Masoud Salehi Page 27
    Background
    The Motricity Index was used to measure strength in upper and lower extremities after stroke. The weighted score based on the ordinal 6 point scale of Medical Research Council was used to measure maximal isometric muscle strength. There is dearth of articles dealing with the reliability of this method. Therefore, the aim of this study was to determine the test retest reliability of Motricity Index strength assessments for paretic lower limb in 20 chronic stroke patients with one week interval.
    Methods
    In a cross sectional study, intrarater reliability of lower extremity Motricity Index strength assessments with one week interval were measured.
    Result
    The SPSS 18 was used for analysis of data. Two-way random-consistency model of ICC was used for assessment of test-retest reliability. The ICC values showed high reliability of strength measurement of Motricity Index (ICC=0.93).
    Conclusion
    The Motricity Index can be a reliable instrument for measuring the strength of involved lower extremity when assessment is done by one rater following chronic stroke.
  • Alireza Khoshnevisan Page 31
    Primary and secondary malignant central nervous system (CNS) tumors are devastating invasive tumors able to give rise to many kinds of differentiated tumor cells. Glioblastoma multiform (GBM), is the most malignant brain tumor, in which its growth and persistence depend on cancer stem cells with enhanced DNA damage repair program that also induces recurrence and resists current chemo- and radiotherapies. Unlike non-tumor stem cells, tumor stem cells lack the normal mechanisms that regulate proliferation and differentiation, resulting in uncontrolled production and incomplete differentiation of tumor cells. In current paper recent developments and new researches in the field of brain tumor stem cells have been reviewed.
  • Davod Jafari, Hamid Taheri, Hooman Shariatzade, Farid Najd Mazhar, Alireza Jalili, Mohammad H. Ghahramani Page 41
    We present an exceedingly rare case of left Monteggia-Galeazzi fracture-dislocation and right Monteggiadistal radius fracture occurring simultaneously in a 20-year old male patient who had fallen 13 meters from a building. The combination of Monteggia and Galeazzi fracture-dislocation in the same forearm is very rare and, to the best of our knowledge, simultaneous bilateral Monteggia and Galeazzi or distal radius fracture in the same patient, have never been reported.