فهرست مطالب

Journal of Research in Medical Sciences
Volume:17 Issue: 8, Aug 2012

  • تاریخ انتشار: 1391/07/26
  • تعداد عناوین: 20
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  • Parinaz Poursafa, Roya Kelishadi, Shaghayegh Haghjooy, Javanmard, Laleh Rafiei, Kasra Keramatian Page 718
    Background
    This study aims to determine the association of some genetic polymorphisms in the relationship of air pollutants on the serum levels of thrombomodulin (TM) and tissue factor (TF) in a population-based sample of children and adolescents.
    Materials And Methods
    This cross-sectional study was conducted among 110 participants (52.8% girls) with a mean age of 12.7 + 2.3 years, in Isfahan, Iran. Genotypes of TM G33-A and + 5466A > G polymorphisms were determined by the polymerase chain reaction – restriction length fragment polymorphism method (PCR-RFLP). The enzyme-linked immunosorbent assay (ELISA) was used for measurement of serum TM and TF.
    Results
    The following genotypes were identified for TM: GG in 69.2%, GA in27.2%, and AA in 3.6% of the participants. Considering TF, 108 participants were homozygous for the + 5466A allele, and two subjects had + 5466AG genotype. The mean pollution standards index (PSI) value was at a moderate level; the mean particulate matter measured up to 10 μm (PM10); and ozone (O3), nitrogen dioxide, and sulfur dioxide were considerably high. The mean serum TF and TM levels were not significantly different among the participants with the aforementioned genotypes. Among participants exposed to high quartiles of O3, PM10, and PSI, the TM-33G / A polymorphism (GA + AA genotype) increased the Odds ratio (OR) of the low serum TM level. There was no statistically significant association in the areas of low pollution.
    Conclusion
    The findings of our study support the synergistic effect of the TM-33G / A polymorphism and air pollutants on factors associated with the onset of the atherosclerosis. This might be confirmatory evidence for gene-environment interaction, and related effects on atherogenesis from early life.
    Keywords: Air pollution, atherosclerosis, children, genetics, prevention
  • Rezvan Salehidoost, Ashraf Aminorroaya, Bijan Iraj, Massoud Amini Page 724
    Background
    We investigated the effect of acute hypothyroidism on lipid concentrations especially on high density lipoprotein (HDL-cholesterol) level in athyroatic patients.
    Materials And Methods
    Thirty-one patients, with a history of differentiated thyroid carcinoma and total thyroidectomy, who were candidates of radioiodine therapy, enrolled in the study. Their lipid profiles and serum thyrotropin stimulating hormone (TSH) levels were measured before and two-to-six weeks after thyroid hormone withdrawal. The lipid concentrations were compared with the paired t test and serum TSH using the Wilcoxon singed rank test. P values < 0.05 were considered statistically significant.
    Results
    The median of TSH concentration was 0.06 mU / liter on thyroid hormone suppressive therapy and 102 mU / liter at the thyroid hormone withdrawal phase (P < 0.0001). The serum concentrations of all lipids were significantly increased after withdrawal (P < 0.0001). The mean (SD) of the HDL-cholesterol concentration rose from 44 ± 9 mg / dL to 58 ± 17 mg / dL. The levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride increased by 58, 75, 30, and 59%, respectively, during acute hypothyroidism.
    Conclusion
    The present study showed that thyroid hormone withdrawal altered the lipid concentrations significantly, in a short period of time. The levels of both atherogenic (LDL-cholesterol) and cardioprotective (HDL-cholesterol) particles increased concurrently. Their clinical importance should be investigated in future.
    Keywords: Cholesterol, HDL, hypothyroidism, lipid metabolism, thyroid hormones, thyroid neoplasms
  • Morteza Jabbari Moghadam, Davood Ommi, Alireza Mirkheshti, Mehdi Shadnoush, Ali Dabbagh Page 728
    Objective
    Clonidine, an alpha-2 adrenergic agonist, increases the quality of perioperative sedation and analgesia with a few side effects. This study was designed to assess the effect of clonidine premedication on the anesthesics used for elective below knee surgeries in opium abusers and non-abusers.
    Materials And Methods
    In a randomized clinical trial, 160 patients were selected and assigned into four groups. Eighty patients among the opium abusers were divided randomly into clonidine and no clonidine groups, with 40 patients in each, and 80 among the non-abusers were again divided randomly into clonidine and no clonidine groups, with 40 patients in each group. All were anesthetized for elective orthopedic operation using the same predetermined method. The total administered dose of propofol and other variables were compared.
    Results
    The total propofol dose in a decreasing order was as follows: Abuser patients receiving placebo (862 ± 351 mg), non-abuser patients receiving placebo (806 ± 348 mg), abuser patients receiving clonidine (472 ± 175 mg), and non-abuser patients receiving clonidine (448 ± 160 mg). Hence, a statistically significant difference was observed among the four study groups (P value for ANOVA = 0.0001).
    Conclusion
    Adding clonidine as a preoperative medication decreases the patient’s anesthetic needs; this decrease was even more considerable on the anesthetic needs than the effect of opium abuse history on anesthetic dose.
    Keywords: Clonidine, elective surgery, opium abuse, propofol
  • Nizal Sarrafzadegan, Roya Kelishadi, Mansour Siavash, Gholamhossein Sadri, Hossein Malekafzali, Masoud Pourmoghaddas, Shahin Shirani, Maryam Boshtam, Sedigheh Asgary, Noushin Mohammadifard, Ahmad Bahonar, Babak Eshrati, Farhad Ghamsari Page 732
    Objective
    To assess the impact of gender and living area on cardiovascular risk factors in the context of a comprehensive lifestyleintervention program. Design: Data from independent sample surveys before (2000--2001) and after (2007) a community trial, entitled the Isfahan Healthy Heart Program (IHHP) were used to compare differences in the intervention area (IA) and reference area (RA) by gender and living area. Setting: The interventions targeted the population living in Isfahan and Najaf-Abad counties as IA and Arak as RA. Participants: Overall, 12 514 individuals who were more than 19 years of age were studied at baseline, and 9570 were studied in postintervention phase. Interventions: Multiple activities were conducted in connection with each of the four main strategies of healthy nutrition, increasing physical activity, tobacco control, and coping with stress. Main Outcomes: Comparing serum lipids levels, blood pressure, blood glucose and obesity indices changes between IA and RA based on sex and living areas during the study.
    Results
    In IA, while the prevalence of hypertension declined in urban and rural females (P < 0.05). In IA, the prevalence of hypercholesterolemia and hypertriglyceridemia decreased in both females and males of urban and rural areas except for hypercholesterolemia in rural males (P < 0.01). In RA, the significant changes include both decrease in the hypercholesterolemia among rural males (P < 0.001) and hypertriglyceridemia in urban females (P < 0.01), while hypertriglyceridemia was significantly increased in rural females (P < 0.01).
    Conclusions
    This comprehensive community trial was effective in controlling many risk factors in both sexes in urban and rural areas. These findings also reflect the transitional status of rural population in adopting urban lifestyle behaviors.
    Keywords: Age, cardiovascular risk factor, community health program, health promotion, rural, sex, urban
  • Mojgan Mokhtari, Mina Memar Ardestani, Mohammad Movahedipour Page 741
    Background
    Colorectal cancer (CRC) is a common human malignancy. Epidermal growth factor receptor (EGFR) is expressed in wide variety of human malignancies and is of some therapeutic and prognostic utility. The relationship between EGFR expression and regional lymph nodes involvement, and tumor grade in CRC has not been cleared, thus we decided to show it in a case-control study.
    Material And Methods
    We chose paraffin-embedded tissue blocks of 46 CRCs with regional lymph nodes involvement as case group, and 46 CRCs without lymph nodes involvement as control group and then performed immunohistochemical staining for both groups. Moderate to strong, and complete staining of more than 10% of tumor cells was regarded as EGFR-positive. In analysis, P-value less than 0.05 was considered as significant.
    Results
    EGFR expression was positive in 80.4% and 56.5% of patients in the case and the control groups, respectively, which the difference between them was statistically significant. EGFR was positive in 48% of grade I, 60% of grade II and 100% of grade III tumors.
    Conclusions
    EGFR expression had relationship with lymph node involvement and tumor grade in CRC. Also, lymph node-involved CRCs showed higher scores of EGFR staining than control group. Thus, EGFR may be an additional factor to develop more aggressive CRCs and may predict the probability of lymph node involvement in these tumors.
    Keywords: Colorectal cancer, EGFR, epidermal growth factor receptor, immunohistochemical
  • Abolghassem Zarezadeh, Hamidreza Shemshaki, Mohsen Nourbakhsh, Mohammad R. Etemadifar, Malihe Moeini, Farhad Mazoochian Page 745
    Background
    This study was designed to compare two methods of surgery, anterior subcutaneous transposition (ASCT) and anterior submuscular transposition (ASMT) of the ulnar nerve in treatment of cubital tunnel syndrome.
    Materials And Methods
    This randomized trial study was conducted from October 2008 to March 2009 in the Department of Orthopedic Surgery at University Hospital. Forty-eight patients with confirmed cubital tunnel syndrome were randomized in two groups, and each patient received one of two different surgical treatment methods, either ASCT (n = 24) or ASMT (n = 24). In the ASCT technique, the ulnar nerve was transposed and retained in the subcutaneous bed, whereas in the ASMT, the nerve was retained deep in the transected muscular complex, near the median nerve. Patient outcomes, including pain, sensation, muscle strength, and muscle atrophy were compared between groups.
    Results
    The two groups were similar in baseline characteristics. However, those treated with ASMT had a statistically significant reduction in their pain levels compared with ASCT (21 (87.5%) vs 8 (33.3%), P < 0.05). There were no statistically significant differences between the two groups relative to sensation (11 (45.8%) vs 12 (50%)), muscle strength (17 (70.8%) vs 15 (62.5%)), or muscle atrophy (15 (62.5%) vs 17 (70.8%)) (P > 0.05).
    Conclusions
    Our results indicate that ASMT are more efficient than ASCT for managing cubital tunnel syndrome. In patients who had ASMT, there were significant reductions of pain compared with ASCT.
    Keywords: Cubital tunnel syndrome, subcutaneous, submuscular, transposition
  • Mitra Moodi, Mohsen Rezaeian, Firoozeh Mostafavi, Golam, Reza Sharifirad Page 750
    Background
    Breast cancer remains a substantial health concern in Iran due to delay and late stage at diagnosis and treatment. Despite the potential benefits of mammography screening for early detection of breast cancer, the performance of this screening among Iranian women is low. For planning appropriate intervention, this study was carried out to identify mammography rates and explore determinants of mammography screening behavior in females of Isfahan, Iran.
    Materials And Methods
    In this population-based study, 384 women of 40 years and older were interviewed by telephone. The Farsi version of Champion’s Health Belief Model scale (CHBMS) was used to examine factors associated with mammography screening. The obtained data were analyzed by SPSS (version 16.0) using statistical Chi-square, Fisher Exact test, t-test and multiple logistic regression model to identify the importance rate of socio-demographic and Health Belief Model (HBM) variables to predict mammography screening behavior. In all of tests, the level of significant was considered a = 0.05.
    Results
    Mean age ± SD of women was 52.24 ± 8.2 years. Of the 384 participants, 44.3% reported at least one mammogram in their lifetime. Logistic regression analysis indicated that women were more likely to have mammography if they heard/read about breast cancer (OR = 4.17, 95% CI 2.09, 8.34), menopause in lower age (OR = 0.2, 95% CI 0.87, 0.99) and history of breast problem (OR = 0.9, 95% CI 0.12, 0.32). Also, women who perceived more benefits of mammography (OR = 1.84, 95% CI 1.63, 2.09), fewer barriers of mammography (OR = 0.91, 95% CI 0.86, 0.96) and had more motivation for health (OR = 0.94, 95% CI 0.89, 1) were more likely to have mammography.
    Conclusion
    The findings indicated that the rate of mammography screening among women in Isfahan province is low and highlights the need for developing a comprehensive national breast cancer control program, which should be considered as the first priority for healthcare providers. Also, identification of these factors can help to design an appropriate educational intervention that focuses on benefits of mammography screening, decreasing changeable barriers, improving access to mammography, increasing health motivation, promoting perceived self-efficacy and mammography adherence.
    Keywords: Breast cancer, health belief model, mammography screening, women
  • Seyed M. Lahsaei, Afshin Amini, Seyed M. N. Tabatabei, Golnoush Mehrabani Page 760
    Background
    Postoperative nausea and vomiting are some of the important and common side effects of anesthesia after surgery occurring in almost 20-30% of patients and is the second factor of a patient’s complaint and inconvenience after pain. This study compares the effect of oral cetirizine and ondansetron in the prevention of postoperative nausea and vomiting in adults.
    Materials And Methods
    In a blind and prospective study in fall 2010, 300 patients aged 18-65 years who were among ASA І-П in Chamran Orthopedic Hospital were randomly divided into three equal groups receiving cetirizine, ondansetron, and placebo, respectively. General anesthesia was identical. After operation (after 1-2 h in the recovery room, after 2-12 and 12-24 h in the ward), the presence or absence and any nausea or vomiting was recorded.
    Results
    The postoperative nausea and vomiting (PONV) rate after 1-2 h in the recovery room, after 2-12 and 12-24 h in the ward in placebo, and both groups of cetirizine and ondansetron were 50%, 21%, and 11%, respectively while the difference was significant (P value < 0.05). Regarding the number of vomiting, the least was related to ondansetron (especially in the first 2-12 h) but the difference was not significant (P > 0.05).
    Conclusion
    The PONV rate in cetirizine and ondansetron groups was less than the placebo group.
    Keywords: Anesthesia, cetirizine, nausea, ondansetron, postoperative, vomiting
  • Subhash B. Thakre, Sushama S. Thakre, Swapnil Alone Page 764
    Introduction
    Qualitative research methods provide a means of collecting and interpreting narrative or observational data about such interactions, leading to a deeper understanding of the process of health care delivery. This approach was used to clarify key themes from parents’ comments about challenges on paths to detect hearing impairment.
    Materials And Methods
    An exploratory descriptive qualitative research design is used. In-depth interviews by using a semi-structured questionnaire and focus group discussions (FGD) were held with parents, and other study groups. A study was conducted in Deaf Dum Rural School, Saoner, Nagpur district, Maharashtra, India. Purposive voluntary sampling is utilized. Semi-structured and in-depth interviews and FGD were conducted in private rooms. A FGD guide covered open-ended comments to the set of questions.
    Results
    Parents of 65 children (59%) replied to the questionnaire. Out of them, 55 (85.6%) were the parents of school children resides in the hostel. The majority of the children have profound hearing impairment (75.86%). Theme analysis revealed perceptions about causes, ways, and means of early detection, and powerful emotions experienced by parents at FGD.
    Conclusions
    Reaching beyond numerical analyses, qualitative studies allow for expression of junior doctors, Deaf and Dump School teacher and parents’ thoughts, feelings, and experiences. This study provides a means of collecting and interpreting narrative or observational data.
    Keywords: Focus group discussion, hearing impairment, qualitative analysis
  • Bikash Mondal, Soumyajit Maiti, Biplab Kumar Biswas, Debidas Ghosh, Shyamapada Paul Page 772
    Background
    Hemoglobinopathies are a group of inherited disorders of hemoglobin synthesis. It could be formed a fatal scenario in concern of lacking of actual information. Beside this, ABO and Rh blood grouping are also important matter in transfusion and forensic medicine and to reduce new born hemolytic disease (NHD).
    Materials And Methods
    The spectrum and prevalence of various hemoglobinopathies, ABO and rhesus (Rh) blood groups was screened among patients who visited B.S. Medical College and Hospital, Bankura, West Bengal, India. This study was carried out on 958 patients of different ages ranging from child to adults from January to June 2011. High-performance liquid chromatography (HPLC), complete blood count (CBC) and hemagglutination technique were performed for the assessment of abnormal hemoglobin variants, ABO and Rh blood groups, respectively.
    Results
    Results from this study had been shown that there was high prevalence of hemoglobinpathies (27.35%) where β-thalassemia in heterozygous state occurred more frequent than other hemoglobinopathies. Out of 958 patients, 72.65% were HbAA and 27.35% were hemoglobinopathies individuals where 17.64% β-thalassemia heterozygous, 2.92% β-thalassemia homozygous, 3.86% HbAE, 1.15% HbAS trait, 1.25% HbE-β thalassemia trait and 0.52% HbS-β thalassemia trait were found. No incidence of HbSS, HbSC, HbCC, HbD and other variants of hemoglobinpathies were observed. The gene frequencies with respect to ABO systems had been shown as O > B > A > AB. Blood group O was the highest (35.8%) and the least percentage distribution was blood group AB (6.68%). Rhesus positive (Rh+) were 97.7%, while the remaining was 2.3% Rhesus negative (Rh-). The frequencies of A+, B+, AB+, and O+ blood groups were 22.44%, 33.61%, 6.58%, and 35.07%, respectively.
    Conclusions
    Remarkable percentages of hemoglobinopathies were prevalent from the present study. An extensive screening of the population is needed to assess the prevalence of hemoglobinopathies, which will help in identification of carriers of hemoglobinopathies and further it will be of assistance in taking adequate therapeutic and preventive measures.
    Keywords: ABO, blood groups, hemoglobinopathy, HPLC, rhesus, West Bengal
  • Rasoul Aliannejad, Seyed M. Hashemi, Asharaf Karbasi, Mahvash Jafari, Jafar Aslani, Maryam Salehi, Mostafa Ghanei Page 777
    Background And Aim
    Bronchiolitis obliterans (BO) is the main pulmonary involvement resulting from sulfur mustard (SM) gas exposure that was used against Iranian civilians and military forces during the Iran-Iraq war. The present study aimed to investigate the prevalence of gastro-esophageal reflux (GER) and gastric micro-aspiration in SM gas injured patients with chronic pulmonary diseases and recurrent episodes of exacerbations.
    Materials And Methods
    This cross-sectional study was done at Baqiyatallah University of Medical Sciences, Tehran, Iran. Gastric micro-aspiration and GER were assessed in the enrolled patients by assessing bile acids, pepsin and trypsin in their bronchoalveolar lavage fluid.
    Results
    Our result showed that bile acids were found to be high in 21.4% patients, and low in 53.6% of patients. Only in 16% patients, no bile was detected in the BALF. Trypsin and pepsin were detected in BAL fluid of all patients.
    Conclusion
    Most of BO patients after exposure to SM suffer GER, while none the etiologic factors of GER in post lung transplant BO are present. It would be hypothesized that GER per se could be considered as an aggregative factor for exacerbations in patients. Further studies will provide more advances to better understanding of pathophysiological mechanism regarding GER and BO and treatment.
    Keywords: Bronchiolitis obliterans, gastro, esophageal reflux, sulfur mustard
  • Mahmoud Etebari, Behzad Zolfaghari, Abbas Jafarian, Dehkordi, Roya Rakian Page 782
    Background
    Today most of herbal medicines are marketing without any standard safety profiles. Although common assumption is that these products are nontoxic but this assumption may be incorrect and dangerous, so toxicological studies should be done for herbal drugs. According to the frequent use of Echium amoenum as immunostimulant and useful in conditions including pain, cough, sore throat and arthritis, and Nardostachys jatamansi as tranquilizer and sleep inducer and evidences of some toxicities, we assessed the probable effect of their extracts on DNA of hepG2 cells using the comet assay.
    Materials And Methods
    Different concentrations of above extracts of the plants are incubated with hepG2 cells for 24 h. A mixture of cell suspension and agarose gel were put on slides, then slides were embedded in a lysing solution and were put in electrophoresis buffer (pH = 13). Then the electrophoresis procedure took place in an alkaline solution and after neutralization stage, colorization was done by ethidium bromide and comets were observed using a fluorescence microscope. At least 100 cells of each sample were evaluated and three parameters including comet length, percent of DNA in tail, and tail moment were assessed.
    Results
    Both Aqueous and hydro-alcoholic extract of E. amoenum were genotoxic in the concentrations of 25 mg/ml and aqueous and hydro-alcoholic extract of N. jatamansi were genotoxic in the concentrations 5 and 10 mg/ml, respectively.
    Conclusions
    Although E. amoenum and N. jatamansi are highly used in medicine, these herbs have genotoxic effects in determined concentrations and they should be used cautiously.
    Keywords: Comet assay, DNA damage, Echium amoenum, Nardostachys jatamansi
  • Masoumeh Sadeghi, Fatemeh Esteki Ghashghaei, Katayoun Rabiei, Hamidreza Roohafza, Hamid Afshar Page 787
    Introduction
    Coronary artery disease (CAD) is the leading cause of death and disability all over the world. A sedentary lifestyle and dyslipidemia are known to be the major risk factors, which play an important role in the progression of coronary artery disease. Regarding gender differences, the risk of developing coronary heart disease is recognized as being different between non-obese males and non-obese females. Hence, the aim of this study is to assess the benefits of a comprehensive cardiac rehabilitation program (CRP) on the functional capacity and lipid profiles, such as, total cholesterol, triglycerides, low density lipoprotein cholesterol, and high density lipoprotein cholesterol in non-obese males and non-obese females with coronary artery disease, and comparing these groups.
    Materials And Methods
    We evaluated 585 non-obese males and females with coronary artery disease. All the participants completed the cardiac rehabilitation program for two months, which included 24 exercise training sessions, medical evaluation, and consultation. For investigation of the effects of the cardiac rehabilitation program on the functional capacity and lipid profiles, exercise tests were carried out by each patient, and also, their blood samples were taken on entrance and at the end of this period.
    Results
    The findings, following 24 sessions in the cardiac rehabilitation program, showed that the functional capacity (P = 0.00) and all lipid profiles had significantly improved in both the groups, except that the high density lipoprotein cholesterol did not show a significant difference in non-obese females. In addition, comparing the two groups did not show any significant differences in lipid profiles, but the changes in functional capacity were significant (P = 0.00) between the two groups, following the cardiac rehabilitation program.
    Conclusion
    The CRP, which was performed by the patients under supervision of a physician and an exercise physiologist, plays a key role in improving the functional capacity (FC) and all lipid profiles in non-obese males and females with coronary artery disease, without any attention to gender differences.
    Keywords: Cardiac rehabilitation program, coronary artery disease, gender, risk factor
  • Parvaneh Abazari, Zohreh Vanaki, Eesa Mohammadi, Massoud Amini Page 792
    Aims
    Reforming and improving the patient education process need more insight into the strengths and weaknesses of the existing education process. There is little documentation on patient education in National Diabetes Prevention and Control Program in Iran, so the present study aimed to describe patient education process in diabetes centers in one of the provinces of Iran.
    Materials And Methods
    This is a qualitative content analysis. Twelve nurses who work as diabetes nurse educators (DNEs) and an internal medicine specialist participated in this study. Data was obtained through semi-structured face-to-face interviews, a focus group, existing documents, field notes, and multiple observations. Data analysis was guided by the conventional approach of qualitative content analysis.
    Results
    Three main themes including unequipped trainers (insufficient knowledge and experience, lack of appropriate educational facilities, lack of time, lack of patient’s interest), unstructured education (lack of educational need assessment, lack of evaluation, lack of continuing patient education), unmanaged education (lack of official planning for patient education and supervising the education process) emerged from qualitative content analysis.
    Conclusions
    Although patient education is one of the important strategies in National Diabetes Prevention and Control Program, there however has not been necessary investment and adequate space to achieve it. Patient education was not structured and based on scientific principles. Training of diabetes nurse educators (DNEs) is neglected, and there is no supervision on patient education process.
    Keywords: Diabetes mellitus, education, health educator, need assessment
  • Mohammad Ali Tahririan, Mehdi Motififard, Mohammad Naghi Tahmasebi, Babak Siavashi Page 799
    Heel pain, mostly caused by plantar fasciitis (PF), is a common complaint of many patients who requiring professional orthopedic care and are mostly suffering from chronic pain beneath their heels. The present article reviews studies done by preeminent practitioners related to the anatomy of plantar fasciitis and their histo-pathological features, factors associated with PF, clinical features, imaging studies, differential diagnoses, and diverse treatment modalities for treatment of PF, with special emphasis on non-surgical treatment. Anti-inflammatory agents, plantar stretching, and orthosis proved to have highest priority; corticosteroid injection, night splints and extracorporeal shock wave therapy were of next priority, in patients with PF. In patients resistant to the mentioned treatments surgical intervention should be considered.
    Keywords: Plantar fasciitis, plantar heel pain, risk factors, imaging studies, treatment
  • Yin, Lu Ding, Shao, Yong Wang Page 805
    A gastrosplenic fistula (GSF) is an unusual complication arising from a variety of primary gastric or splenic malignant lesions and less commonly from benign diseases. Splenic large cell lymphoma may be a main cause of this distinctive complication. We report a case of 62-year-old male with spontaneous GSF due to pathologically proven splenic large cell lymphoma who was diagnosed by computed tomography and treated successfully by surgical management.
    Keywords: Computed tomography, gastrosplenic fistula, splenic lymphoma
  • Namsik Yoon, Kye Hun Kim, Hyung Wook Park, Jeong Gwan Cho Page 808
    A 56-year-old man got admitted as he was suffering from dizziness for 3 days. Electrocardiogram (ECG) showed complete atrioventricular (AV) block with ventricular rhythm of 35/min. We found that he had no inferior vena cava (IVC) which drained into right atrium in the middle of temporary pacing lead insertion. Venous drainage into superior vena cava from dilated azygos vein was identified after venogram. Echocardiogram revealed a congenitally corrected transposition of the great arteries (CCTGA). Chest computed tomography (CT) angiogram revealed AV and ventriculoarterial discordance with reversed ventricles and interrupted IVC with azygos continuation. DDD pacemaker was implanted via left axillary vein without any problem.
    Keywords: Complete atrioventricular block, congenitally corrected transposition of the great arteries, interrupted inferior vena cava
  • Yuyun Xu, Jianhua Yuan, Vincent Chong, Zhongxiang Ding Page 811
    Villous adenomas occur most frequently in the rectum and colon. These tumors are rarely seen in the gallbladder. We report a case of gallbladder villous adenomas in a 69-year-old patient who has systemic lupus erythematosus (SLE). The patient was admitted for investigation of a gallbladder mass. Ultrasonography, computed tomography, and magnetic resonance imaging showed two wellcircumscribed lobulated masses in the gallbladder. Open cholecystectomy was performed and histological examination revealed typical features of villous adenoma. This report describes the first case of villous adenomas of gallbladder with SLE, and documents its imaging findings comprehensively.
    Keywords: Computed tomography, gallbladder, magnetic resonance imaging, systemic lupus erythematosus, ultrasonography, villous adenoma
  • Banu Yoldas, Hidir Esme, Mustafa Calik Page 814
    Isolated sternal fracture is a benign condition which generally heals with conservative treatment. But sometimes surgical intervention is necessary due to pain, other organ injury and union problems. There are several ways for repair; however, the best method is not yet defined. In this report, we presented two cases who were treated surgically for different indications with different suture materials. When anatomically correction can be achieved, using suture materials is a safe and effective method.
    Keywords: Repair, sternal fracture, surgery
  • Yukti Sharma, Sanjay Jain, Kapil Chandra, V. K. Khurana, Madhur Kudesia Page 817
    Sir,Incidence rates of fungal infections have increased significantly over the last 15 to 20 years.[1]This disorder is significant due to clinical consequence with respect to its contagious nature, cosmetic consequences, chronicity, recurrences, and therapeutic difficulties. The present study was done to assess the clinicoepidemiological profile of fungal infections, species identification, and to compare clinical diagnosis with direct microscopy and culture positivity from clinically suspected cases. From March to August 2011, 80 specimens were processed from clinically suspected cases of dematophytosis/dermatomycosis attending the Dermatology Out Patient Department and sent to Microbiology for mycological work-up. Specimens included skin scales, hair, nails (superficial mycoses), and tissue (deep mycoses). Specimens were analyzed by direct microscopy and subjected to culture study (Sabouraud‘s Dextrose Agar, cornmeal agar, blood agar).Pathogens were differentiated from contaminants following these guidelines: (1) Dermatophyte isolated on culture was considered a pathogen, (2) a nondermatophyte mould (NDM) or yeast cultured was significant only if direct microscopy was positive and (3) NDM required repeated isolation.[2]…