Tanaffos Respiration Journal
Volume:11 Issue: 4, Autumn 2012

Accumulation of nitrated protein is seen in peripheral lung and cells from patients with chronic obstructive pulmonary disease (COPD). Nitrated protein causes abnormal protein function, but the nitration was believed to be an irreversible process. However, there are accumulating evidences that this process is reversible by an active denitration pathway. The aim of this study is to detect denitration activity in protein extracts from peripheral lung tissue of COPD and to compare with those in healthy subjects. Peripheral lung tissue from 4 healthy, 4 smokers without COPD, 4 GOLD stage 1 and 4 GOLD stage 2 were used for denitration assay. Denitration activity was determined as reduction of nitro-tyrosine level of nitrated histone protein after incubation with protein extracts from peripheral lung, which was determined by western blotting. In addition, RNA is extracted from peripheral lung of 8 healthy, 7 smoking control, 8 stage 1 and 2 COPD and 10 stage 3 and 4 COPD and nitrate reductase mRNA expression was determined by real time RT-PCR. Peripheral lung protein extracts from healthy subjects reduced nitrotyrosine level of nitrated histone. Thus, we were able to show denitration activity in peripheral lungs. The denitration activity was slightly reduced in smoking controls, and significantly reduced in COPD patients. We also showed that the expression of the human homologue of nitrate reductase (chytochrome β2 reductase), a potential candidate of denitrase, was significanty reduced in COPD lung. This study suggests that accumulation of nitrated protein in lung tissue of COPD may, at least in part, be induced by a reduction in denitration activity or nitrate reductase.

Arterial blood gas (ABG) analysis is useful in evaluation of the clinical condition of critically ill patients; however, arterial puncture or insertion of an arterial catheter may cause many complications. The aim of this study was to determine whether venous blood gas (VBG) values can be used as an alternative to arterial blood gas measurements in patients under mechanical ventilation. This study was carried out on patients admitted to the Intensive Care Unit of Kashan Beheshti Hospital. Blood for VBG analysis was obtained from the cubital vein, while for ABG analysis blood was taken simultaneously from the radial artery. ABG and VBG samples were obtained simultaneously, and indexes of pH, PCO2, HCO3, base excess (BE), PO2 and O2 saturation level were analyzed. A total of 102 pair of simultaneous venous and arterial blood samples were obtained from 102 patients (mean age 58.4±21.5 years). Seventy (69%) were males. The mean difference between arterial and venous values was 0.04 for pH, 5.6 mm/Hg for PCO2, -0.32 mmol/l for HCO3, -1.03 mmol/l for BE, 53.6 mm/Hg for PO2, and 23.5 % for O2 saturation. The Pearson correlation coefficients between arterial and venous values for pH, PCO2, HCO3, BE, PO2 and O2 saturation were 0.874, 0.835, 0.768, 0.810, 0.287, and 0.310, respectively. Linear regression equations for the estimation of pH, PCO2, HCO3, BE, PO2 and O2 saturation were as follows: arterial pH=1.927+0.745×venous pH [r=0.801, p<0.001]; PCO2=6.470+0.706×venous PCO2 [r=0.835, p<0.001]; arterial HCO3=7.455+0.681×venous HCO3 [r=0.768, p<0.001]; arterial BE=- 0.952+0.736×venous BE [r=0.810, p<0.001]; arterial PO2=70.374+0.620×venousPO2 [r=0.287, p=0.003]; arterial venous saturation= 89.753+0.082×venous O2 saturation [r=0.317, p = 0.001]. Venous blood gases, especially pH, Base excess, and PCO2 levels have relatively good correlation with ABG values. Because this correlation is not close, VBG cannot substitute ABG in mechanically ventilated patients.

This study aimed to evaluate the prevalence of serum sodium and potassium disorders and assess their effects on mortality rate in hospitalized patients in the ICU and also to identify prognosis and predictors of survival. A retrospective case-control study was conducted on 457 hospitalized patients in the ICU of Rasoul-e-Akram Hospital (Tehran, Iran). There were two groups: 239 patients who died in the ICU(cases) and 218 patients who were discharged from the ICU(controls). Normal serum concentrations of sodium and potassium were considered as 135-150 and 3-5.5 mEq/L, respectively. Data were analyzed using Chi square test, Independent t-test, One Way ANOVA, Correlation and Receiver Operating Characteristic (ROC) curve. The mean serum sodium concentration in patients who died and discharged patients was 137.56(SD=8.56) and 137.17(SD=5.11) mEq/L, respectively. Whereas, hyponatremia was significantly more common in expired patients (39.7% vs. 28%, P<0.001). On the other hand, the mean serum potassium concentration in expired and discharged patients was 4.42(SD=0.90) and 4.16(SD=0.59)mEq/L, respectively. Hyperkalemia was significantly more common in expired patients (9.2% vs. 0.9%, P<0.001). There was a significant negative correlation between serum sodium concentration and patient’s age (P=0.029, R Spearman = - 0.123). In addition, ROC analysis showed that serum potassium concentration could potentially be a predictor of death in ICU patients (P=0.003, Area Under Curve (AUC) = 0.581) Hyponatremia and hyperkalemia are highly prevalent in expired ICU patients which is compatible with the findings of some other studies. Mortality of ICU patients is linked, in greater part, to organ dysfunction, but the severity of serum sodium and potassium disturbances remains a significant predictor of mortality. Thus, correcting electrolyte disturbances in ICU patients is important

Shoe making is among the oldest traditional occupations. Hazardous chemical substances such as adhesives containing benzene and toluene are used in the manufacturing process. Due to the lack of studies on exposure of shoemakers to benzene and toluene in Iran, this study was organized aiming at evaluating occupational exposure and risk assessment in shoemakers. Overall, 48 shoemakers (12 workshops) in East Tehran were selected randomly for this study. Personal exposure of shoemakers in four different task groups of cutting, modeling, fitting and finishing was examined during three consecutive months (October, November and December) with different climatic conditions. Sampling and analysis of samples were based on an OSHA method (Method No.12). The results of personal monitoring of subjects’ exposure to benzene and toluene in each of the three consecutive months (Mean ± standard error) were 1.10± 0.11, 1.37 ± 0.14 and 1.52 ± 0.18ppm, 11.78 ± 1.77, 14.87 ± 1.71 and 16.08 ± 2.31ppm respectively. Due to climatic temperature changes from October to December and restriction of air flow due to closure of windows and shut down of general ventilation systems, a general trend of increased exposurewas noticed. However, the difference among these three examinations was not statistically significant. Shoemakers in four task groups did not have statistically significant differences in exposure to benzene and toluene. The severity of shoemaker's exposure to toluene was significantly correlated with the number of manufactured shoes and the amount of glue used for the process. Considering the magnitude of personal exposure of task groups to benzene and toluene which was higher than TLV-TWA and unacceptably high risk of cancer and non-cancerous diseases in these subjects, improvement of work conditions for shoemakers seems imperative.

Iran signed the Framework Convention on Tobacco Control on June 16, 2003 and it was ratified by the parliament and the House of Representatives on November 6, 2005. Finally, it came into force on February 4, 2006. In this study, we aimed to evaluate health expert's opinion about tobacco control activities in Iran. This was a qualitative case study. We used a series of openended questionnaires to assess important information regarding Iranian National Tobacco Control law and FCTC implementation. The study population comprised of health experts. Use of this method ensured the validity of questionnaires’ contents. The first round of the questionnaire had been pre-tested in a pilot study. The final structure and lay out of questionnaires consisted of three main parts. The first part was designed with 7 multiple choice questions. Participants were able to rank answers from five (the most important) to one (the least important). The second part comprised four questions mainly on National Tobacco Control Program (NTCP) and the final part was about FCTC. Data collection was carried out between May 2010and May 2011. In the analysis process each interview was considered as a separate case and then compared to other cases to ascertain variations in answers. All 40 members (100%) of the panel completed the entire process. All the participants had a consensus on tobacco control program in Iran. They believed the prevention programs to be important priorities in this regard. Tobacco Company as a governmental organization is believed to be the main barrier against tobacco control activities in Iran, and banning sales of tobacco to minors and controlling its smuggling are important factors for decreasing the supply of tobacco products. It is essential to implement comprehensive tobacco control law in Iran. It is essential to implement comprehensive tobacco control law in Iran that covers all the priorities mentioned above. Considering the chronological aspect of law implementation, priority should be given to the more important parts of the law.

This study aimed at evaluating HRCT pulmonary manifestationsin children with Common Variable Immunodeficiency (CVID) hospitalized inthe Pediatric Ward of Masih Daneshvari Hospital during a 10-year period. This study aimed at evaluating HRCT pulmonary manifestations in children with Common Variable Immunodeficiency (CVID) hospitalized in the Pediatric Ward of Masih Daneshvari Hospital during a 10-year period. This retrospective study evaluated 25 children hospitalized with the diagnosis of CVID in the Pediatric Ward of Masih Daneshvari Hospital from 2001 to 2011 and their pulmonary HRCT scans were evaluated. The most common pulmonary HRCT findings were lymphadenopathy (66.7%), bronchiectasis (50%), air trapping (33.3%) and peribronchial wall thickening (33.3%). The highest percentage of CT-scan findings was detected in patients aged 13-17 yrs. Most of the pulmonary changes due to CVID are preventable or treatable. Also, it is possible to prevent irreversible complications of disease if it is diagnosed early. Therefore, HRCT is strongly recommended as an accurate and effective method for monitoring and fast recognition of pulmonary manifestations of the disease especially bronchiectasis which is a very common finding indicative of poor prognosis

Pericardial cysts are rare congenital abnormalities with a reported incidence rate of 1/100,000 males. The most common locations of these cysts are middle mediastinum and right cardiophrenic angle. Pericardial cysts are usually asymptomatic unless a complication or rapid growth occurs. Diagnosis is generally made incidentally or using combined radiological X-ray, contrast Computed Tomography (CT), and echocardiography imaging. Various forms of treatments include observation, needle aspiration, and surgical excision of the cysts. Recurrence of the disease is common when aspiration approach is selected. Herein, we present a case of pericardial cyst affecting right cardiophrenic angle in a 36 year-old man with an atypical right chest pain and chronic cough. Finally, the patient was treated successfully using surgical approach.

Large cell calcifying Sertoli cell tumor of the testis (LCCSCT) is a rare tumor that is usually benign and multifocal. It may be associated with hereditary endocrine anomalies such as Carney's and Peutz-Jeghers syndromes. It is a rare histological variant of sex cord stromal tumors. It is exceptional in elderly men and the outcome is rarely fatal. We report a case of LCCSCT in a 44 year-old man with fatal outcome. The tumor involved the right testis and several areas of the tunica albuginea were grossly invaded. It composed of cords and trabeculae of large polygonal cells embedded in a myxoid and fibrous stroma with areas of calcification along with nuclear atypia, necrosis, and abundant mitoses. The Peutz-Jeghers syndrome (PJS) is known to be commonly associated with ovarian tumors. However, its association with testicular tumors is uncommon. To the best of our knowledge, this is the eight such case being reported in the literature. Our case, to our knowledge, is the only other reported case of malignant large cell calcifying Sertoli cell tumor with clinical and histopathological features related to aggressiveness, such as large tumor size, cellular pleomorphism, high mitotic rate, necrosis and aneuploid deoxyribonucleic acid. Such characteristics are not found in benign large cell calcifying Sertoli cell tumors

Mucopolysaccharidoses (MPSs) are a group of hereditary diseases characterized by accumulation of Glycosaminoglycans (GAGs) due to deficiency or malfunctioning of lysosomal enzymes. Difficult intubation is anticipated in these patients because of a variety of anatomical and functional abnormalities. We report the successful use of sevoflurane and laryngeal mask for airway management of a 15 year-old boy requiring corneal transplantation surgery.