Tehran University Medical Journal

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57 women affected by abortion or threatened abortion were investigated in view of antitoxoplasmosis antibodies by immunofluorscence. 11 women who have aborted for the first time have positive titer of polyvalent antibodies more than 1/400. 77.3% of these women have IgM titer greater than 1/20. The highest percentage of abortion was in the third month of pregnancy and this is probabley related to the increase in the percentage of women who have IgM titer greater than 1/20 and who were in the acute stage of the disease. The percentage of women with a positive titer of IgM titer greater than 1/20 and who were in the acute stage of the disease. The percentage of women with a positive titer of IgM of greater than 1/20 decreased from the third month of pregnancy. It seems that the care and follow-up of pregnant women with toxoplasmosis whether from antibody titer or from its type is of great importance. It is preferable to titrate antitoxoplasmosis antibody titers in the sera of women before pregnancy.

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Carnitine is a water-soluble quaternary amine which increases the long-chain fatty acid metabolism by facilitation of their transport to the oxidation site (mitochondria). Carnitine most likely is present in all animal species, in many microorganisms, and in many plants. In this study, we determined the carnitine level of sera in pregnant and non-pregnant women by segade modified method. Average concentration of carnitine in the sera of fifty pregnant women was about 25/83 umol/I: First trimester-30.96 umol/I. Second trimester-29.11 umol/I. Third trimester-25.11 umol/I. concentration of cholesterol and triglyceride in the above-mentioned group was the following: Cholesterol: 258.84 mg/dl triglyceride: 267.02 mg/dl. The above values show that the carnitine level in sera of pregnant women decreases significantly and this decrease is tolerated well by pregnant women. According to our results, the serum carnitine concentration in pregnant women gradually decreases as gestation proceeds. So that the end of this period, is half of its concentration before conception. During pregnancy, there was an inverse correlation between carnitine level and that of cholesterol and triglycerides. Decrease in carnitine concentration and increase in cholesterol and triglyceride levels may be due to the following factors: 1) Increase in FFA oxidation in pregnancy. 2) Hormones. 3) Dilution of the blood. 4) Decrease in Fe storage in pregnant women.

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Four patients were studied for intercostals nerve blockade in cholecystectomy. All of the patients were poor risks (Class 4) and received premedication before the procedure. Intercostals nerve blockade (ICNB) of the 7th and 10th thoracic nerves on the right side was performed with lidocaine 1% plus adrenaline 5 ml. at each segment, T7-T10 (a total dose of 20 ml). Ventilation was controlled using intermittent positive pressure throughout the observation period. Heart rate and arterial pressure remained within normal limits in all patients.

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This study has been conducted on the path reports of diagnostic curettage carried out in Mirza koochek-khan hospital during the 6 months of the year 1989 (April to September). The reports examined have been further classified into incompelete abortion, diagnostic currettage and others. A total number of 645 women have had D&C according to the above criteria. In this period of time, incomplete abortion had the highest rate (34% of all D&C's), of which 62.5% were under 20 years of age and 22.6% were primigravida. The ratio of total abortion to the number of deliveries was 9.8% and post-delivery retention of placenta constituted 4.8% of all D&C's, with the highest rate amongst the age group of 15-19 years old, who mostly had home deliveries. The incidence of hydatidiform mole was 3.07 per 1000 deliveries, out of this number, the highest rate (50%) belonged to the age group of 20-24 years old. The above incidence is 6.4 times more than the U.S. incidence and 0.9 times less than the incidence reported in other Asian countries (6, 8, 10). Knowing the complication of unplanned abortion such as perforation of the uterus, infection, hemorrhage, adhesions (synechiae) and secondary sterility, special attention should be paid to the diagnosis of high-risk pregnancies in prenatal clinics.

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Patients referred to Amir-Alam hospital, affiliated to Tehran University of Medical Sciences, were given anesthesia through two ways inhalationally (by means of sodium thiopenton) and intravenously (halothane+N2O). In this article, we discuss the results obtained from the patients' bronchoscopies. According to our study, inhalational anesthesia have had desirable effects since halothane has a positive inotropic effect, and N2O, due to its quick onset, has a high tendency to combine with halothane. Most of our cases were children who showed a high tolerance during an inhalational anesthesia. The overall mortality rate of intravenous anesthesia was two cases in contrast to that of the inhalational anesthesia which had none. It can be concluded that: 1) Although many cases necessitate bronchoscopy, their results are negative. 2) The incidence of bronchial bleeding, due to foreign bodies, is more in young boys than young girls. 3) There seems to be no difference in bronchoscopic results in different months of a year

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IgD myeloma is very rate. It differs from multiple myeloma of other classes in several aspects and its laboratory diagnosis may be difficult, as total plasma protein concentration is often normal, and a paraprotein peak may not be easily demonstrable by the conventional electrophoretic techniques. We report here two cases of IgD myeloma investigated in this laboratory. Immunochemical, biochemical, and hematological studies were carried out: Serum total protein values were within normal range. Quatitation of serum immunoglobulins revealed a decrease in the level of IgG, IgA, and IgM. Bence Jones proteinuria of l type was present in both patients. Serum immunoelectrophoresis, using specific antisera, showed the presence of IgD l paraprotein the diagnosis of IgD myeloma was made after further investigations. Our findings indicate that all patients who have been suspected to have multiple myeloma should be investigated for IgD and IgE myeloma

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A 30 years old female presented with dyspenea, tachycardia and post sternal pain of one year ago in ECG and echocardiography pericardial effusion is suggested there was a large mass M.20×12×5 cm in mediastinum in thymic zone and thymus was not present. The mass was well circumbscribed and encapsulated without invasion to other viscera. The pathology reported as a thymolipoma

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In this survey, 55 patients were studied in a period of six years for having the anesthesia in the sitting position. In this position, the surgeon will had a better access to the location, whose damages have been sustained, so less damages would be given to the healthy tissues. For the patients, due to their critical general conditions, one week prior to giving anesthesia to the posterior fossa, operation in the sitting position the right ventriculoatiral shunt was placed. For preventing the fall of blood pressure, a bandage was placed in the lower limbs after inducing anesthesia and changing supine position to sitting position. Before the induction, central venous pressure was measured for treating the air embolism. The head of catheter was placed inside the right atrial. Premedications such as atropine, pethidine, and inductive agents like thiopenton, and muscle relaxants, maintained with halothane and nitrous oxide. All of the patients endured this condition without the fall of blood pressure and air embolism

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The diffractive multifocal IOL provides simultaneous bifocal imaging by utilizing both diffractive and refractive optics. In both distant and near vision, there is a clear highly focused image on the retina. The second image is highly defocused, providing only faint background illumination. A small amount of the light goes to the higher orders of diffraction which are not perceptible by eyes. The bright spot produced by a zone plate is so intense that the plate acts much like a converging lens. There are also fainter images corresponding to focal lengths f/3, f/5, f/7, ...

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For monitoring of renal transplant function, serum B2m was evaluated in 23 recipients. According to clinical diagnosis the patients were in four groups: 1) Successful renal transplant the mean concentration of SB2m pretransplantation was 73.1±26.1 mg/L but decreased to nearly normal level (4.43±1.17 mg/L) within 24-48h and then reached to 3.1 mg/L duting 20 days after transplantation. 2) Renal dysfunction (except rejection) the maximum changes of SB2m was 1.1 mg/L/day and no significant changes of SB2m were found between this group and group 1. 3) Accelerated and acute rejection during immunological rejection crisis, SB2m level increased and after response to antirejection therapy decreased. The daily changes of SB2m allowed to diffrentiate renal dysfunction fom rejection in 84% of cases. Moreover according to SB2m fluctuation levels, SB2m had a prognostic pattern for acute rejection due to significant differences between the level of SB2m on the day of clinical diagnosis of rejection and 4 days previously (P<0.025), and also 2 days before rejection (P<0.025), while this pattern was not found for serum creatinin and BUN.

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Alterations have been found to occur in every component of immune response during an anesthesia and surgery. These alterations represent the body's general physiological responses and are mainly depended on the extent of surery as well as on blood transfusion. Basically, the immune response to an anesthesia and surgery is a beneficial reaction needed in local defences, wound healing, and preventing the body from making auto-antibodies against its own tissues. The responses may, however, contribute to the development of post-operative infections and spread of malignant disease, and opporturistic agents.

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Cardiac rupture, particularly rupture of the left ventricular wall, has a very high mortality rate. In this occasion, even if injured patients being alive when carried to the hospital, many of them will die due to following possible reasons: severe bleeding, cardiac tamponade, wasting time for routine and usual diagnostic procedures or transferring the injured to other hospital equipped for cardiac surgery. The only way to avoid these dangerous hazards is prompt thoracotomy and repair of the wound, which must be done in any surgical ward available. We report a case of cardiact rupture due to penetrating injury caused by a slender sharp object, passing through the heart anteroposteriorly. The patient was successfully rescued. This report indicates that in hospital, where no facility for cardiac surgery is available, this kind of emergency surgery for cardiac rupture is very indicative and may save the life of injured patient.

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Association of Helicobacter pylori with pathogenesis of gastrointestinal disorders (including gastritis in children with special endoscopic anteronodular) have significant importance in prognosis of infection resulting from this bacteria in children. However, in this research it was found that there is significant and clear correlation between nodular anteritis (in endoscopy) and active presence of lymphoid follicle (in histology findings with replacement of H.pylori) was noticed in children. In this research 14 persons (34.1%) out of total patients were positive. The average age of positive H.pylori patients was clearly higher than negative H.pylori patients. So increase of possible infection occurrence together with increase of age in children was confirmed. Meanwhile, there is significant relationship between presence of bacteria and clinical symptoms particularly epigastric pain, vomiting, and nausea. One of the other results of this study was confirming the relationship between history of gastrointestinal disorders in immediate family members and infection resulting from H.pylori in patients.

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In this work, we tried to know something more about the embryotoxicity effects of the doses of 50, 200, 400 mg/kg/day of ranitidine of (H2 antihistaminic agent) by intraperitoneal administration on mice. The studies were performed on albino mice kept under specific conditions and a constant dark-light cycle at 24+1C and 55+5% relative humidity. Generally, the animals were acclimatized for four weeks before mating. Two female mice at 12-14 weeks of age were placed overnight with a male of proven fertility. The day on which a vaginal plug was found, was taken as day one of pregnancy. Also the vaginal smear was prepared for further proof. Treatment of pregnant females was started from day 7 and continued up to the 15th day of gestation and then on day 18 they were necropsied for routine teratological observations. The live fetuses were weighed and inspected for gross external abnormalities under a dissecting microscope. Resorption plus dead fetuses less than 6mm of length were designated early death and dead fetuses of more than 6mm of length were consequently called late death. The statistical study was done by student t-test. One-third of the fetuses were fixed in bouin's fluid to detect visceral malformations by the rasor- section technique. There was no significant difference in the frequency of late death between the control groups and the groups given ranitidine. Differences were observed in the number of implantation sites except for 400 mg/kg/day. Data pooled from all experimental groups clearly show that pig tail, deformed cranium, low body weight and skeleton, unshaped external ear and jaw and polydactyly are the most common external abnormalities. Results of this study show the hazards o the ranitidine used during early pregnancy.

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In this study, counter immunoelectrophoresis (CIE) and latex agglutination (LA) were employed to evaluate rapid detection of streptococcus group B (GBS) specific antigens in sera, urines, CSF and patient's blood cultures of infants suspected of septicemia and meningitidis. Out of 530 specimens which were investigated 73 blood cultures were found to be positive, including 4 (5.5%) specimens from these infants were positive for strep group B. GBS was also detected in the CSF of 1 specimen from these 4 infants. CIE was conducted on sera, urines and CSF of these patients and the number of positive specimens were found to be 3, 3 and 1 respectively. LA was also conducted on the same specimens and the number of positive specimens were found to be 3, 4 and 1 respectively. Detection of GBS specific antigens by LA and CIE on the supernatants of blood cultures after 24 hours incubation showed that all the 4 specimens were positive an indication that the sensitivity of these two imunological methods in 100%.

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The basis of acupuncture is still being studied from many different aspects. Some preliminary views include: 1) The analgesic function of acupuncture derives from the clashing of the biochemical lines of acupuncture and those of the pain stimulus in the transmitting processes of the central nervous system, the former overriding the latter. 2) Acupuncture strengthens the cerebral cortex's inhibiting processes and raises the pain threshold. 3) Acupuncture has an effect on the reticular structures of the brain stem and the limbic system of the cerebrum. 4) Acupuncture stimulates the sympathetic nerve centers of the hypothalamus, and it's functions are mediated by the sympathetic nerves. 5) Acupuncture's effect is transmitted through the chemicals in the body's fluids.

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88 patients with drug addition were evaluated for HBsAg, HBeAg, anti-HBC, anti HIV syphlisis and anti-toxoplasma antibodies. 48 of them were male and 40 were female. The range of their ages was between 19 to 49 years and their addiction time were between 6 month to 30 years. The results show that 5.6% of the patients have HBsAg in their blood serum and 40.9% of them have anti-HBe antibodies. All of them lacked anti-HIV antibodies. 17% of patients were positive on FTAabs test and 37.2% of them have anti-toxoplasma antibodies. There fore we can say that the drug addicts could be attacked by some opportunistic disease such as toxoplasmasis and hepatitis, and so their health control are very important because in this way we could reduce incidence of these disease

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Hospital acquired infection have 2 origins: 1) Infections acquired from the hospitalization. 2) Infections that transmit from hospital personnel and those who referred to a hospital. According to the studies approximately half of hospital acquired infection is under the first group. Gram-negative bacilli is of prime importance from all bacteries that caused hospital acquired infection. There are 3 main ways spreading hospital acquired infections include: 1) Auto infections 2) Transmit infections 3-environmental infections. In addition, three following factor's will help to cause hospital acquired infections. 1) Reduced immunologic defenses in patient. 2) Local reducing of immunologic defense. 3) Hospital pathogens. From 7/7/1367 to 30/3/1368 samples from patients were collected from 4 hospitals. Then with use of microbiological methods, identified pathogenic organisms

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Beta Thalassemia major patients receive repeated transfusions in order to compensate anemia and use desferal to remove iron overload. Comparing immunoglobulins and complement components in the serum of these patients with normal range shows a significant increase (P<0.001) in IgG, IgA and IgM and a decrease in C3c and C4. The regression analysis confirms a relation between the numbers of transfusions and the mentioned immunological factors that means increasing the number of transfusions, increases immunoglobulins and decreases the complement. Also, this evaluation shows that use of washed RBC and regular in take of desferal will prevent excessive increase of immunoglobulins or decrease of complement

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In our investigation, rabbit hyper-immune serum to V.cholerae ogawa was absorbed with V.cholerae inaba whole-cells and vice versa. Applying ammonium sulphate precipitation method, mono-specific g globulins were purified and concentrated from the absorbed whole serum. These antibodies were fixed on staphylococcus cowan 1 NCTC-8325 whole-cells, using different chemical fixatives. It was observed that maximum fixation of g globulin to protein-A was achieved by 1-propanol 50% at 3 hours, which revealed through single radial immuno-diffusion techniqe. The rectal swab samples were cultured in an enrichment bile-peptons broth. After 5 hours 37°C while agitations, one drop of each sample was mixed with one drop of vibrio-cholerae bivalent mono-specific coagglutination reagent (VBCR). The results were read after 2 to 3 minutes. Finally though statistical analysis sensitivity and specificity of coagglutination test were calculated to be 95.1% and 99.2% respectively, when compared to positive & negative controls and conventional culture methods. Using VBCR, coagglutination test can be therefore considered as a simple, reliable and rapid method to detect V.cholerae O1 in the stool of patients in endemic area and less equipped laboratories