Tehran University Medical Journal

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From hygienic and economical point of view, drug therapy and prophylaxy in infectious diseases are of great importance. After the world war II, a reduction in the efficacy of sulfonamide in the treatment of shigellosis was observed and later on it led to a survey on drug resistance and the way of its transmission. The aim of this survey, during which 100 cases of gram-negative bacteria were identified, is to study the drug resistance of this bacteria against five types of aminoglycosides by antibiotic sensitivity test (disc-diffusion). Out of 100 strains, 47% were resistant to gentamycin, 70% to kanamycin, 82% to streptomycin, 53% to tobramycin, and 8% to amikacin

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Many years ago the treatment of sarcoma was radiotherapy up to 2000-4000 rad. This treatment was very complicated, due to producing neoplasm after radiotherapy. By this method of treatment of osteosarcoma, the rate of survival became about 20% (two years). The second method of treatment was chemotherapy for a period of 2-5 weeks that amputation was performed afterwards. By chemotherapy, the rate of being alive reached up to 25-27% (five years). Right now, the best treatment for sarcoma is limb salvage. In our report, the chance of being alive in chondrosarcoma was about four years. This was nearly the same as that of the other institutes in the world especially in America, Europe, and Japan. The rate of recurrence was also more than that from different parts of the world. The survival rate in osteosarcomatic patients was about two years less for males the females, and it was more in tall people than short ones. The survival rate of the patients with giant cell tumor was more than osteosarcoma up to five years, and it has no recurrence or metastasis

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The treatment of choice for bladder tumors is TUR, but because of high incidence of recurrence in these tumors, various treatments are suggested. In one study, 32 patients involved with superficial T.C.C. of bladder selected and divided in two equal groups. In the first group, after T.U.R, 10 million IU of a alpha-interferon was injected into the bladder through a catheter and in the other group, after TUR, they treated with injection of BCG into bladders. The results of these two drugs in prevention of recurrence and their side effects were studied and compaired

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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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Clozapine is the first antipsycotic drug with a great efficacy. Thirty to fifty percent of treatment-resistant schizophrenics markedly improved with clozapine. Approximately, 25% of long-term patients, treated with clozapine, could be discharged. This improvement included negative as well as positive symptom areas. Clozapine produced no extrapyramidal side effects. Tardive dyskinesia, a major side effect of antipsychotics is not probably induced by the drug. Agranulocytosis that occurs in 1-2% of patients treated with clozapine is the most dangerous side effect with a high mortality rate. So, weekly monitoring of white blood cell count is necessary for safe and effective use of clozapine because fatal outcomes can be reduced and even completely prevented by the early detection of the reduction in white blood cell count. Clozapine offers considerable promise for better antipsychotic effect than currently available drugs, but its high cost causes substantial problems for patients with limited financial income

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Ito cell (Fat Storing Cell=FSC) is one of the cells which forms the liver sinusoidal wall it also forms the connective tissue of the liver. The cell was first identified in 1963 by a scientist named Ito. It will get damaged due to the plasma fat increase which is resulted from a diet of corn oil 10% and fish oil 10% the damage wil be in form of fat storing cell. The FSC morphology may represent the damage to the liver tissue. The biopsy of an infant's liver reveals that, Ito cell has a very small cell body which contains a core in the middle occupying 2/3 of the area of cytoplasm its basal cytoplasm is hollow and very clear. This study indicated that not only the ultrastructure of Ito cell is circular and three dimensional, but also its presence may show the damage to the liver tissue.

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This article aim is to introduce a case of PAPVC (partial anomalous pulmonary venous connection). The patient was a 25-year-old women who had dyspnea and palpitation. She expressed no special disease, no past medical history, and no drug usage, but her brother and her aunt had the above-mentioned history. In the physical examination, lungs were clear and the heart had S2 splitting, and there was a systolic murmur in the pulmonary area. Her liver could be palpitated two centimeters below the costal edge, but she didn't have any hepatomegaly. In cardiac catheterism, she had PAPVC, atrial septal defect (ASD), and mitral valve prolapse (MVP). The patient underwent operation had left pulmonary vein was separated from the superior vena cava and anastomosed to the left atrial auricle. By means of the pericardial patch, the left atrium became enlarged and ASD was closed. She was in a good condition after surgery and left the hospital without any complication with a good condition and recovery and had no problem any longer.

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In this study, 1600 pregnant women who had referred to two prenatal clinics (Imam Khomeini and Mirza Kochek-Khan) were investigated. Ninety cases of asymptomatic bacteriuria were observed 77 of those cooperated with us until the end of our study. The subjects, who were within the 14-36 weeks of gestational age, were randomly divided into two groups: Group A received the medicine (Amoxicillin) in a single-dose (3gr.) and, group B received it within seven days (1gr. TDS). The rate of recovery (65% in group A and 56.8% in group B), based on chi-squared test, showed no significant difference (P=0.747%). According to the results of this study, we can conclude that single-dose treatment has the same value as a seven-day treatment and the advantages such as decreased total dose, lower cost, and a better patient compliance.

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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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Alpha-interferon therapy has been approved for treatment of chronic hepatitis C and B. Candidates for treatment are patients with well-compensated liver disease and histologic evidences of chronic hepatitis who have demonstrated abnormal aminotransferase levels for more than 6 months. From 30 patients with chronic hepatitis with diseases prolonged more than 6 months, we selected only 16 patients with necessary criteria for interferon therapy (10 patients with chronic HBV and with evidence of viral replication, and 6 patients with chronic HCV). Dose of interferon used for hepatitis B was 5mu TIW for 16 weeks and for hepatitis C was 3mu TIW for 24 weeks. At the end of treatment, HbeAg was eliminated from 3 patients. From 10 patients chosen, from none of them the HBsAg was not eliminated at the end of 4 months treatment. In comparison with 10% elimination of HBsAg in treated groups that have been reported in other countries, our results demonstrated that interferon therapy is less effective in Asian patients in comparison with western patients.

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The present survey covers a number of 91 Iranian repatriated war prisoners who, six months after their freedom, approached three psychiatric clinics in Tehran during 1989 and spring 1990. Of these, 34 persons (37.4%) who showed higher symptoms of disorders were hospitalized and 57 (62.6%) who showed milder signs of disorders were carefully diagnosed mentally and psychologically as outpatients. The prevalent disorders revealed by this study were adjustment disorders (48.3%), mood disorders (22%), schizophrenia (11%), anxiety disorder (9.9%) and organic mental disorders (7.7%). The survey showed statistically the existence of a meaningful relation between the disorder severity with such factors as negative opinion of the prisoner's family on his going to the war front, and observance of martyrdom of co-fighters by the patient. However, no significant relation was observed between the severity of disorders and such factors as being involuntarily dispatched to the front, duration of captivity, type of being captive (singular or in group), having a previous record of solitary imprisonment, observing the treason of co-fighters during his captivity.

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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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We report our experience with 124 patients were referred 70 our urology clinic in Sina hospital for urinary retention. Serum PSA analyzed by using a monoclonal assay. All patients underwent digital rectal examination. The patients devided in 3 groups: Group 1 (87 men) with a serum PSA level less than 4 ng/ml, group 2 (26 men) with a serum PSA level 4-10 ng/ml and group 3 (11 men) with a serum PSA level greater than 10 ng/ml. After prostate biopsy and trans urethral resection or open prostatectomy, of the 87 men in group 1, one man had cancer of the prostate, of the 26 men in group 2, 2 men had cancer of the prostate and of the 11 men in group 3, 9 men had prostate cancer.

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Psoriasis is a chronic, inflammatory and proliferative skin disease that has a wide distribution throughout the world. The immune system plays a critical role in developing this disease. In this survey, we have studied 50 patients suffering from Psoriasis and 50 control subjects for various immunological factors, simultaneously. Anti-stratum corneum (SC) antibody was evaluated by immunofluorescent technique that showed a high significant level of it in patients (P<0.005). The titer of immunoglobulins (IgG, M, and A) measured by radial-immunodiffusion (RID) method was also higher in normal population. CIC estimated by PEG precipitating technique demonstrated high concentration in patients. TNF, a cytokine with strong performance to induce inflammation, had no significant rising amount in patient sera, but in synovial fluid in Psoriasis arthritis may have higher levels. We discuss that due to immunological findings we consider that Psoriasis is probably as an autoimmune disorder. The prevention, treatment and prognosis of the disease may follow the same procedures as other autoimmune diseases and further investigation will be helpful to achieve the above goal

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Pseudomembrane colitis (PMC) and antibiotic associated colitis (AAC) are acute disease of the colon. In the case of in adequate treatment, the disease will often become chronic and my lead to the dysplasia of the epithelial cells of the infected areas. Previously because of poor knowledge. Treatment in this case, one of the method for treatment was surgical ablation of the large intestine while the patients could have been treated with oral vancomycin. In this study the following results were obtained: Out of 2517 enterocolitis patients under study, 1384 were men and 1133 women. By anaerobic culture method, 132 cases C.Difficile were isolated from the total samples and Hela cell culture method, toxin was determined in 36 samples (1.43%).

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Different opinions exit in histological typing of bone cysts. Epidermoid cysts are very rare as the small numbers of published cases indicate. They arises following preceding trauma exclusively in distal phalanges and skull. The roentgenogram shows a round osteolytic resion with no trabecular pattern. We observed 2 cases of epidermoid cyst of finger in Imam Khomeini hospital central path department the patients were young workers complaining from local pain several months after trauma. Bone curettage was performed.

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Leiomyoma of the esophagus is rare, but it is the commonest among the benigh tumors of the esophagus. Among 95 cases of esophageal tumors, there was just 4 cases of Leiomyoma (3 were females and 1 was male) and this is contrary to the reports already published. Main symptoms of esophageal Leiomyoma include: Disphagia, pain and hematemesis from the above mentioned cases 1 tumor was in the thoracocervical zone, 1 in the middle third and the other 2 in the lower 3rd of the esophagus. Tumors were single. The youngest patient aged 30 and the eldest aged 60 years. Radiography of the esophagus (Barrium meal) is the best diagnostic method, in which a round, characterized defect is seen. Ultrasonic endoscopy and CT-scan are useful too, but biopsy is not recommended. From the above-mentioned patient, 2 cases under went esophagectomy and in the other 2, the tumor was excised itself. There wasn't any mortality in the procedure

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The autopsies, which have been performed within the last 50 years, have revealed that real prevalence of prostatic carcinoma is more frequent than clinical one. The real prevalence of prostatic carcinoma, is prevalence combination of carcinomas which have been revealed clinically (They have been confirmed by autopsy or by operation) and the prostatic latent carcinomas are those, which are found in autopsy or randomly in the biopsies taken for hyperplasia. But they have no clinical syndromes. In order to review prevalence of prostatic latent carcinoma in Iran, all prostatic lesions (Including hyperplasia or carcinoma) were studied in Imam Khomeini medical complex during 10 years (1981-91), in university Jihad center and medical center of Iran within 2 years and in Yazd faculty of medicine within 3 years (1981-84). The total cases were 1110 among which 1085 cases were selected upon reviewing for statistical analysis. At first all lamellas were studied, then the ratio of adenocarcinoma to total prostatic lesions were analyzed and types of carcinoma and their percentage in total cases were identified. Finally the prostatic latent carcinoma and its percentage in total malignancy cases were presented

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Yersinia enterocolitis causes a wide spectrum of human diseases including gasteroentritis, which is the most frequent of its manifestation. Other diseases and clinical syndromes resulting from Yersinia enterocolitica are septicemia, mesenteric lymphadenitis, apendisitis, exudative pharyngitis, reactive artiritis, nodosum erythema and rarely Reiter's syndrome. In many countries such as western European, Scandinavian and north American countries, Australia and Japan the role of Yersinia enterocolitica particularly the 0:3, 0:8 and 0:9 serotypes in human diseases have been clearly identified. In spite of significant development in the field of separating Yersinia enterocolitica from feces as well as from the environmental specimens during the last decade, there has been only one documented report of isolating Yersinia enterocolitica in Iran in 1977. Thus we decided to test 300 samples of feces within 5 months. In this method, CIN agar as a selective and special medium and Mac conkey agar as classic medium were used. Also cold enrichment method in PBS (pH=7.8) was used. In order to determine importance of enterocolitica, we separated other pathogens of intestine such as salmonella, shigella and entropathogenic E.Coli. The achieved results from abundance points of view are as follows: 17 strains of EPEC (5.66%), 9 strains of shigella (3%), 8 strains of Yersinia enterocolitica (2.66%) and 6 strains of salmonella (2%)

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The newborn who is born before terms is a candidate for the development of idiopathic respiratory distress syndrome. The intense hypoxia and acidosis that ensue as the consequence of inadequate alveolar-capillary exchange of oxygen and carbon dioxid may prove fatal antenatal steroid therapy can affect RDS (Respiratory Distress Syndrom) and its complications. The newborn before 34 weeks have a significantly lowered incidence of RDS and neonatal mortality from RDS with antenatal steroid therapy. In a retrospective study we compared 37 preterm infants whose mothers had received corticosteroids to 29 similar but untreated infants. The study showed that antenatal steroid therapy reduced neonatal mortality from RDS more than reducing the incidence of RDS and further it was concluded that this beneficial effect was more significant in female fetus than male fetus, but it was not significant statistically