Tehran University Medical Journal

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Listeria infection is still a dominant infectious problem in Iran, particularly in abortion. Looking for a paraclinical technique other than bacterial methods (which is not always available) lead to serological survey indicating estimation anti listeria antibody by Immunoflourescent test. Unfortunately the false positive results due to cross reaction between "listeria monocytogenesis" and certain gram positive cocci, made it an unacceptable technique. Here we performed a test to extract the Listeria M. (Stranin 4a and 1b) soluble antigen and detecting the antibody by counter immunoelectrophoresis (CEI). The results indicated that of four bacterial soluble antigen fractions F1 and F3 were significantly positive with patients sera. We will discuss using the soluble antigen by CEI technique may be helpful to omit the false positive reactions.

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Thyroid scintigraphy has been helpful in detecting and evaluation of thyroid nodules. Sodium pertechnetate Tc-99m is the most commonly used radionuclide for thyroid imaging because of its general availability, favorable dosimetric characteristics and low cost. But, there are reports of occasional disparity in isotope uptake in lesions compared with radioiodide. In order to determine percentage and clinical significance of this disparity, we screened 101 patients with solitary functioning nodules using sodium pertechnetate TC-99m in comparison with subsequent Iodine-131 scan in research institute for nuclear medicine. We conclude that sodium pertechnetate TC-99m is a reliable radiotracer for the detection and evaluation of thyroid nodules and there is no need for the subsequent Iodine-131 scan.

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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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Basic physical principles of nuclear magnetic resonance imaging (N.M.R.I), a nonionizing medical imaging technique, are described. Principles of NMRI with other conventional imaging methods, ie, isotope scanning, ultrasonography and radiography have been compared. T1 and T2 and spin density (S.D.) factors and different image construction techniques based on their different combinations is discussed and at the end physical properties of some N.M.R images is mentioned.

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Of 14 cases who underwent this operation only in one of them because of infection in operation site, we had to extract the expander. Also, in the first day of the operation that we injected serum inside the expander of two other patients, the wound opened up and the expander appeared and came out automatically. The remaining ten patients have tolerated the operation after treatment period without any complications and good result was achieved. This method in covering up skin lesions and in eliminating burn as well as old wound scars was very effective and the patient become satisfied because there was no need to remove skin from other parts of the body and thus no new scars would have been created. The only problems in this method of treatment were its duration which is needed for injection inside the expander as well as bad appearance in operation region and these problems cause the patients to become depressed and to become isolated from the public for a long period. For the past three years that we used this method for covering skin lesions in different parts of the body and even in treating extensive spots and the hemantrium we achieved excellent results and the report will subsequently be submitted.

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Documented war experiences have provided early descriptions of different group of psychiatric features. A combat soldier with palpitation and chest pains was felt to have a functional cardiac disturbance, called soldier's heart. Anxiety and other symptoms indicating increased arousal were called shell shock and were thought to be related to lesions in the central nervous system (CNS). Describing analytically war events could operate with an enormous emotional intensity breaking through the ego defences and flooding it with an uncontrollable anxiety. Post traumatic stress disorder (PTSD) delineates a syndrome developing after a discrete traumatic event in a stress setting. Diagnostic conceptualization which tie PTSD to stress and trauma invariably involve two different approaches from two different theoretical bases: the concepts dealing with trauma on the one hand (which could effect on CNS) and those dealing with stress-response theory on the other. Author emphasizes on viewing the patients who complain of war psychiatric effects in three categories: (1) Non PTSD diagnoses that the patient ought to be treated accordingly (2) Traumatic neurosis which has overwhelming war stress related emotional aspects and is occurred in predisposed individuals. This category is suggested to be classified as post war stress disorder specifically, to be differentiated from other post traumatic psychiatric categories. (3) Author also suggests the third category as post traumatic war stress syndrome which is thought to have organic origin. Symptoms such as hyperacusis, hyperirritability, tinnitus and particular type of head aches which are mostly refractory to treatment confirm the hypothesis.

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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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The appropriate time for performing transfers in radial nerve palsy is somewhat a controversial matter. Brown suggested that it would be advisable to proceed early with the full component of tandon transfers when there is a questionable or poor prognosis for the nerve repair. For example, when there is a nerve gap of greater than 4 cm or when there is a large wound or extensive scarring or skin loss over the nerve. He recommended ignoring the nerve and proceeding directly to tandon transfer

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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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This deformity is often reffered to as thumbclutched hand, but a better term is the congenital clasped thumb. The congenital clasped thumb is associated with several well-de-fined syndromes, although it may also present as an isolated abnormality. Weckesser, Reac, and Heiple called it a syndrome and divided the syndrome in to four groups. In group I, the thumb is deficient in extention only. In group II, flexion contractur combine with deficient extention. In group III, the thumb is hypoplastic, and tendons and muscles are deficient. Group IV consists of the few remaining cases that so not fit into the first three groups. Group I cases are found three times as frequently as group II cases, while group III and IV cases are five times less frequet than group II cases. The congenital clasped thumb is twice as common in males as in females and is nearly always bilateral. During the early weeks of life, an infant frequently clutches the thumb and releases it intermittently for spontaneous motion. However, by the third or fourth month of life, the normal child ceases to clasp his thumb under his fingers. If the clasping persists and normal independent action of the thumb dose not develop, the syndrome of congenital clasped thumb is present

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We have studied the effect of amitriptyline, a tricyclic anti-depressant drug on several immune parameters of the Balb/c mice in order to evaluate its immunomodulatory effects. Results showed that amitriptyline will potentiates all of the immunocytes functions except for the production of PGE2 by LPS stimulated monocytes. We have also showed that amitriptyline can normalize the immunosuppressive effect of dexamethasone on mice (experimental stress). These results suggest that one of the mechanisms of action of the tricyclic anti-depressant drugs might be through the modulation of the immune system which has been suppressed by stress or distress

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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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Histiocytic syndromes have been studied and investigated in these recent years for their cell origin, morphology, pathology, histochemical, immuno-phenotype characteristic, and their nomenclature, but the results of all these studies are confusingly, vague and not acceptable for all scientists and pathologists. Histiocytes very in the morphology, duty and their immunological behaviour. In different lesion these cells are in the form of mononuclear, foamy cell, macrophages like plasma cell and giant cell with many nuclei. When considering malignant Histiocyte cells and benign reactive histiocytes are both present in malignant histiocytic lesion, one can recognize the diagnostic problems of the pathologist. Markers for recognizing histiocytes are numerous and are increasing rapidly, in spite of that monoclonal antibody investigation, and genetic molecular method, the results as yet are not satisfactory. We have to accept that the new method are not at all sufficient and we have to look for a better method which is more sensitive to histiocyte for diagnosis of numerous histiocytic syndromes. In this paper, we discuss the difficulties on encountered in the diagnosis, and problem in defining and nomenclature of these syndromes and, some efforts are made to present the most acceptable classification for them

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Midazolam (Dormicum) is a benzodiazepine in general anesthesia. Midazolam is very suitable for premedication, induction, and maintenance pronounced anxiolytic action, sedation and amnesia, rapid onset of the action, virtually no impairment of cardiovascular or respiratory parameters in therapeutic doses, short duration of action, and excellent local tolerance are among its most important effects. the rate of midazolam in intravenous anesthesia has been highly confirmed. The required dose for the induction between 0.15 and 0.6 mg/kg, depending on the intervention, patient status (age and condition of his/her health) and premedication.

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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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Administration of a precise amount of activity in thyroid gland radioiodine (¹³¹I) therapy is of prime importance. Several methods for this purpose have been suggested and used over many years. In this paper, a method for required ¹³¹I activity calculation for each case has been proposed. Major factors affecting ¹³¹I calculation such as gland volume, integral dose, and prescription index have been described. Using the method, ¹³¹I activity or any other radioisotope activity required for a certain case can be determined with a good estimate.

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201 blood samples were collected by cluster sampling from 7-11 years old children and measles antibody titer was measured by hemagglutination inhibition test. Despite testing all the sera, the results were analysed on the 139 samples that had documented vaccination records and no history of measles. Among 139 children 44 had received 2 doses of vaccine one dose before 12 and one after 15 months, 64 had one dose after 15 months, 29 had only one dose before 12 months and 2 had not received vaccine. The antibody titer of the first two groups had no significant difference with those that had received one vaccine dose, before the age 12 months (P<0.001). There were no significant differences in the titer of antibodies with time elapse in none of the vaccination histories. This may be due to efficacy of vaccine and also circulation of wild virus in the community. Regardless of the history of vaccination, 95.5% of children had immunity to measles (titer?3). Considering the results if the current strategy of vaccination implemented completely, the status of immunity would be satisfactory.

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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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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.