Tehran University Medical Journal

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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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A cross-sectional study was conducted on type II diabetic patients during 1991-1996 in Isfahan. By systemic sampling, 715 patients were enrolled. Variables studied, include: age, gender, duration of diabetes, body mass index (BMI), literacy, smoking habits, hypertension, lipid profiles, fasting blood glucose (FBS), retinopathy, ischaemic heart disease (IHD), proteinuria and type of treatment of diabetes. Prevalence of IHD in males (37.4%) was more than females (32.6%). Logistic regression analysis revealed a direct association between IHD prevalence with age, BMI, hypertension, proteinuria, diabetic retinopathy and type of treatment. Conclusions: 1) The factors mentiond are good predictors of IHD, but genetic influences may also contribute to the risk of IHD. 2) As obesity and BMI are prone to medical manipulation, control of these risk factors may decrease prevalence of IHD.

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AV-node modification by catheter RF energy delivery is treatment of choice in the symptomatic patients with AVNRT. This study included 30 patients with AVNRT (19 women, 11 men). We did slow pathway ablation in 29 cases successfully. Maximum effective energy delivery was 40 watts for 40 msec. 1:1 AV conduction increased from 290±40 msec before ablation to 340±65 msec after ablation. Also AV-node ERP increased from 235±35 msec before ablation to 280±65 msec after that. There was no recurrence of arrhythmia in the group with slow pathway ablation during 28 months follow-up. We did fast pathway ablation in one case. In this patient AH interval increased from 120 to 200 msec, maximum RF energy delivery was 20 watts for 20 msec (2 times). Recurrence of non sustained PSVT occurred in this patients 20 months after RF ablation. There was no case of permanent AV Block. We recommond slow pathway catheter RF ablation in patients with symptomatic AVNRT.

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The aims of this study were to determine incidence and types of observable congenital abnormalities among births of Mirza Kochak-Khan, Imam Khomeni and Shariatti hospitals between first of Novermber 2000 to the end of September 2001.
Materials and Methods: We used neonates that survived for 24 hours after delivery. A questionnaire was specially designed to explore each of the objectives for our study. A group of experts that were thoroughly trained to completed questionnaires by interview to mothers and evaluation of neonates. Data analysis was performed and by Excel and SPSS.
Results: Results showed that congenital abnormalities were present in 205 (3.2 %) of 6424 neonates, from 3 hospitals. The most frequent abnormalities consisted of musculoskeletal defects (37.3 %), Nervous system defects (24.7 %), urogenital defects (24.3 %) head and neck defects (13.6 %).
Conclusion: The result of this study showed that incidence of visible congenital abnormalities ratio in contrast to other countries have not significant difference but the types abnormalities were significant.

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One of the useful function of melatonin is its protective effect against endogenous oxidants. The object of this investigation was to study the protective effect of melatonin on stress-induced gastric lesions.
Results: Our results show that pretreatment of animals with melatonin decrease the stress-induced gastric lesions dose dependently.
L-NAME, a nitric oxide synthesis inhibitor, potentiat the stress-induce gastric lesions and melatonin produced gastro-protective effect against concurrent stress and L-NAME-induced gastric lesions.
Conclusion: Our results indicate that melatonin may produce its gastro-protective effect Via increasing level of nitric oxide.

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Background: Medical education is inherently stressful and demanding to deal with various stressors, which may cause impaired judgment, reduced concentration, lack of self-steam, increased anxiety and depression.

Materials and Methods: A cross sectional study was conducted on 250 medical students from 6 month period to graduation in medical college of Tehran university of Medical sciences in order to assess their anxiety and practice of health behaviors and also the relation between the two variables and some other related factors..

Results: The results of study show that of 6.6% medical students suffer from severe state and 4.9% from trait anxiety. The finding of this study shows that 83.3% of girls and 84.6% of boys have practicing risky health behaviors. No statistical relationships found between, anxiety and practicing health behaviors. The relation between anxiety and health satisfaction was Statistically significant mental and physical (P<0.001).

Conclusion: The information found in this research, can help medical education institute to capitalize an opportunities to help their students in preventing risky behaviors, and different stress management techniques should be taught at medical schools.

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Background: The male antifertility activity of Gossypol, the active ingredient of cotton seed, inspired the idea for development of an agent with male contraceptive activity. The result of subsequent studies lead to the discovery of several class of compounds with antifertility activity. In this study the antifertility activity of iso-Propyl and iso-Butyl derivatives of dihydropridine were evaluated.
Methods: The two aforementioned compounds were administered subcutaneously in (10 mg/kg/day) dose to male rats. The animals were treated and kept according to the TUMS committee recommendations on ethical and animal maintenance considerations. Sixty days after the first injection the following fertility and histological indices were evaluated, animal’s body weight difference (B.W.D), sperms motility, sperm viability, ESR (epididymal sperm reserve), DSP (daily sperm production), serum testosterone concentration, fertility index, GSI (gonado somatic index). Histological indices are respectively the area and circumference of seminiferous tubules, each testis and their crosswise dissections, the diameter of seminiferous tubules and the number of seminiferous tubules per square millimeter, that were determined.
Results: The values of the two test groups were determined and compared with the results of normal group that were using normal saline only and the blank that were receiving propyllenglycol only.
Conclusion: The significant inhibitive activity of candidate compounds on animal's physiologic indices were in accordance of our pervious estimation of compounds activity as (lead compound) for synthesis and preparation of new compounds with male contraceptive activity

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Background: The Composite International Diagnostic Interview (CIDI) is a comprehensive, standardized diagnostic interview for the assessment of psychiatric disorders. There have been few studies on the validity of the CIDI. The objective of present study was to assess the validity of a Farsi translation of the complete CIDI and its psychosis/mania module in five referral clinical psychiatric settings.
Methods: Two hundred and three as well as 104 consecutive admissions were interviewed using the complete and the psychosis/mania module, respectively. Within two days of the CIDI interview, two last year residents of psychiatry or psychiatrist who were blind to the CIDI diagnosis completed the Clinical diagnostic checklists (based on DSM-IV and ICD-10 criteria) simultaneously and reached the consensus diagnosis. Data analysis was performed using SPSS 11 to determine the validity of CIDI.
Results: The sensitivity and specificity for the diagnosis of schizophrenia was 0.12 and 0.96 using DSM-IV criteria. According to ICD-10 criteria, the results were the same with 0.19% sensitivity and 0.96% specificity. The sensitivity for the diagnosis of bipolar I disorder was low (0.21 using DSM-IV criteria and 0.17% using ICD-10) and specificity, high (0.90 compared to DSM-IV and 0.89 compared to ICD-10 criteria). The results were rather similar for the psychosis/mania module of CIDI.
Conclusion: This study suggests that the Farsi translation of both the complete CIDI and the psychosis/mania module of CIDI have good specificity, but poor sensitivity for the diagnosis of schizophrenia and of bipolar I disorder.

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Background: Abdominal compartment syndrome (ACS) is a clinical entity that develops from progressive, acute increases in intra-abdominal pressure (IAP) and adversely affects all vital organ systems In this study, the development of intra-abdominal hypertension (IAH) and ACS in a surgical ICU population is described and examined.
Methods: Over a one-year period (2004), urinary bladder pressure (UBP) was measured prospectively in all surgical patients with abdominal problems admitted to the ICU of the Imam Hospital complex. UBP of >20 cm H2O indicated IAH. ACS was defined as the development of multiple organ dysfunction including peak airway pressure (PAP) >50 cm H2O, Horowitz quotient <150 torr or urine output <0.5 ml/kg/hr in the setting of IAH. Data were gathered on all patients with IAH and ACS.
Results: We evaluated some 353 patients, consisting of 165 elective laparatomies and 188 emergency cases, including 28 trauma patients. The incidence of IAH and ACS was 2 and 1 per cent (7 and 3 patients, respectively). The mean IAP of these seven patients was 29.8 cm H2O. No elevated IAP was observed after elective laparotomy (165 patients), nor in emergency cases with temporary abdominal wall closure (29 patients). APACHE II score, PAP and worst base deficit were significantly higher in patients with elevated IAP. None of the three patients with ACS underwent decompressive laparotomy. The mortality rate for patients with elevated IAP was 85%, significantly higher than the total study population.
Conclusion: IAH is a rare disease of the rarity of IAH, routine measurement of IAP is necessary only in high-risk patients. Prophylactic temporary abdominal wall closure may prevent IAH and ACS in high-risk patients. Patients with elevated IAP have dismal outcomes. Critical care practitioners should become familiar with different aspects of IAH and ACS, including decompressive laparotomy.

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Background: Septic arthritis in neonates can be difficult to diagnose and may be associated with severe morbidity and even mortality. A majority of apparent septic arthritis cases may have a negative culture, thereby creating a dilemma regarding treatment. The present study investigates demographic, laboratory and clinical variables of septic arthritis in neonates hospitalized over a period of 17 years.
Methods: The medical files of all neonates hospitalized in Imam Khomeini and Vali-e-Asr Hospitals in Tehran, Iran, from 1989 to 2005 were assessed and the files of 59 neonates with a diagnosis of septic arthritis were further evaluated. Variables such as age, sex, gestational age, birth weight, history of hospitalization, body temperature, involved joints, blood and joint fluid cultures, ESR, CRP, and WBC count were evaluated in this group of hospitalized patients. Results: Of the 59 neonates, 39 cases were male and 20 cases were female. At the time of hospitalization, 45.8% of the neonates were 20-28 days old and 52.2% were 10-20 days old, and 67.7% and 35.6% of cases had been preterm and had low birth weight, respectively. Histories of hospital admission were found for 30.5% of patients. The two most common joints involved were hip (30.5%) and knee (23.72%). The mean body temperature was 36.6oC. ESR was elevated in all patients (mean 85 mm/h) and CRP was positive in all cases. The WBC count was >15,000/mm3 in 39% of the neonates and was in the range of 10,000-15,000/mm3 for 47.4%. Blood and joint fluid cultures were positive in 51% and 91.5% of cases, respectively. The organisms isolated from joint fluid culture were Klebsiella (54%), S. aureus (37%) and E. coli (9%). Conclusion: Due to the rarity of septic arthritis in neonates and paucity of signs and symptoms, all neonates with a high index of suspicion should be examined carefully with septic arthritis in mind.

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Background: Fanconi anemia (FA) is a rare autosomal recessive disorder characterized by short stature, skeletal anomalies, increased incidence of solid tumors and leukemia, and bone marrow failure (aplastic anemia). FA has been reported in all races and ethnic groups and affects men and women in an equal proportion. The frequency of FA has been estimated at approximately 1 per 360,000 live births. In some populations, including Ashkenazi Jews, Turks, Saudi Arabians and Iranians, this frequency appears to be higher, probably as a result of the founder effect and consanguineous marriage. Because of extensive genetic and clinical heterogeneity (the age of onset, clinical manifestations and survival), diagnosis of FA on the basis of clinical data alone is unreliable and its molecular diagnosis is difficult. The diagnosis of FA exploits the hypersensitivity of FA lymphocytes and fibroblasts to bifunctional alkylating agents such as mitomycin C (MMC), diepoxybutane (DEB) and nitrogen mustard and differentiates it from idiopathic aplastic anemia. In this study, in addition to the patients' clinical profiles, a cytogenetic test using MMC was implemented for an accurate diagnosis of Fanconi anemia.

Methods: In this study, the lymphocytes of 20 patients referred for FA, and those of their normal sex-matched controls, were treated with three different concentrations of mitomycin C (20, 30, 40 ng/ml). Slides were prepared and solid stained. In order to determine the number and kind of chromosome abnormalities, 50 metaphase spreads from each culture were analyzed. Clinical information was obtained from patient files.

Results: Five patients manifested increased chromosome breakage with MMC, confirming the FA diagnosis. Two different concentrations of MMC (30, 40 ng/ml) were most effective.

Conclusion: The chromosomal breakage test is important for the accurate diagnosis of Fanconi anemia. DNA crosslinking agents used to treat idiopathic aplastic anemia may be lethal for patients with FA. Thus, aplastic anemia patients with unknown etiology, infants with congenital abnormalities involved in FA and siblings of FA patients should also be cytogenetically tested.

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Background: Myeloperoxidase (MPO), an iron-containing protein, is found in the azurophilic granules of neutrophils (PMNs), and catalyzes the conversion of hydrogen peroxide and chloride ions (Cl) into hypochlorous acid, which plays an important role in oxygen-dependent bacterial killing. The enzyme was first isolated in 1941, and deficiency of MPO was first described in 1954. Fewer than 5% of patients with MPO deficiency contract severe infections, which are usually fungal infections in diabetes mellitus (DM) patients. Besides the disorder in antifungal activity, diminished rate of bacterial (S. aureus) killing, and carcinogenesis, it seems that MPO deficiency is also related to atherosclerosis, degenerative neurologic diseases, as well as other disorders. In this study, we compared the levels of the MPO enzyme in the peripheral neutrophils of infected and non-infected DM patients at Imam Khomeini Hospital during 2005-2006. We compared these two groups the prevalence of MPO deficiency in each group, in order to then determine any correlations this may have with infection.

Methods: In this case-control study, 50 patients were in the infected group (case group) and 50 were in the control group. Patients were chosen using simple sampling methods. Data was gathered from blood samples, using a qualitative test to determine MPO deficiency (Kaplow stain), laboratory results (BUN, Cr, PMN, HbA1c), interviews and completion of a questionnaires, as well as hospital records. Data were analyzed with SPSS software using T test and chi-square test, with a confidence index of 0.05.

Results: In spite of differences seen in stained slides, the MPO enzyme was positive in all of the patients, and no differences were seen between the two groups.

The average patient age and the duration of DM in the case group were more than those of the control group. No statistical differences in the type of DM and glycosylated hemoglobin (HbA1c) levels were found between the two groups. Body mass indexes (BMI) and PMN counts were higher in the case group. The most prevalent infections were in the skin and soft tissue, bones and joints, as well as chronic respiratory infections (TB), pneumonia, urinary infections, CNS infections, gastrointestinal and intra-abdominal infections, mucormycosis, and sepsis.

Conclusions: We found no correlation between MPO enzyme deficiency and age, sex, type or duration of DM, HbA1c levels and BMI.

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Background: The health risk associated with chronic exposure to organic solvents investigated in several epidemiologic studies indicates a significant relationship between solvent exposure and glomerulonephritis. Solvents are the most commonly used chemicals in industry. According to European statistics 43% of all solvent consumption takes place in the painting industry, 10% in metal cleansing, 6.7% in adhesives and 3.9 percent in the laundry (dry cleaning) industries. Although BUN and creatinine indicate massive loss of glomerular function, microalbumin is a sensitive urinary marker for nephrotoxins in the early detection of solvent-induced effects on the glomerulus. The purpose of our study was to use microalbumin, serum BUN and serum creatinine levels to identify occupational solvent-induced effects on the glomerulus.
Methods: Renal dysfunction was monitored by microalbumin, BUN and creatinine serum levels in a cohort study of 92 workers currently exposed to solvents (solvent group). A control group of 92 individuals were selected from parts of the same factory not exposed to solvents. All individuals in the study were men, without diabetes or hypertension. The percentage of smokers was equal between the two groups. The solvent group was selected using environmental monitoring of organic solvents in different parts of the painting room. The individuals were chosen by simple random selection. Exclusion factors included less than one year of work in the painting room, use analgesic or aminoglycoside one month before the study and medically diagnosed renal disease, such as glomerulonephritis or renal failure. Data was gathered using a questionnaire requesting demographic information, history of present and past diseases, present and past occupational history, drug history, history of illness in their colleagues and safety conditions at work (use of safety gloves, masks, clothing, goggles and general and local ventilation). The results analyzed with SPSS 11.5.
Results: Several studies showed that solvents cause renal disorder (tubular and glomerular), although glomerulonephritis is more prevalent. The mean age of the solvent group was 28.6 ±2.7 years and was 33.7 ±7 years in control group (p<0.05). The mean duration of solvent exposure was 4.8 ±1.5 years. Statistically meaningful differences were found between solvent and control groups for microalbuminuria, increased serum BUN and creatinine levels (p<0.05), although there was no significant correlation between these parameters and the duration of exposure (p>0.05).
Conclusion: The results suggest that kidney dysfunction results from chronic occupational exposure to solvents at levels found in automobile painting rooms in Iran. We recommend increased monitoring of workers using solvents and increased review and enforcement of safety regulations regarding such use of solvents.

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Background: Tumor cells need food and oxygen supply for growth and division. Therefore one of the most promising areas of cancer therapy focuses on using agents that inhibit tumor angiogenesis. Inhibition of angiogenesis prevents cell growth, division and metastasis. Previous studies showed that plasminogen related Protein-B has an anti-tumor activity in mice. This protein has a high level of homology with preactivation Peptide (PAP) of human plasminogen. According to this high homology, antiangiogeneic activity of PAP was investigated in an in vitro angiogenesis model.

Methods: PAP encoding region of human plasminogen gene was isolated by Polymerase Chain Reaction and ‎cloned in pGEX-2T vector. This plasmid was expressed in Escherichia coli as a fusion protein (GST-PAP). ‎GST-PAP was expressed as inclusion body and purified by affinity chromatography on GSH-sepharose ‎resin after refolding. antiangiogenic effects of purified protein were surveyed with Matrigel assay‏.‏‎ ‎

Results: The GST-PAP was expressed and purified and its accuracy was confirmed by SDS-PAGE analysis ‎and immunoblotting. Microscopic studies showed that GST-PAP inhibited angiogenesis in Matrigel system ‎which is shown by shrinking the length of capillary like structures and a decrease in the number of tubule. ‎While applying concentarations of 25μg/ml of GST-PAP and concentrations above that, antiangiogenic ‎activity of GST-PAP was significant comparing to the controls. ‎

Conclusion: Finding shows that GST-PAP can inhibit network formation in Matrigel system. This findings ‎support the theory that PAP is a potent angiogenesis inhibitor.‎

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Background: The use of synchronized intermittent mandatory ventilation (SIMV) and pressure support ventilation (PSV) have been used for older children and adults. The purpose of this study was to compare PSV and SIMV modes in weaning from mechanical ventilation in neonate with respiratory failure.

Methods: A randomized clinical trial study carried out in NICU ward of Valiasr hospital Imam Khomeini Hospital complex, Tehran, Iran. Thirty neonates enrolled in two groups of 15. At the weaning time they randomly assigned to SIMV or PSV. They compared for tidal volume (V_T), peak inspiratory pressure (PIP), incidence of pneumothorax, weaning failure and duration of weaning. For two groups to be homogeneous, maternal disease during pregnancy were also considered.

Results: In this study, V_T, PIP, incidence of pneumothorax and weaning failure did not differ between groups duration of ventilation of the two methods (hours) and duration of hospitalization (days) were separately calculated. The only meaningful difference in two groups were due to weaning duration. The neonates weaned by PSV mode experienced shorter weaning time. (6.05 hours). The weaning time in SIMV mode was longer (45 hours) (P=0.006). There were no other meaningful differences between the two groups

Conclusions: According to the results of this study there were no advantage using PSV over SIMV except that the weaning time were shorter in PSV. This decrease in weaning time causes less dependence of the neonate to the ventilator and as a result secure them from complications.

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Background: Myasthenia Gravis (MG) is a neuromuscular disorder with weakness of skeletal muscles. Thymectomy is now recognized as a treatment modality in MG. The aim of this study was to evaluate the clinical effect of thymectomy on MG.

Methods: MG patients with history of thymectomy at a tertiary referral center during twelve year period were included. The medical records were reviewed and telephone survey was conducted to evaluate the effects of thymectomy.

Results: Sixty MG patients, 46 females and 14 males, aged 30.4±11.1 years, underwent open (n=48) or video-assisted thoracoscopic thymectomy (n=12) during study period. The mean dosage of preoperative pyridostigmine was 235.4±86.2mg/day. This figure reached to 129±18mg/day after thymectomy (p<0.0001). 17 patients (28.3%) had complete remission (complete freedom of symptoms without medications). Improve-ment (improved symptoms or less medication requirement) was seen in 34 patients (56.6%). There was no response to surgical therapy in six patients (10%). Three patients (5%) had experienced progression of disease postoperatively. Overall, benefit of thymectomy was observed in 85% of patients. Age, sex, duration and severity of disease, quantity of preoperative drugs, surgical approach, and presence of thymoma did not affect the outcome. Satisfaction was stated as excellent in 17%, good in 43%, moderate in 35% and poor in 5% of patients after operation.

Conclusion: Thymectomy is an effective treatment for MG which leads to less severity of disease and less drug requirement. It would be considered in all myasthenic patients regardless of age, sex, duration and severity of disease and presence of thymoma.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 B ackground: Preterm birth which is defined as delivery before 37 completed weeks was implicated in approximately two thirds of neonatal death. Also preterm labors are the most common cause of mortality and morbidity of infants in recent years and it costs high prices for health system. We evaluate the relationship between prepregnancy maternal body mass Index (BMI) and spontaneous and indicated preterm birth.
Methods: This study included 250 healthy pregnant women, without any risk factors of preterm birth, were classified into categories that were based on their body mass index. Association between BMI, weight gain and rout of delivery were examined. Rates of indicated and spontaneous preterm birth were compared.
Results: Obese women delivered at a more advanced gestational age. (38/34±1/66 weeks vs 37/61±2/44, p=0/006). Obese patients had significantly lower incidence of spontaneous preterm birth at < 37 weeks of gestation (16/8% vs 31/2% p=0/008). Obese women had larger infants (3354/95±596/75 vs 311.24±558/357 p=0/001), and had more frequent cesarean delivery (69/6% vs 52/8%, p=0/006). Weight gain during pregnancy is poorly correlated with prepregnancy BMI (14/41±7/93 kg vs 13/78±4/94kg, p=0/4) and preterm birth.
Conclusion: In this survey, there was adverse correlation between body mass index (BMI) before pregnancy and preterm labor less than 37 completed weeks and we suggest more study for evaluation between spontaneous and induced preterm labor mechanism and in obese and non obese women. However according to this survey obesity before pregnancy is associated with a lower rate of spontaneous preterm birth.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Polyethylene glycol (PEG) solution can induce complications when used as preoperative bowel preparation. The aim of this study was to compare two methods for mechanical bowel preparation in elective operations of colon.
Methods: In a randomized clinical trial, 129 patients elected for anastomosis of colon and referred to the surgical clinic of Imam Khomeini Hospital of Tehran between March 2008 and March 2009 were included. They were randomly allocated into two groups of PEG1 (1liter of PEG or 70gr plus 15 mg bizacodil, n=63) and PEG4 (4 liter of PEG), according to the way of bowel preparation and on the day before surgery, they received oral and IV prophylactic antibiotics and cleared solutions. In the morning of the surgery, they received their medication during 240 minutes. Then, they underwent anastomosic surgery of colon. The principle variables recorded were nausea, vomiting, flatulence, Na and K in the night before surgery, patients' and surgeons' satisfaction from bowel preparation and postoperative infection and leakage.
Results: The majority of the patients were male (62%). Nausea (28.57% vs. 98.48%, p=0.001), flatulence (36.51% vs. 95.45%, p=0.001), and vomiting (4.76% vs. 75.76%, p=0.001) were significantly lower in PEG1 and the patients' satisfaction were significantly higher (59.02% vs. 1.52%, p=0.001) Peroperative Na was significantly higher in PEG4 group (141.21±3.63 vs. 139.94±2.97mg/l, p=0.001) and serum K was significantly lower (3.55±0.25 vs. 3.76±0.21, p=0.001). Surgeons' satisfaction were significantly higher in PEG4 group (good to very good 72.73% vs. 43.54%, p=0.001). Postoperative infection of surgical site, anastomosis leakage and ICU admission were comparable between study groups.
Conclusions: Bowel preparation with 1 liter of PEG plus 3 bizacodile pills instead of 1 liter of PEG in patients undergoing elective anastomosis of colon is not only associated with lesser nausea, vomiting, flatulence, but also increases the patients' satisfaction and tolerance, lessens electrolyte disturbances and do not influence postoperative infection of surgical site and anastomosis leakage.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Dendritic Cell (DC) is an important antigen-presenting cell that present tumor antigen to CD8⁺ and CD4⁺ T- Lymphocytes and induce specific anti-tumor immunity. In order to induce effective anti-tumor response, an option is increasing the efficiency of antigen presentation of dendritic cells and T cell activation capacity. The aim of the present study was to investigate the effect of dendritic cell maturation with protein components of toxoplasma gondii on cytotoxic T lymphocyte activity and their infiltration in to the tumor.
Methods: For DC generation, bone marrow cells were cultured in the presence of GM-CSF and IL-4 for five days. After that, LPS, protein components and whole extract of toxoplasma gondii were added to the culture media and incubated for another two days for DC maturation. To generate tumor, mices were injected subcutaneously with WEHI-164 cell line. For immunotherapy 10⁶ DCs matured with different compounds were injected around the tumor site. Infiltration of CD8⁺ T cells were determined by flow cytometry and cytotoxic activity was measured by LDH detection kit.
Results: Immunotherapy with DCs treated with protein components of toxoplasma gondii led to a significant increase in the activity of cytotoxic T cells and infiltration of CD8⁺ T cells in to the tumor. Immunotherapy using protein components of toxoplasma gondii significantly improved the survival of the mice compared with other groups (p<0.0001).
Conclusion: Protein components of toxoplasma are able to increase DC capability in induction of CTL-mediated anti-tumor response and increase infiltration of these cells in to the tumor.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Pelvic Organ Prolapse (POP) and related urinary symptoms are frequent disorders in elderly women and their management improves life expectancy and quality of life. Urodynamic tests applied in pathophysiologic diagnosis and treatment of urinary disorders are not always cost effective. This study aims to evaluate the results of Urodynamic tests in patients with pelvic organ prolaps.
Methods: This case- control study was done using UDI-6 questionnaire during 18 months in vali-e-asr clinic of Imam Khomeini Hospital, Iran with 105 cases of POP the cases were divided into two groups: group one (66 cases with urinary incontinency) and group two (39 without incontinency) and assessed with urodynamic tests.
Results: Based on UDI-6, the patients of group one had more clinical symptoms (frequency, urine leakage, urge incontinence and stress incontinence). (p<0.001). Except for first desire to voide and normal voided volume indices, there were no significant differences in the other urodynamic parameters in two groups. Sensitivity and specificity of urgency leak in group one was 22 and 68/8% and in group two was 30 and 65/5% respectively. Stress leak sensitivity and specificity in group one were 25/4% and 100% and in group two were 57/1% and 71/9% respectively.
Conclusion: In this study, considering sensitivity and specificity of symptoms and urodynamic test for urinary incontinency assessment is advised in patients with POP who need surgery.