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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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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Results of some cancer researches show that a number of hormones in ceratin tumors are growing up. Often, the majority of these hormones are produced by tumor cells or by an unknown origin in the neoplastic area. Also, it is clear that some of these ectopic hormones are produced only by specific tumors. In addition, different effects of these abnormally produced hormones on the immune system are shown in recent years. Thus, we decided to study the hormonal status of patients with chronic lymphocytic leukemia (CLL) patients. The results of this study showed that the LH and FSH levels in the majority of patients are rising above normal while testosterone level in many of them is decreased. In the next step, we are going to study the immunological effects of LH, FSH, and testosterone one the lymphocyte function in vitro.

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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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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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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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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 is a report of a case study on 234 patients with impetigo who referred to Razi Dermatology Hospital from April to November, 1989. Treatment was started immediately after obtaining direct smear and performing culture and antibiotic sensitivity test. The most common organism responsible for impetigo was the coagulase-positive staphylococcus (71%). In 13.7% of the cases, the coagulase-negative staphylococcus was grown on culture media, but none of the cultures showed streptococcus as the main organism. Treatment was started with oral penicillin V, oral erythromycin, benzathine penicillin G injection, oral cephalexin, and topical fuccidin. Clinical and bacteriological evaluation after 3-7 days showed that it is preferable to use oral cephalexin instead of other protocols such as oral erythromycin, which has previously been the drug of choice for impetigo. In addition, topical fuccidin with a 75% curative rate was the first drug for treatment, with the same effect as the oral cephalexin

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This investigation aims to diagnose the incidence and complications of labor and delivery of grandmultiparity (GMP) in Tehran. The results obtained are as follows: 1) The incidence of high parity was 11%. 2) 47.3% of GMP women were within the age range of 14-16 years at their marriage time. 3) The infants of GMP women were born with lower apgar score than the infants of the control group. 4) The incidence of fetal distress was estimated up to 31.8%. 5) In 1.8% of cases, infants showed to have born with Down's syndrome. 6) Other congenital abnormalities showed no significant differences between the two groups. 7) The rate of stillbirth in GMP women was higher than that of the control group (4.5% vs. 1%). 8) Cesarean section performed in 25.5% of GMP women in comparison to 14.5% in control group

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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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The skin hyperreactivity, detected by the pathergy test, is a well known phenomenon in Behcet's disease. Two different methods were used for the pathergy test. a) A needle prick, b) An intadermal injection of normal saline. In this study 83% of Behcet's patients had a positive pathergy test. Where as 44% was of pustule type and 39% of papule type. In 26% of patients the papule formation was observed with both methods. In the control groupe 16% of subjects had a positive pathergy test. All were of papule type . Only 3% of them demonstrated a positive reaction with both methods. The sensitivity of the pathergy test, in this study, was 83% with a specificity of 84%. From these results we may conclude that a positive pathergy test of pustule type, with one of the major manifestations of Behcet's disease, (as proposed in disease). The papule type reaction, by both methods, may have the same diagnostic value as pustule type

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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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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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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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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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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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Studies were undertaken to evaluate content of IgG, IgM, C3, C4, CH50 and proteines of sera from 53 drug addicts by immunological methods. Results shows an increase of IgG and no significant variatrion in the level of other Ig(S). In the same time we have seen an augmentation of gamma globuline in the protein electrophoresis pattern. The level of C3 and C4 of complement component rest unchanged.