Tehran University Medical Journal

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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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In the past years, there was a tendency to excise the patella in pathologic conditions affecting this bone. The patella has many critical effects in the function of the knee joint. For example, after its exicision the force of quadriceps muscle decreases by forty percent (40%) and the knee joint becomes prone to early osteoarthritic changes. For these reasons, in the recent years the "biologic resurfacing of patella" has been used in pathologic conditions instead of its complete removal. In this new method after resection of the diseased part of the bone, the fascia of the quadriceps muscle, with its intact base, is used to cover the resected part of the bone. In practice, after pain relief, the active motion of the joint is started. Then the limb is placed in a splint or brace and after a period of 3 weeks, passive motion is begun.

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

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The basis of this paper has been planned on the functions of the meniscus and its effects. i.e. the existence of meniscus will prevent arthritis in other word torn-off (wholly meniscus and/or partly) will lead to suffering from arthritis. In view of the above, it is reasonable that attempt will be made to amend the torn meniscus instead of the surgical removal (meniscectom). The amendment may be done by the surgical operation and/or arthroscopy. (It is more advisable to use the arthroscope, because the least troubles may occur). In the meantime, meniscus transplantation from one individual to another, or meniscus prosthesis may be used. In the year 1371 (from Khordad to Bahman) 20 people - 18 males & 2 females - who were suffering from torn meniscus (diagnosed through arthrography and arthroscopy) were amended. In this connection, we should inform that 18 patients had peripheral torn meniscus who were amended, and the 2 remainders had central torn meniscus which torn parts were removed. After six months the patients were examined again, and no clinical marks - torn-off locations - could be observed i.e. fibrous tissues had completely filled us the torn places. Therefore, it is emphatically insisted that amendments should be performed on torn meniscus, especially when tearing is in peripheral parts of the meniscus

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The effect and arrangement of cytoskeleton (microtubules, microfilaments and neurofilaments) in neurulation of chick embryo examined by immunoperoxidase method from stage 6 to stage 12. The results were as follows: 1) Microtubules aggregated in the perinuclear region from which they radiated to take longitudinal course beneath the membrane. 2) Microfilaments were aggregated in the apical ends (free-surface) of neural epithelium causing the cells to become flask-shaped. 3) Neurofilaments (Nfs) had no important role in neural tube formation

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The 3.4 million polulation of Isfahan province was evaluated by cluster sampling. In this study, 11230 cases had one or several medical complaints, 9818 had sought treatment in medical centers 146 were hospitalized. Only 74 of the latter were admitted to university hospitals. During the month prior to study, 945 cases had been resting at home. The ratio of cases resting at home to those who were hospitalized was 6:1. This study shows that the number and variety of outpatient cases is higher than hospitalized ones, and that university hospitals are not adequate for the training of medical students, and that attending community based outpatient clinics and training centers is essential for a good medical education

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The rapid growth of population in the third world countries specially in recent decades has posed an important social problem. There have been some attempts to propose solutions for this problem by scientists from various disciplines. However, it seems that an integrated approach calling for collaboration of various efforts can be more fruitful. In this work, we study the relation of women fertility and socio-economical indices along with government's programmed efforts in the third world countries. Employing a statistical approach, we show that development indices such as gross national product, infant mortality rate, education enrolment, and access to mass media along with government's programmed efforts are effective in reducing the fertility rate, but more important is the interaction between these factors. Thus, an integrated approach emerges as a better solution to population control

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A prospective study during 1990-1995 was conducted to assess the risk of rejection and infection in kidney-transplant recipients, who's original kidney had vesico-ureteral reflux (VER). Two groups of recipients with and without VER were followed for one month after transplant 24 and 250 cases respectively. The calculated relative risks for the effect of VER showed a moderate increased risk for rejection in VER group (RR=1.82, CI=1.12-2.95, P<0.05). No effect was found for VER being one-or two-sided. Hence, VER has a moderate effect on rejection, but no effect on infection.

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Dysplasia Epipysealis Hemimelica (DEH) is a rare disease, prevalence is one in 1000000. The incidence is unknown. Its characteristics is abnormal cartilage growth accompanied by ossification of cartilages of epiphyses of long bones, bones of foot ankle and wrist. A hereditary or familial factor hasn't yet been known. Occurrence in males is three times more than females. Our case is a girl observed from 7 months of age to 5 years. The progression of disease and symptoms are reported. Other names of the disease are: Tarsomegaly, Tarsoephiphyseal Aclasis, Trevor's Disease, Benign Epiphyseal Osteochondroma.

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Only orchiectomy is still commonly used today either as a single therapy or in combination regimens. Hypophysectomy & adrenalectomy showed such devastating effects on the endocrine equilibrium as to be inconsistent with an acceptable quality of life or even with survival. Chemical adrenalectomy was also tried with drugs (eg. aminoglutethmide, spironolactone) leading to consequences superimposable to those of surgical adrenalectomy. Along with orchiectomy, three groups of substances are commonly used today for the hormonal therapy of prostate cancer: estrogens, LHRH agonists & anti androgens. Bilateral orchiectomy removes 90-95% of circulating testosterone. Clinical studies document 60-80% of positive responders to castration, on continued evaluation, relapse occurs usually within 6-24 months in responders, with a death rate of 50% within 6 months. The androgenic activity still remaining after castration may explain the partial & progressively decreasing effectiveness of this & other testosterone reducing therapies. Antiandrogens define substances that act directly at the target site, where interacting with steroid hormone receptors, they impede the binding of androgens. A trend towards the combination of testosterone-reducing & androgen-blocking treatment is developing in modern therapy of prostate cancer. This is due to the complementary characteristics of the two different pharmacological mechanisms that are involved. In this study castration+antiandrogen is compared to castration alone. The results demonstrate a significantly greater percentage of positive objective & subjective responses with antiandrogen than with placebo. In addition survival time was increased in patients treated with castration+antiandrogen than castration+placebo.

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Wastewaters are one of the most important sources for transmission of pathogenic agents in environment, so they should be disinfected in a manner that their overall qualities become accordant with WHO-guidelines, if it is needed to reus water correctly. Unfortunately, the protozoa and parasitic worm's eggs can not be destroyed by chlorination alone. This experiment was carried out in order to determine the efficiency of the UV-Lamps in inactivation of the Ascaris Lumbericoides-ova which is the most resultant organism among the other nematode eggs. The minimum inhibitory dose of UVR (UVC plus UVB irradiances) for Ascaris-ova complete destruction ascertained to be 420 miliwatts-seconds per square centimeter.

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Hyperthyroidism is often accompanied by diverse types of neuropychiatric complications. To demonstrate these complications we studied 500 hyperthyroid patients, who developed neuropsychiatric complications of hyperthyroidism for which other causes of these neuropsychiatric findings were carefully excluded. The patients were 15 to 65 years old (female to male ratio was 5:1), most of the cases were in third and fourth decades of life. Nervousness, tense dysphoria, insomnia and anxiousness were among the most common psychiatric complications, and tremor, hyperreflexia, thyrotoxic myopathy, thyrotoxic periodic paralysis were the most common neurologic complications. Therefore any physician, wether he or she is a general practitioner or a specialist must be aware of these diverse complications, because these neuropsychiatric complications can lead to the diagnosis of hyperthyroidism and treatment of these potentially serious complications.

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This paper represents a retrospective study of 142 patients with skeletal tuberculosis during the years 1350 to 1357 at Shafa Yahiaian Hospital. Confirmation of diagnosis is made by positive culture or pathology. The mean age of the patients was 27.5 years (range from 1.5 to 72 years). Most of the patients were in the second, first and third decade respectively. 45.3% of the patients were female. The spine was the most common site and was affected in 40.88% of the patients. The next sites were knee, hip and elbow, in order of frequency. The commonest site in spine was thoracic. The mean of sedimentation rate in the first visit was 48. Tuberculin skin test was negative in 23% of the patients. Evidence of pulmonary tuberculosis in chest radiography was present in 48.61% of the patients. Five patients had tuberculosis osteomylitis without involvement of the joint.

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Congenital cyst of the pancreas is an uncommon problem in the pediatric patient. The common symptoms at the time of diagnosis have been abdominal mass and pain or fullness, nausea and vomiting. Despite of various paraclinic methods for diagnosis, ultrasound is now recognized as the most effective and best noninvasive method for diagnosis of pancreatic cyts. Surgical intervention is the best mode of therapy. Upper abdominal cystic mass are seen in the fetus and newborn infants. In Amirkabir Hospital, during 12 years from 1981 to 1993, 8 pancreatic cysts have been operated on and only in this case it was congenital.

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The poll was designed to let the management system of the university know about the opinions, criticisms and suggestions of the faculty members and create a sense of cooperation and promote the level of relationships. In November and December 1997, short after the new Chancellor of the University was selected, the poll was conducted by the new board to reach the above goals. In this survey, all the faculty members of the University were questioned about the problems they faced in the University. A questionnaire of 23 questions in two pages was given to them and was returned by mail. About 47.5% of the questionnaire were returned. Analysis of the results showed that a significant majority (93%) of the respondents believed that Tehran University should be the best University of Medical Sciences in Iran, and that it dose have the capability to be so, however, a majority (66%) of them claimed that it is not so at the present. A significant majority of the respondents believed that education and research are the two most important duties of the University, and the health, treatment, and cultural duties rank next. Except for the Medicine and Health Faculties others were not satisfied with their status at the University. The satisfaction of the faculty members with educational and research performance of the faculties was questioned the results varied in different faculties. Dissatisfaction with research status was most obvious. Forty-six and 25 percent of the staff in the faculty of medicine were satisfied with educational and research performance of their faculty, respectively. The teaching staff were also questioned about their problems the most important of which was shown to be that of convenience. More than 90% of respondents stated that opinion poll is an appropriate way to relate the management of the University to the faculty members and emphasized on holding periodic sessions with the Chancellor of the University and personal visits to him.

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The present research is a quasi-experimental prospective study to determine usefulness of stripping the fetal memberanes at term for preventing of postterm pregnancy. 212 pregnant women with firm gestational dates entered the study, 112 underwent stripping of the membranes and 100 controls did not. The difference between the number of patients who advanced beyond term (>290 days) was statistically significant between groups (P<0.01). The mode of delivery and neonatal APGAR score were similar in both groups.

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Despite unwillingness to fertility, about 30% of couples do not use any kind of contraception and this will lead to unwanted pregnancy. In this clinical trial study, 4177 subjects who had at least one alive child, and delivered in one of the 12 university hospitals in Tehran were recruited. This study was conducted in 1996. The questionnaire included some questions about contraceptive use, their attitudes about unwantedness or wantedness of their current pregnancies. Data were analysed using a Logistic Regrassion Model. Results showed that 20.3% of those who had no fertility intention, did not use any kind of contraception methods, 41.1% of the subjects who were using a contraception method before pregnancy, had got pregnant unwantedly. Based on Logistic Regression Model age, education, previous familiarity of women with contraception methods and husband's education were the most significant factors in contraceptive use. Subjects who were 20 years old and less or 35 years old and more and illeterate subjects were at higher risk for unuse of contraception methods. This risk was not related to the gender of their children that suggests a positive change in their perspectives towards sex and the number of children. It is suggested that health politicians choose an appropriate model to enhance the literacy, education and counseling for the correct usage of contraceptives and prevention of unwanted pregnancy.