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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According to our experience, the best treatment for operable supracondylar fractures of the adults' humerus is surgery via open reduction following internal fixation and early mobilization. The preferred approach is olecranon because of its observable fragments of the fracture and easy fixation without damaging ulnar nerve and triceps muscle. In this article, we review several cases treated by this method whose results were quite satisfactory

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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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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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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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100 patients (93 females and 7 males) in ages ranging between 23 and 65 years were subjected to laparoscopic cholecystectomy for biliary colic (92 pts), acute cholecystitis (7 pts) or asymptomatic gallstones (1 pt). None had a history of icterus and in every case choledocholithiasis was excluded by means of serum alkaline phosphatase assessment and sonography (In addition to ERCP in 3 pts). 3 operations were converted to open cholecystectomy (Because of uncertainty about anatomy in 1 pt, extensive adhesions in 1 pt, and persistent bleeding in 1 pt). Mean operation time was 80 min. 90 patients were discharged on the 2nd post-operative day. Apart from 2 pts who were readmitted (For omental evisceration in 1 pt and sub hepatic hematoma in 1), complications were limited to minor complaints. Laparoscopic cholecystectomy is a safe procedure in the hands of a skilled surgeon who is aware of anatomic variations and is always prepared to liberally convert the operation to an open cholecystectomy

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The purpose of this study was the utilization of different methods of tissue culture in proliferation of epithelial cells and autologous graft to cover surface areas without skin specifically, which is due to thermal burns more than 50%. In this experience we performed from rabbits and success to cover almost 24 times original donor site with autograft.

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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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We studied the effect of the selective alha-2 adrenoceptor blocker idazoxan and precursor serotonin (5-HTP) on anxiety-related behavior in rats. The conflict drinking test, and evaluator plus-maze were used as model. Idazoxan (2 mg/kg) showed an anticonflict effect, having doses dependently increased the number of punished lickes. 5-HTP showed that anxiolytic-like effect in both models. This drug reversed action and produced anxiogenic-like effect at high doses. In contrast, arecholine which is a cholinergic muscarinic agonist drug, produced anxiogenic-like behavior. At 2 mg/kg increased number of entrance (OE) and using time (OT) in open arms in montgomery's test. Anxiolytic-like effect of this drug was less than of chlordizepoxide. These results showed that increase release of noradrenaline in synaptic nerve terminals of neurons produced anxiety-related behavior. While high release of serotonin in this area reduced behaviors disorder in rats.

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Diabetes Mellitus is one of the common diseases leading to dialysis. In a cohort study, diabetic dialysis patients were compared with non-diabetic dialysis patients for one year about age, sex, cause and times of admission and rate of mortality. The study was done on 101 patients. At the end of the study, 88 patients remained. Results were interprected by T-test and chi-square statistical analyses and signified with P value less than 5 percent. Results: Diabetes was the cause of 17.8 percent of renal failure in 101 patients. The mean age of diabetics was greater than non-diabetics (P=0.02). Mortality of diabetics in one year was 20 percent, similar to non-diabetics. Infection (chills and fever) was the most common cause of admission in diabetics (33 percent) and non-diabetics (25 percent) with no significant difference. Conclusion: Mortality and morbidity between diabetic and non-diabetic dialysis patients had no significant difference.

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In a bacteriological study on 230 biopsies of patients suffering gastrointestinal disorders in Imam Khomeyni Hospital, 88 patients were selected as case and another 88 as control groups. Case group was treated by triple (Bismuth subcitrate, Metronidazole and Tetracycline) drugs for a period of 14 days. The latter treated by nonbismuth regiment eg. Amoxicillin and Ranitidine mainly. All of the patients were examined bacteriologically by biopsies in 1, 6 & 12 months after treatment. Obtaind data revealed that the Bismuth composed regiment was more effective than non-bismuth composing ones. In fact, bacterial eradication was approved in 89.8% of case group without recurrence of symptoms among them at least for entire year. Conversely, eradication occulted just in 23.5% of control group, frequent recruidescen Cl of pipriculear observed among them within one year.

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Helicobacter pylori (H.Pylori) is the most common human infection in the world. This agent has a strong role in pathogenesis of chronic gastritis and peptic ulcer. Therefore introducing of simple and cost effective tests are important for diagnosis of H.Pylori infections. ELISA has been considered as an alternative test compare with biopsy, histological staining, culture and urease test in diagnosis of H.Pylori infection. In this investigation, 111 patients referred to GI endoscopy department of Imam Khomeini Hospitals for U.G.I problems which were evaluated for H.Pylori infection. Culture and histological staining (GIMSA and H & E) were used as a gold standard test compare with ELISA-IgG and urease test. Sensitivity and specificity for ELISA were 90%, 93% respectively. This report suggests that ELISA is a cost effect and valid test in diagnosis of H.Pylori infection

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Variation of recurred branch of median nerve in relation to the median and flexor retinaculum are significant for both hand surgeons and specialists always. In this study, 64 cadaver hands (32 men) have been dissected. The median nerve was identified at the proximal edge of the flexor retinaculum, and in order to expose carpal tunnel the ligament was divided, and the above subjects were studied. The results are: 1) The relation of recurrent nerve to the flexor retinaculum was classified into 4 types: A) In (53.1%) of subjects, this branch arises from the median after the flexor retinaculum. B) In (31.3%) of subjects, it arises from the median in the carpal tunnel and the moves around the lower edge of flexor retinaculum and enters the thenar region. C) In (14.1%) of subjects, it arises from the median in the carpal tunnel and pierces the flexor retinaculum. D) In (1.56%) of subjects it arises, in the carpal tunnel and it divides into two subbranches here. One follows pattern A and the other pattern C. 2) In this step, the relation of the recurrent branch to the median nerve was studied. The results show that inspite of this image even though most often the recurrent branch arises from the lateral side of median, in (68.75%) of subjects it arises from it's anterior surface. The MC Nemar test reveals that there is no relation between manifestation of mentioned patterns with right or left hands.

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Due to the important role of the trace elements (i.e. zinc and copper) in the biochemical processes of body and the effects of exogenous and endogenous hormones in distribution, absorption and excretion of these elements, we decided to determine the rate of the zinc and copper content of serum in women taking (LD) OCPs. Our finding indicates that the rate of the zinc content decreased significantly (P<0.001), whereas the copper content of women serum during this period showed a significant increase (P<0.001). In regard to previous months, the process of increasing were lasting for six months. Therefore, we would like to suggest that the serum content of these two elements should be monitored during the period of medication with OCPs, to avoid the deleterious effect of flactuation rates of these elements in serum.

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In this paper, factors affecting the result of prophylactic lymph node dissection in 125 patients with skin melanoma during the period between 1987-1992 in the cancer institute were evaluated and prognostic parameters ascertained. The result showed prevalence of head and neck melanoma in men were two times more than in women with a preponderance of regional and lymphatic recurrence. Majority of patients presented with advanced clark levels (76.8 Pct). Clinical and histologic evaluation of the regional lymph nodes failed to show any meaningful relation.

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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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Iodine availability for the maternal thyroid is reduced during pregnancy as a result of the loss of the nutrient by increased renal clearance, and competition by the fetoplacental unit. So with a marginal iodine intake, pregnancy constitutes a stimulus for both the maternal and fetal thyroids. On the other hand, iodine deficiency in the first trimester of pregnancy results in impaired development of the central nervous system, lack of T4 then results in smaller brain size associated with fewer neurons which are also shorter in length. This cross-sectional study was undertaken to evaluate pregnant women and their newborns, these two susceptible groups to IDD in an endemic area such as Shiraz. Urinary excretion of iodine as iodine (µg/dl)/creatinine (gr) ratios in two groups of pregnant women, one group without goiter (52.88%) and the other with goiter (grade Ib and II 47.2%) and their newborns were compared. There was no significant difference in urinary excretion of iodine in mothers and newborns of the 2 groups. In all newborns even in those of mothers excreting <50 mg iodine/gr creatinine, there was a significantly greater excretion of iodine probably due to increased renal clearance of iodine by the immature kidney, and their excretion of iodine was not parallel to those of mothers. There was no significant difference between weight, height and head circumference of the two groups of newborns. It is concluded that iodine excretion in neonates can not be used as an indicator of iodine deficiency disorder. In iodine deficient areas pregnancy justifies monitoring thyroid function and volume and therapeutic intervention to avoid hypothyroxinemia and goiterogenesis in both mother and newborn. Likewise neonatal thyroid screening constitutes a valuable and sensitive index for detecting the presence of iodine deficiency.

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102 patients with ascites were enrolled in a sonographic study of abdomen and pelvis without awaring of history, clinical and paraclinical findings. So with only sonographic finding we suggested the diagnosis and etiology of ascites. All patients were hospitalized. Finally all the patients were diagnosed definitely and were compared with sonographic diagnoses done before. Results: In this survey 42% of patients had cirrhosis, 20.5% had malignancy, 14.7% had renal disease. Overall sensivity of sonography in diagnosing etiology was 91.1%, overall specifity was 97.8%, overall accuracy was 94.4%. Sensivity, specifity and accuracy of each group have also been determined separately.

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Helicobacter pylori (H.pylori) is the most common human infection in the world. This agent has a strong role in pathogenesis of chronic gastritis and peptic ulcers. Therefore introducing of simple and cost effective and non invasive tests are important for diagnosis of H.pylori infections. In this study 215 patient suffering from different gastrointestinal disorders referred to GI endoscopy department of Dr. Ali Shariati Hospital were selected as case and another 50 as control group, which were evaluated for H.pylori infection. Direct smear (staining with Giemsa) and urease tests were used as gold standard tests compared with IFA-IgG and culture. Sensitivity and specificity and accuracy for IFA were 94%, 86% and 90%, respectively. Absorption with campylobacter jejoni did not change the level of IgG against H.pylori. Negativity of urease test dose not show the eradication or absence of bacteria, but shows the low number of bacteria in biopsy materials. This report suggest that IFA is an advantageous, sensitive and reliable test in diagnosis of H.pylori infection.