Tehran University Medical Journal

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This is a mortality study in internal medicine wards of Amir-Alam Hospital, since the beginning of 1374 to end of 1376. Here, we reviewed, prevalence of disease lead to death, the ward and invasive interventions and duration of admission of patients before death. In this study, records of 85 patients were reviewed. 68.2% of patients were men and 31.8% women. Mean of age was 61.6% with minimum of 18 and maximum 95 years. The most prevalent diseases leading to death were cardio vascular (41.2%), cancer 29.4%, GI tract diseases (10.6%), pulmonary diseases (8.3%), CNS (7.1%), hemathologic (4.7%), DM (3.5%). Mean duration of stay in hospital before death was 6.6 days (max 30-min 1). This figure in different wards were: ward 1 (7 days), ward 2 (11 days), ward 3 (5.9 days) ICU (5 days) and CCU (4.7 days). 90.5% of patients died due to their diagnosed illnesses. Invasive tests and intervations were performed in 40% of them. As a whole 35 patient were died in CCU. This research and others like it showes the failures of our patient management system and can guide us in approaching to better medical care.

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Regarding the prevalence of cancer in tongue and the management procedure of cases who have recurrence in cervical lymph nodes after partial glossectomy and in order to determine appropriate management of neck in early oral tongue cancer it was decided to conduct a study. A retrospective review of 62 patients with T1,2 N0 M0 SCC of the oral tongue treated by only partial glossectomy at Cancer Institute of Tehran university was conducted (from 1991 to 2000). Most of these patients were in 7th decade of life, men were affected more than women. Cervical lymph node recurrence at 2 years was 45.1 percent (28 patients from 62). In 34 patients (54.9 percent) who had not any recurrence in neck, 12 patients had received prophylactic neck radiation therapy after operation. With excluding this group of patients, the rate of cervical recurrence in early oral tongue cancer will rise to 56 percent. According to these findings, it is recommended that elective node dissection should be considered in the initial management of T1,2 N0 M0 oral tongue squamous cell carcinoma in our country.

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Background: Stereologic methods are used to obtain quantitative information about three dimensional structures from histologic sections. The aim of present study was using new and unbiased stereological techniques to investigated changes in volume and number of glomeruli after chronic lead acetate intoxication. Lead is one of the heavy metals that have adverse effects on renal function. Its effects can involve both renal tubules as well as glomeruli. So many studies based on observation and qualitative reports. Some of which report changes in volume and number of glomeruli.

Materials and Methods: Male Wistar rats were randomly divided to four groups (n=9). During a period of 8 weeks, the treatment groups were given 0.5 percent and 1 percent lead acetate in drinking water and the control and sham control were given distilled water and 0.4 percent acetic acid solution respectively. Stereological analysis based on Cavalierie's principle was performed to determine the reference volume (VRefrence), the fraction volume of glomeruli (VVGlom) and total glomerular volume (VTGlom). Furthermore, for estimating the numerical density (NVGlom) and total number of glomeruli (NTGlom), the physical dissector was utilized.

Results: Results showed that the number of glomeruli in treatment group which received 1 percent lead acetate in drinking water decreased significantly (P<0.05), but no changes occurred in 0.5 percent group (P>0.05). On the other hand glomerular total volume in both 0.5 percent and 1 percent groups increased significantly in comparison to control and sham control groups (P=0.000).

Conclusion: This experiment is in agreement with other qualitative reports by using unbiased method of stereological methods and showed changes in volume and number of glomeruli following lead acetate intoxication.