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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Carnitine is a water-soluble quaternary amine which increases the long-chain fatty acid metabolism by facilitation of their transport to the oxidation site (mitochondria). Carnitine most likely is present in all animal species, in many microorganisms, and in many plants. In this study, we determined the carnitine level of sera in pregnant and non-pregnant women by segade modified method. Average concentration of carnitine in the sera of fifty pregnant women was about 25/83 umol/I: First trimester-30.96 umol/I. Second trimester-29.11 umol/I. Third trimester-25.11 umol/I. concentration of cholesterol and triglyceride in the above-mentioned group was the following: Cholesterol: 258.84 mg/dl triglyceride: 267.02 mg/dl. The above values show that the carnitine level in sera of pregnant women decreases significantly and this decrease is tolerated well by pregnant women. According to our results, the serum carnitine concentration in pregnant women gradually decreases as gestation proceeds. So that the end of this period, is half of its concentration before conception. During pregnancy, there was an inverse correlation between carnitine level and that of cholesterol and triglycerides. Decrease in carnitine concentration and increase in cholesterol and triglyceride levels may be due to the following factors: 1) Increase in FFA oxidation in pregnancy. 2) Hormones. 3) Dilution of the blood. 4) Decrease in Fe storage in pregnant women.

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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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Histiocytic syndromes have been studied and investigated in these recent years for their cell origin, morphology, pathology, histochemical, immuno-phenotype characteristic, and their nomenclature, but the results of all these studies are confusingly, vague and not acceptable for all scientists and pathologists. Histiocytes very in the morphology, duty and their immunological behaviour. In different lesion these cells are in the form of mononuclear, foamy cell, macrophages like plasma cell and giant cell with many nuclei. When considering malignant Histiocyte cells and benign reactive histiocytes are both present in malignant histiocytic lesion, one can recognize the diagnostic problems of the pathologist. Markers for recognizing histiocytes are numerous and are increasing rapidly, in spite of that monoclonal antibody investigation, and genetic molecular method, the results as yet are not satisfactory. We have to accept that the new method are not at all sufficient and we have to look for a better method which is more sensitive to histiocyte for diagnosis of numerous histiocytic syndromes. In this paper, we discuss the difficulties on encountered in the diagnosis, and problem in defining and nomenclature of these syndromes and, some efforts are made to present the most acceptable classification for them

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201 blood samples were collected by cluster sampling from 7-11 years old children and measles antibody titer was measured by hemagglutination inhibition test. Despite testing all the sera, the results were analysed on the 139 samples that had documented vaccination records and no history of measles. Among 139 children 44 had received 2 doses of vaccine one dose before 12 and one after 15 months, 64 had one dose after 15 months, 29 had only one dose before 12 months and 2 had not received vaccine. The antibody titer of the first two groups had no significant difference with those that had received one vaccine dose, before the age 12 months (P<0.001). There were no significant differences in the titer of antibodies with time elapse in none of the vaccination histories. This may be due to efficacy of vaccine and also circulation of wild virus in the community. Regardless of the history of vaccination, 95.5% of children had immunity to measles (titer?3). Considering the results if the current strategy of vaccination implemented completely, the status of immunity would be satisfactory.

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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.

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Behcet disease (BD) is a systemic inflammatory disease of the unknown etiology. There is however, some evidence to suggest that immunological abnormalities are important in its pathogenesis, furthermore several T-cell abnormalities which may be quite relevant to autoimmune origin of the disease have been described. We report here our study of T-cell subsets, B and NK cells in 68 patients with BD in comparison to 30 normal controls, by monoclonal antibodies against CD3 (pan T-cell), CD4 (Helper) CD8 (Suppressor/cytotoxic), CD22 (B-cell) and CD16 (NK-cell) markers. The results show the increase (P=0.008) of T (CD3), T (CD4) (P<0.000001) and decrease of T (CD8) (P<0.000001) and reduction in ratio of CD4/CD8 cells (P<0.000001), but any alteration in B and NK cells number were not seen. In patients with BD 69.8% negative PPD test and above results suggests that the cellular immunity in these patients is anergic, which may be an important etiological factor.

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The Turkmans are one of the Iranian ethnic population. HLA typing (class I and II) was performed in this population. The data obtained from this study was compared with different populations of the world. We observed that the Turkman population is most similar to the Northern chinese and Uigur population. The distributions of HLA antigens in Turkmans are somewhat between Iranian population, Northern chinese and Uigur population. Natural selection and gene alteration select the people who could better adopt themselves with new conditions. Investigation of Turkman's HLA in comparison with Iranian's HLA reveals more details in genetics of Behcet's disease. Behcet's disease is very rare in Turkmans (index 0.5) whereas its frequency is high in other Iranians and Northern chinese. Distribution of susceptible antigens like B5 is the same in Turkmans and Northern chinese (19.5%) but much higher in other Iranians, whereas B35 have almost the same distribution in Turkmans and Iranians (37% and 33% respectively). DQW1 and CW4 antigens which were suspected to have a negative association with Behcet's disease are the most frequent antigens in Turkmans.

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In this work, we tried to know something more about the embryotoxicity effects of the doses of 50, 200, 400 mg/kg/day of ranitidine of (H2 antihistaminic agent) by intraperitoneal administration on mice. The studies were performed on albino mice kept under specific conditions and a constant dark-light cycle at 24+1C and 55+5% relative humidity. Generally, the animals were acclimatized for four weeks before mating. Two female mice at 12-14 weeks of age were placed overnight with a male of proven fertility. The day on which a vaginal plug was found, was taken as day one of pregnancy. Also the vaginal smear was prepared for further proof. Treatment of pregnant females was started from day 7 and continued up to the 15th day of gestation and then on day 18 they were necropsied for routine teratological observations. The live fetuses were weighed and inspected for gross external abnormalities under a dissecting microscope. Resorption plus dead fetuses less than 6mm of length were designated early death and dead fetuses of more than 6mm of length were consequently called late death. The statistical study was done by student t-test. One-third of the fetuses were fixed in bouin's fluid to detect visceral malformations by the rasor- section technique. There was no significant difference in the frequency of late death between the control groups and the groups given ranitidine. Differences were observed in the number of implantation sites except for 400 mg/kg/day. Data pooled from all experimental groups clearly show that pig tail, deformed cranium, low body weight and skeleton, unshaped external ear and jaw and polydactyly are the most common external abnormalities. Results of this study show the hazards o the ranitidine used during early pregnancy.

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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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Psoriasis is a chronic, inflammatory and proliferative skin disease that has a wide distribution throughout the world. The immune system plays a critical role in developing this disease. In this survey, we have studied 50 patients suffering from Psoriasis and 50 control subjects for various immunological factors, simultaneously. Anti-stratum corneum (SC) antibody was evaluated by immunofluorescent technique that showed a high significant level of it in patients (P<0.005). The titer of immunoglobulins (IgG, M, and A) measured by radial-immunodiffusion (RID) method was also higher in normal population. CIC estimated by PEG precipitating technique demonstrated high concentration in patients. TNF, a cytokine with strong performance to induce inflammation, had no significant rising amount in patient sera, but in synovial fluid in Psoriasis arthritis may have higher levels. We discuss that due to immunological findings we consider that Psoriasis is probably as an autoimmune disorder. The prevention, treatment and prognosis of the disease may follow the same procedures as other autoimmune diseases and further investigation will be helpful to achieve the above goal

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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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Failed back surgery syndrome (FBSS) is many a times an intractable problem confronted in patients with surgical disease of lumbar spine and at the same time is a pressing problem for the physicians as well. This clinical entity is defined as continuation of pain in the lumbar region and lower extremities following surgery of the lumbar spine. Knowledge of the etiological factors and their prevention is the best line of treatment to overcome the evolution of this syndrome. During this study, which was conducted in Imam Khomeini hospital Tehran from the year 1989 till 1990, 43 out of 114 patients developed "FBSS". 23 cases responded to conservative treatment and psychotherapy whereas medical treatment failed to achieve fruitful results in the rest. The latter underwent extensive radiological investigations and repeat surgery. According to this study, we recommend that in the initial management of these patients. The surgeon should observe the dictum of "5-mis" to overcome and minimize the "FBSS" entity

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In 100 healthy, adult and female mice weighing about 20 to 25 g each, paris of full thickness and nearly symmetrical cutaneous wounds, 100±15 mm² each were created in dorsolumbar region. Mice were divided into 3 groups randomly, group 1 (Right wound exposure), group 2 (Left wound exposure) and group 3 (Control). Wounds were exposed to laser He-Ne (632.8 were length and 16 mw constant power) for 10 days, 250 seconds each day. The control group mice were in equal situation except for the exposure wound were measured in size once every 2 days. Also biopsies were made from a clear number of cases once every 3 days from microscopic evaluation of wound healing stages. The difference in wound healing between the test groups and controls was significant as confirmed by statistical methods (E.g. one way ANOVA and SCHEFFE) with (?=0.05) and proved by microscopic findings. This experiment were made in "Blind" form. There was no significant difference in wound healing between 2 sides in test groups, this strengthens the idea that laser therapy causes the release of systemic wound healing factors

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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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In our investigation, rabbit hyper-immune serum to V.cholerae ogawa was absorbed with V.cholerae inaba whole-cells and vice versa. Applying ammonium sulphate precipitation method, mono-specific g globulins were purified and concentrated from the absorbed whole serum. These antibodies were fixed on staphylococcus cowan 1 NCTC-8325 whole-cells, using different chemical fixatives. It was observed that maximum fixation of g globulin to protein-A was achieved by 1-propanol 50% at 3 hours, which revealed through single radial immuno-diffusion techniqe. The rectal swab samples were cultured in an enrichment bile-peptons broth. After 5 hours 37°C while agitations, one drop of each sample was mixed with one drop of vibrio-cholerae bivalent mono-specific coagglutination reagent (VBCR). The results were read after 2 to 3 minutes. Finally though statistical analysis sensitivity and specificity of coagglutination test were calculated to be 95.1% and 99.2% respectively, when compared to positive & negative controls and conventional culture methods. Using VBCR, coagglutination test can be therefore considered as a simple, reliable and rapid method to detect V.cholerae O1 in the stool of patients in endemic area and less equipped laboratories

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A case with bilateral spontaneous pneumothorax was presented. Etiology, mechanism, and treatment were discussed on the review of literature. Spontaneous Pneumothorax is a clinical entity resulting from a sudden non traumatic rupture of the lung. Biach reported in 1880 that 78% of 916 patients with spontaneous pneumothorax had tuberculosis. Kjergaard emphasized 1932 the primary importance of subpleural bleb disease. Currently the clinical spectrum of spontaneous pneumothorax seems to have entered a third era with the recognition of the interstitial lung disease and AIDS as a significant etiology. Standard treatment is including: observation, thoracocentesis, tube thoracostomy. Chemical pleurodesis, bullectomy or wedge resection of lung with pleural abrasion and occasionally pleurectomy. Little information has been reported regarding the efficacy of such treatment in spontaneous pneumothorax secondary to non bleb disease

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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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Vestibular schwannoma is the most common tumor of the posterior fossa of the skull. Patients referred with the primary otologic symptoms such as hearing loss, tinnitus, vertigo, imbalance, and the cranial nerve palsy. Thirty-three patients were operated and treated by a team of otolaryngologist and neurosurgeon, anudiometrist, and internist. Patients'chiefcomplaint was due to 94% hearing loss and 27% tinnitus. They scarcely complain of vertigo. If a patient refers with the palsy or paralysis of facial nerve preoperation, we must think of the facial nerve schwannoma or hemangioma or congential cholestoma or malignant metastases rather than acoustic neuroma. The best way for preoperative diagnosis is audiometry, ABR (Auditory Brain Response), and SDS (speech discrimination score) with 90% success, but computer Tomography (CT) scan and MRI (Magnetic Resonance Image) are the valuable anatomic diagnostic radiographic devices. The best method of operation is translabirynthine approach (TLA), since it has the advantages such as an easy access to nerve paths and being the nearest path to CPA (Cerebellopontine Angle). Physicians ought to talk to patients about the importance of the microscopic surgery, surgical methods, and their probable diverse effects such as hearing loss, facial nerve palsy, and intracranial problems.