Tehran University Medical Journal

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The autopsies, which have been performed within the last 50 years, have revealed that real prevalence of prostatic carcinoma is more frequent than clinical one. The real prevalence of prostatic carcinoma, is prevalence combination of carcinomas which have been revealed clinically (They have been confirmed by autopsy or by operation) and the prostatic latent carcinomas are those, which are found in autopsy or randomly in the biopsies taken for hyperplasia. But they have no clinical syndromes. In order to review prevalence of prostatic latent carcinoma in Iran, all prostatic lesions (Including hyperplasia or carcinoma) were studied in Imam Khomeini medical complex during 10 years (1981-91), in university Jihad center and medical center of Iran within 2 years and in Yazd faculty of medicine within 3 years (1981-84). The total cases were 1110 among which 1085 cases were selected upon reviewing for statistical analysis. At first all lamellas were studied, then the ratio of adenocarcinoma to total prostatic lesions were analyzed and types of carcinoma and their percentage in total cases were identified. Finally the prostatic latent carcinoma and its percentage in total malignancy cases were presented

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Survey of anatomic variations of coronary arteries is the most fundamental of researches in the field of these vessels. For performing this survey, coronary arteries (CA'S) of 463 human heart cases (gathered from three different surces: 1) Legal medicine center corpses, 2) Cadavers of dissection rooms in medical schools, and 3) CA'S angiographic films from hospital centers) were studied. After comparison between the statistical results in this research and the foreign ones, similarities and differentes from this subjects were ascertained as below, that, there were relatively considerable differences between: the number of CA'S (presence of 2 or 3 branches), origin of S.A. node artery, and type of main left coronary artery divisions (2 or 3 branches producing), but, in the other instances no considerable differences were observed

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Children undergoing general anesthesia for strabismus surgery have a higher incidence of postoperative vomiting than those receiving the same anaesthesia for other types of ambulatory surgical procedures. Droperidol (0/0 75 mg/kg IV) and promethazine (0.05-1.0 mg/kg) were used in 100 children between 2-15 years old. Promethazine which has sedative property, anticholinergic antihistaminic, antiemetic and anti-motion sickness effects is recommended for children 0.05 mg-1.0 mg/kg of body weight IV. After induction of anesthesia and before operation and manipulation of the eye and combined with 0.5 mg/kg IM promethazine after operation. The incidence of vomiting following strabismus surgery might be reduced more than with intravenous droperidol

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Proximal weakness specially in extremitas is a common neurologic symptom of patients, for which the physician should consider toxic, metabolic, infectious and paraneoblastic diseases affecting muscular system as well as primary myopathies. Osteomalacia is one of the most common considerations which is treatable but disabling as its natural course. Osteomalacia is the most often due to VITD or calcium deficiency but work up is necessary to find other primary defects that cause this disease. Renal tubular acidosis is one of these primary defects and osteomalacia secondary to it dose not respond to classic treatment of osteomalacia, so specific management is necessary. In this article we report six patients who have been referred to the clinic of neurology of Imam Khomeini Hospital since 1370 to 1374 with proximal weakness for whom RTA has been diagnosed

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A seventeen-years old woman was presented with infertility and primary amenorrhea. She had normal stature, femate phenotype and normal development of breasts, external genitalia, vagina and cervix. Pelvic examination showed a large lobulated mass. On sonography there was a mass with probable origin of ovary. Paraclinic tests were carried out. Gonadotropins were in postmeno pausal limits. Alpha Fetoprotein, Beta Subunit (B-HCG) assay were normal Laparotomy revealed a gonadat mass on right side, normal uterus and left streak gonad. Pathologic report of tumor was dysgerminoma and teratoma. Due to pathology of tumor and Y chromosome, we advised the patient to remove the other streak gonad and have irradiatio

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Psoriasis is an common, chronic, recurrent, inflammatory disease of the skin, characterized by red scaling plaques on the skin surface. The morphology of psoriatic lesions allows classification of the different types of psoriasis that included plaque type, pustular type and Erythrodermic type. I have studied the relationship between distribution of RH and ABO blood groups in 110 psoriatic patients and compared with control normal blood groups. The result of this study was as follow: The rate of blood group type AB was significantly lower than that of the control normal blood group ABO

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Levamizole hydrochloride (C11H12 N2 S.HCl) is a drug capable of being rapidly absorbed from the gastrointestinal tract and is also rapidly eliminated from plasma. It has a modulating effect on the immunesystem, and may be used in treatment of parasitic diseases and infections. Because of its toxicity to liver and its rapid clearance from plasma, this drug must be formulated in such a way so as to decrease its necessary dosage and thus its toxic effect on the liver while improving or at least maintaining its present tolerance to disintegrating factors in the surrounding and its ability to efficiently reach its target tissues (the immune system). Therefore, the liposomal form of levamizole hydrochloride can be helpful in achieving the stated goals. In this study, first a preparation of a multilayer liposome with hydrophilic coating was done. For this purpose, a mixture of phosphate buffer (soudium and potassium phosphate I, 4 mmol, pH =7.4) ethanol and lipid (100 mg phosphatidyl choline, extracted from soya) was used (buffer 200 mg, ethanol 80 mg, lipid 100 mg). Also levamizole hydrochloride with half a solubility in water was used. The above solutions from levamizole containing liposomes under a few cycles of freeze-thawing method (20-60°C). Ultracentrifugation (45 min, 60.000 rpm) was used to determining the extent of drug encapsulation in this method we can calculate the percent encapsulation using a control. In our method this percentage was calculated to be 92.7%.

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Mycosis fungoides is virtually a kind of cutaneous T cell lymphoma. The wide spectrum of clinical, and histopathologial features of MF accessitated performing an exact study on it. During a retrospective survey, clinical findings of 115 in-patients and histopathological finding of 366 ontpatients and inpatients of MF in an 8½ years period were studies with special attention to the pathological Aspects: Males were affected more than females. Their ages ranges from 11-88 years. The most common symptom and sign were pruritus and scaling, respectively. The first involved areas in male were the limbs and females was the trunk. The role of environmental and occupational factors in pathogenesis deserves greater contemplation. There were four distinct histopathological pattern in the epidermis: 1) without significant changes, 2) hyperplasia, 3) poikilodermatosus and 4) pagetoid patten. Epidrmotropism with or without associated pauntrier's microabscesses and halo cells was noted in the majority of cases (233 patients). The inflammatory infiltrate with predominence of atypical lymphocytes and also fibrosis, edema and occasional grenz-zone were the prominent finding of papillary dermis. The major finding of hypodermis was septal panniculitis. In conclusion integrated correlation between clinical and wide spectrum pathologic features of M.F could be a gnide to early diagnosis and appropriate mangement.

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The discovery of antifertility activity of gossypol led the scientists and researchers to the development of compounds with antifertility activity that can be used as male contraceptive. It is obvious that without the contribution and sense of responsibility in men, the population control programs and family planning will have no considerable success. In the present study, I have tried to evaluate two newly synthesized analog of diaminopyrimidines compounds with the chemical name of 2,4-diamino-5 (3,4-dichlorophenyl) 6-alcheloxymethylpyrimidine (ethyoxy and isobothyloxy) on male rats. This study indicates that this compounds without any toxic effects, significantly decrease the serum testosterone, sperm mortility (SM), percent of viable sperms, daily sperm production (DSP), epididimal sperm reserve (ESR) and fertility rats

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Differential diagnosis of Iron-deficiency anemia and Beta-Thalassemia, two common causes of anemia, affects the treatment in pregnant women. To help the diagnosis, we have tried to asses the pure effect of gestation on diagnostic criteria, eliminating iron and folate deficiency. In a prospective study, 46 thalassemic women were given Ferrous Sulphate tablets and Folate. Some indices, CBC and HbA2 were measured before and after treatment during pregnancy. The haemoglobin and HbA2 decreased and MCV increased, all with significant P value. We concluded that HbA2, independent of iron, will decrease during pregnancy and MCV will increase

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In this study, 307 samples of the sediments of fish breeding pools of the different parts of North of Iran were tested for the survey of different environmental Mycobacteria. After the process of cultivation, 107 cases of Mycobacterium were gained which after the performance of different biochemical tests. 112 cases of Mycobacterium were identified. From among the isolated Mycobacteria, the highest rank belonged to M.fortuitum with the frequency of 13.97% and the next M.gordonae 10.66% M.xenopi, M.nonchromagenicum 8.2% and the last M.marinum with the frequency of 5.74%. M.marinum was the case of Tuberculosis of fish and had important role in the creation of granuloma. Next to that, M.fortuitum, M.kanasasii and M.gordenae had less importance. The existence of such Mycobacteria in the fish breeding pools were on one hand the cause of pollution of fish and on the other hand the fishman and other people who are somehow connected to the fish and the pools sediments are subject to disease in case of existence of injury in their hands or feet

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Some of the endocrinologic diseases, especially Acromegaly, Cushing and Pheochromocytoma have multiple effects on blood glucose metabolism and regulation in non-diabetic patients. In this retrospective survey, records of patients of Tehran Medical Sciences University hospitals have been reviewd. Of 124 Acromegals, GTT was performed for 51 patients, being impaired in 18%. To evaluate diabetes, FBS and BS of 90 patients were checked, overt diabetes was detected in 27%. Among 90 Cushing patients, blood glucose was checked in 60 cases, 47% of these patients had levels above the normal range, and 39% had glucosuria. Among 80 Pheochromocytoma patients, 16 cases (26.5%) had overt diabetes. In comparison with other studied, we have obtained a little different results concerning diabetes and impaired GTT prevalence

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In this survey, 600 autopsy files from Legal Medicine Center were reviewed to find out the cause of death in traumatic patients. The results are presented by age, gender, type of trauma and cause of death. The most common type of trauma is vehicle accidents and 70% of subjects are males. Trauma resulting in death is most common ing third decade of life

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Carpal tunnel syndrome (CTS) is considered by researchers because of its high prevalence, and several studies have been done to find the causes and factors which increase the chance for the syndrome. These studies have shown relationships between this syndrome with some physical parameters like wrist dimensions, weight and systemic conditions. There is no investigation on risk factors in CTS in our country. So the main goal of this research is to find and introduce predisposing factors for carpal tunnel syndrome. Methods: Seventy patients and 33 controls 22 to 70 years old were studied. Standard methods for median and ulnar nerve studies were used and questionnaires included physical measurements, history of diseases and personal information were completed for each person. Results: Patients had higher wrist ratio (mean difference, 0.0267, P<0.001), weight (mean difference: 6.098, P<0.001) and body mass index (mean difference: 3.376, P<0.001). Regression analysis showed strong positive relation between wrist ratio and median latencies. The strongest correlation was found between wrist ratio and median minus ulnar distal sensory latencies (Y2=0.4014, P<0.0001). No relation was found between weight and body mass index with median latencies. Seventy-nine percent of patients and 48.5% of controls had wrist ratio of 0.7 or greater (P<0.05). Seventy-two percent of patients with repetetive hand activities and 78% with associated conditions had wrist ratio of 0.7 or greater. Seventy-six percent had wrist ratio less than 0.7. No relationship was found between obesity, diabetes, thyroid disorders, rheumatoid arthritis, taking oral contraceptive, hysterectomy, oophorectomy, menopause and repetetive hand activities with involvement of carpal tunnel syndrome. Discussion: Wrist dimensions seem to be an important predictor for carpal tunnel syndrome also in patients with associated conditions. If individuals with squarer wrists are involved in special conditions, they may show symptoms of the syndrom. Carpal tunnel syndrome is caused by many factors but wrist dimensions seem to be a predisposing factor and provides an explanation for bilateral involvement or familial occurrence of it.

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Pain is one of the most important and sometimes difficult problems, that patients and physicians are encountered. It may be clinically acute or chronic, acute pain has usually definite cause and favourable response to treatment. On the other hand there are difficulties in diagnosis and management of chronic pain. Peripheral and cranial nerves convey pain impulses toward central nervous system, and modulations take place at several levels. Diagnosis of different pains, including nociceptive, nerve trunk pain and deafferentation types is essential to acceptable management. In this article we review pain pathway, neurotransmitters and modulation.

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Pheochromocytoma is a rare disease. A retrospective study of the signs and clinical course of this disorder was performed by evaluating medical records. Our fidings indicate that the prevalence of pheochromocytoma was equal in men and women, and most patients (56%) were in their second and third decades of life. In 10% of the cases, the disease was bilateral, and in 13% it was outside the adrenal (totally para-aortic). The tumor was more common on the right side (8%), and 3.5% were familial. Almost all cases had a history of hypertension and hypertensive crises. Attack-like episodes of clinical symptoms and signs and hypertension were observed in 98%, headache in 71% and profuse perspiration in 68% of the cases. An abdominal mass was palapated in 13% of the cases, 26% had overt diabetes, 23% had ECG changes. Malignancy was observed in 4%, with metastases to the liver (n=2) lung (n=1) and spine (n=1). In the latter four cases, the metastic lesion was histologically proven to be pheochromocytoma. In three of the 28 female cases, the first hypertensive crisis occurred during pregnancy causing abortion in one case.

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A cross-sectional study was conducted on type II diabetic patients during 1991-1996 in Isfahan. By systemic sampling, 715 patients were enrolled. Variables studied, include: age, gender, duration of diabetes, body mass index (BMI), literacy, smoking habits, hypertension, lipid profiles, fasting blood glucose (FBS), retinopathy, ischaemic heart disease (IHD), proteinuria and type of treatment of diabetes. Prevalence of IHD in males (37.4%) was more than females (32.6%). Logistic regression analysis revealed a direct association between IHD prevalence with age, BMI, hypertension, proteinuria, diabetic retinopathy and type of treatment. Conclusions: 1) The factors mentiond are good predictors of IHD, but genetic influences may also contribute to the risk of IHD. 2) As obesity and BMI are prone to medical manipulation, control of these risk factors may decrease prevalence of IHD.

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L-fucose (6.deoxy. L.galactose) is the only monosacharide which is placed in non reducting position of glycoproteins structure in L-deoxy form. L-fucosidase and fucosy 1 transferase directly take part in the elevation or decrease of sorum L-fucose levels. Tumors may directly induce enzymes that release L-fucose from glycoproteins formed in the neoplastic tissue, or the glycoproteins may be released indirectly as a result of body-defense metabolic secretion of glycoproteins and their filtration in glomeruls, and has a close correlation with glomerular filtration rate (GFR). In this study we compared urinary L-fucose of 30 known cases of cancer versus 40 healthy people. Fifteen patients had Gastrointestinal (GI) cancer and 15 patients Gyneclologic (Gyn) cancer. There was significant difference between urinary L-fucose of patients with GI cancer and controls (P<0.01), and also we saw the same result (P<0.01) in Gyn patients in comparison with controls. Significant elevations of urinary L-fucose, in GI and GY cancers may lead us in the way to further evaluation of its relationship with L-fucose levels to make its early diagnosis and better prognosis in susceptible individuals and those at a high risk of developing cancer, possible.

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In this study, we investigated variations of the angle between neck and shaft of femur after amputation of tigh above the knee. In amputated tigh the angle between neck and shaft of the femur is decreased than normal (nearly 90° degrees) (coax vara). The angle of the normal femur usually increases due to weight bearing (coax valga). In the patients that both tighs have been amputated the changes of the angle are equal.

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The culture results of 203 cases with different wounds were studies 150 of the latter were burn cases (mainly second and third degree burns), and 53 were of other types (surgical, traumatic, ect). Four subtypes of Bacillus cereus were isolated upon culture, and the different toxins produced in DHT broth with 0.1% glucose were assessed. The lethal toxin was injected intravenously to Syrian rats, none of whom died. VPR factor was assessed in the 4 subtypes. Three subtypes produced VPR in significant amounts.