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Volume 66, Issue 4 (7-2008)
Abstract
Background: The Ross procedure has been known as a good method for aortic valve replacement. Pulmonary allograft postoperative stenosis subsequent to the Ross procedure has been noted as an important disadvantage of this technique, although risk factors related to this complication are not clearly recognized. In this study we evaluate the risk factors of pulmonary allograft stenosis after Ross procedure.
Methods: This retrospective cohort study was carried out on 42 patients who underwent the Ross procedure. Left ventricular outflow tract obstruction was repaired using pulmonary allografts 22.7±2.5 mm in diameter. Echocardiographic and clinical examinations were performed for all patients at six and 12 months after surgery. Echocardiographic data as well as data related to the allografts were recorded.
Results: The mean age of the patients was 28.5±10 years. Postoperative pulmonary valve stenosis was detected in 13 patients (31%). Nine patients (21.4%) had mild stenosis and four patients (9.5%) had moderate stenosis. No relationship was detected between the degree of stenosis and the size of allograft (p=0.08). There was a significant correlation between postoperative pulmonary stenosis and donor age (p=0.04). Predictive variables of pulmonary allograft stenosis after the Ross procedure were low donor and recipient age (p=0.03 and 0.05, respectively).
Conclusions: This study shows that the Ross procedure has a rather low incidence of postoperative stenosis and is a suitable substitute for aortic valve replacement. Low donor age is associated with pulmonary allograft stenosis formation, perhaps due to greater viability of tissue cells from younger donors.
L Sharifi, Z Pourpak, S Bokaie, A Karimi, M Gharegozloo, M Movahhedi, M Moin,
Volume 66, Issue 5 (8-2008)
Abstract
Background: In the treatment of bronchial asthma, the identification, isolation, and elimination of causative allergens is the most effective part of treatment. With the recent diversification within the pet industry, pet owner exposure to many unknown antigens is on the rise. The results of population studies have been contradictory and some epidemiological studies have failed to confirm this, some indicating that keeping pets might actually reduce the risk of sensitization and asthma. The purpose of this study was to determine the association between pet ownership and asthma.
Methods: This case-control study included 300 asthmatic participants referred to the Children's Medical Center over a two-year period. Participants were asked to fill out a questionnaire regarding pet ownership, pet gender and puberty, the place it was kept, how long the pet was kept and the reason for keeping the pet. The same questions were asked from 300 age- and gender-matched nonasthmatic individuals as the control group. Statistical analysis was performed to calculate odds ratios (OR) of asthma morbidity in individuals who kept pets.
Results: The OR for asthma morbidity in patients who kept pets was 2.59 (CI=1.60-4.21 and p>0.001). Financial aim was the most common reason for keeping a pet and most pets were mature and kept outdoors. No significant correlations for pet genders were observed.
Conclusion: This survey provides evidence that pet ownership is an important risk factor for asthma, therefore we suggest that individuals at risk for asthma (atopic individuals) must avoid contact with pets. However, more research in this field in Iran is necessary.
Rahimi Sharbaf F, Mirzaei F, Kaveh M,
Volume 66, Issue 6 (9-2008)
Abstract
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Background: The
prevalence of Rh alloimmunization has decreased following the use of anti-D
immunoglobulin. With serial amniocentesis, Doppler sonography of the middle
cerebral artery and treatment of anemia with intrauterine blood transfusion, perinatal
mortality has declined. However, Rh alloimmunization in twin pregnancies poses
a diagnostic and therapeutic challenge.
Case report: We are reporting,
for the first time in Iran, the successful treatment of severe Rh
alloimmunization in a dichorionic- diamnionic twin pregnancy leading to the
live births of both neonates. Before treatment, the fetal hemoglobin levels
were 3.1g/dL and 3.9g/dL, with ascites in both fetuses. The fetuses were
treated with several IUTs.
Results: After treatment, the neonates were
delivered, weighing 2200 and 2300g, with good Apgar scores, at a gestational
age of 34 weeks.
Conclusion: 10%
of population in Iran is Rh-negative, although Prophylaxis for Rh
alloimmunization is universal, as other part of the world it cannot irrigated.
For the best management of these cases, we need a well-equipped referral
center.
Ghafouri A, Nasiri Sh, Karam Nejad M, Farshidfar F,
Volume 66, Issue 7 (10-2008)
Abstract
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Background: Port-site metastasis following laparoscopic
cholecystectomy with unsuspected gallbladder carcinoma is a serious problem.
Gallbladder carcinoma is found in 1% of all biliary tract operations, in most being diagnosed only after
histological examination of the gallbladder. The spread of cancer following
laparoscopy appears aggressive and widespread, as noticed from re-operation for
radical treatment. The pathologic findings of gallbladder were consisting of
tumoral and necrotic tissue, indicating of well differentiated adenocarcinoma.
Mucosa and submucosa were involved, but no evidence of invasion to muscular
layer and gall bladder serosa was found (T1). In this article we present the first of an unusual case of four port
site adenocarcinoma metastasis from gallbladder cancer.
Case report: A 63 year old woman
underwent laparoscopic cholecystectomy for acute cholecystitis. Thirty months
later, she was admitted to the hospital with a complaint of masses at the four
trocar sites. A biopsy from the port sites was undertaken
and led to the diagnosis of adenocarcinoma metastasis. There is no published
report of all four port site metastasis of
gallbladder cancer after laparoscopic cholecystectomy.
Radmehr H, Tatari H, Salehi M, Bakhshande A,
Volume 66, Issue 12 (3-2009)
Abstract
Background: The usage of pericardium of patient himself, for support of anastomosis lines may carry benefits in patients undergoing aortic valve replacement with pulmonary autograft (Ross). The aim of the present study was to compare the short term results of aortic valve replacement with pulmonary autograft with routine and offered methods.
Methods: In a non-randomized clinical trial, 64 patients who referred to cardiac surgery ward of Imam Khomeini hospital Tehran Iran from December 2002 to December 2006 for aortic valve replacement with pulmonary autograft with two different methods. In the first two years of this study all of the patients were operated with routine procedure (group A, n=28) and during the next two years, all of them were operated with authors' offered method in which the patient`s pericardium was used for support of anastomosis lines (group B, n=36). Some of clinical parameters and outcome were compared between two groups.
Results: There were no significant differences between mean of age, sex, pathology, preoperative and postoperative EF in two groups. In group B, the mean pump time was significantly lower than group A (144.09±26 vs. 179.64±25 min). The mean Cross-clamp time was significantly lower in group B (118.5±22 vs. 136.93±19 min) Need for blood transfusion in ICU was significantly lower in group B (35.71% vs. 68.57%). Mean ICU Stay and Postoperative Hospital Stay were significantly lower in group B (1.3±0.3 vs. 1.9±0.7 and 5.2±0.9 vs. 5.9±1.5 days respectively). Overall mortality was four death (6.25%) which was not significant between two groups.
Conclusions: The usage of patient's pericardium for support of anastomosis lines in patients undergoing aortic root replacement with pulmonary autograft carry advantages to routine procedure and its utilization is advocated in other centers.
Ahani R, Derakhshandeh Peykar P, Raoofian R, Heidari M,
Volume 67, Issue 1 (4-2009)
Abstract
Background: Leukemia is one of the most common pediatric malignancies. T-cell Acute Lymphoblastic Leukemia (T-ALL) accounts for 15% of hematopoetic cancers. It has been well understood that identification of genetic alterations associated with leukemias is very critical. The molecular genetic techniques have promoted the identification of leukemia-associated genetic changes that may characterize the most accurate predictors of clinical outcome. These considerations reinforce the requirement for rapid identification of the abnormalities.
Methods: Multiplex RT-PCR, a highly sensitive and specific method applied to screen simultaneously three most frequent transcription factors, TLX1/HOX11, TLX3/HOX11L2 and TAL1/SCL which are associated with T-cell Acute Lymphoblastic Leukemia (T-ALL).
Results: We describe here our efforts to establish a multiplex RT-PCR analysis system that facilitates the detection of HPB-ALL and K562 cell lines, respectively.
Conclusion: The multiplex RT-PCR technique is a sensitive, valuable and cost-effective diagnostic tool which could improve our ability to accurately and rapidly risk-stratification of patients with childhood T-ALL. In order to perform multiplex RT-PCR technique researchers do not need bone marrow samples and they can employ this method using peripheral blood samples. Therefore, the status of treatment could be followed by assessment of the level of mRNA expression of oncogenic transcriptional factor using peripheral blood sample. Use of this procedure not only provides the best results in short term for specialist, but also clinicians could have opportunities to choose suitable treatment strategies with decrement of drug side effects.
Hoseinkhan Z, Shamloo Sani N, Naghibi Mahmoodabadi T, Taghizadeh Imani A,
Volume 67, Issue 2 (5-2009)
Abstract
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Background: The ability
of a specific test to predict a difficult intubation is decreased by the
variability of definitions of difficult intubation/laryngoscopy. The Mallampati
classification system is a widely utilized approach for evaluating patients in
the preoperative setting. Zero class of Mallampati is a new class of airway
view that to add to the four modified Mallampati classes. This study estimates
the incidence of class zero airway and determines the ability of Mallampati
score, age and sex on the prediction of the larangoscopy grade.
Methods: This is a
cross sectional study in which 376 patients aged 7-18 years and A.S.A physical
status I or II were enrolled. They were scheduled for surgery under general
anesthesia All the airway assessments were done in the sitting position, with
the patient's head in neutral position, mouth fully open, tongue fully extended
and without phonation. After induction of general anesthesia, laryngoscopy
grade was assessed in sniffing position using the Cormak & Lehame grading
scale.
Results: Class zero
airways occurred in 0.3% of patients, and the patients with class zero airway
had a grade I laryngoscopy. 49.5% of patient had class I, 37.2% class II, 13%
of patient had class III and there found no patient with class IV airway. Grade
II and III laryngoscopy were more frequent in females than in males but this
correlation was not statistically significant.
Conclusions: Assessment
of airway by Mallampati scoring system and attention to the age can be an
important factor in the prediction of high laryngoscopy grade.
Mehrnaz Mesdaghi, Mohammad Vodjgani, Eisa Salehi, Jamshid Hadjati, Abdolfattah Sarrafnejad, Masoud Movahedi, Farideh Berjisian, Tahereh Shahrestani,
Volume 68, Issue 1 (4-2010)
Abstract
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Background: Allergic rhinitis is a common disorder with great morbidity. Its
prevalence has increased during recent years, therefore attracting attentions
to its mechanisms. Type 2 cytokines play a major role in allergies.
It has been proposed that Natural killer (NK) cells may
be able to produce type 2 cytokines. This study was done to
evaluate NK cells number and subtypes in patients
with allergic rhinitis, comparing healthy subjects.
Methods: In a case control study, patients with allergic rhinitis
were compared to healthy non-atopic subjects. Allergic rhinitis was diagnosed
according to ARIA guidelines. NK cells quantity was studied by staining of peripheral blood mono
nuclear cells with anti-CD16-FITC and anti-CD56-PE
and evaluated by two color flowcytometry. Intracellular cytokines were evaluated by tri-color flowcytometry.
NK cells were separated by magnetic beads,
and cultured for 72 hours. Secretion of IL-4, IL-5, IL-10, IL-13, and IFN-γ was measured by ELISA, in stimulated and unstimulated conditions.
Results: Patients had more CD16+ CD56+ NK cells than control group. IL-4+ NK cells were significantly higher in patients (p<0.001), but the number of IFN-γ+ NK cells was not different. Cytokine secretion of NK cells was similar in case and control groups. Although IL-13 level after stimulation seemed higher in patients, the difference
was not significant.
Conclusion: NK cells number is increased in patients with allergic rhinitis and a
considerable number of them produce IL-4.
Kardar Gha, Pourpak Z,
Volume 68, Issue 3 (6-2010)
Abstract
Background: The hypersensitivity to cow’s milk allergens is the most common
allergies in children at the first year of life. The specific IgE evaluation is one of the important methods in diagnosis of allergic disease. The aim of this study was development of a sensitive and credible procedure for detection of cow’s milk allergens specific IgE.
Methods: The allergen discs were prepared by coating of allergens on nitrocellulose paper. After incubation of allergen discs with patients serum, anti-human IgE conjugated were used. In following optimization of any step of ELISAs test, a complete kit was designed. Efficiency of designed kits were evaluated by determination of specific IgE in normal (n= 29) and patient (n= 153) children serum samples and compared with commercial kits.
Results: The specific IgE against three allergrns involving casein, -lactalbumin and - lactoglobulin were measured on normal and patient children serum with designed and commercial ELISA kits. Results were demonstrated specificity of 93%, 89.7% & 82.8% and sensitivity of 86.3%, 81.3% & 89.6% respectively for casein, -lactalbumin and - lactoglobulin specific kits and these results were similar and comparable with commercial kits.
Conclusion: The Designed kits in comparison with the commercial kits were showed equivalent sensitivity and specificity. The designed kit stability was ultimately one month, probably due to don’t using of stabilizers for prepared allergen discs. We suggest these kits for commercial product in Iran and we hope be helpful for easier
accesses for Cow’s milk allergy diagnosis and extend that for other allergens.
Nuraei A, Khajenouri R, Soleimani M, Dabbagh A,
Volume 68, Issue 4 (7-2010)
Abstract
Background: Patients with chronic renal disease, if not treated appropriately, will be usually terminated into an irreversible stage known as End Stage Renal Disease (ESRD), the final stage of kidney disease. End stage renal disease patients cannot excrete the appropriately potassium ion through the kidney. Among the crystalloid solutions, normal saline is devoid of potassium so it is used in a widespread manner in renal transplant patients. High doses of this solution may cause hyperchloremic metabolic acidosis that is accompanied by extracellular potassium shift and impaired splanchnic perfusion. The aim of this study was to assess the effects of two types of solutions, normal saline vs. lactated ringer in these patients during the perioperative period. Methods: In a double blind clinical trial, 108 patients were randomly assigned in two groups (54 in each), while were assimilated regarding all aspects except for the type of the crystalloid solution. Age, weight, duration of the surgery, total volume of the infused crystalloid, central venous pressure and sex were all assessed.
Results: The two groups were the same regarding the results gained for pre- and post- operative parameters. Follow up assessments did not show any difference between the two groups regarding above variables.
Conclusions: The results of this study demonstrated that both of the crystalloid
solutions assessed, normal saline and lactated ringer solution, are safe for using in patients undergoing surgical operation and there is not a risk of hyperkalemia in renal transplant patients receiving lactated ringer. This study was performed on live kidney transplants and the results were not applicable to cadaver transplants.
Ali Akbar Amirzargar , Majid Mahmoodi , Hedayat Nahvi , Amir Kasaian , Zahra Safari, Mahdi Mahmoudi , Yadolla Shekiba , Kouros Divsalar , Abbas Jafari , Bita Ansarpour , Batool Moradi , Mohammad-Ali Mohagheghi ,
Volume 68, Issue 8 (11-2010)
Abstract
Background: Based on the reports, high frequency of special alleles of HLA class II genes might be associated with susceptibility to or protective from a particular cancer. These alleles might vary depending on the geographical region. Here we investigate the association between alleles of HLA class II genes and breast cancer in Iranian women.
Methods: 100 patients with pathologically proved breast cancer who referred to Cancer Institute, Tehran University of Medical Sciences in Tehran, Iran, were divided to two groups based on ages (40 years old and less/ or more than 40 years old) and were randomly selected and compared with a group of 80 healthy blood donor subjects. HLA class II alleles were determined by amplification of DNA with polymerase chain reaction (PCR) method followed by HLA-typing using sequence-specific primer (SSP) for each allele.
Results: The most frequent alleles in the DR and DQ regions in group 1 (40 years old and less) in comparison with control group were HLA-DQA1*0301 (p=0.002) and HLA-DQB1*0302 (p>0.05). In contrast HLA-DQA1*0505 (p=0.004) had significantly lower frequency in this group compared with control group. Patients of group two (more than 40 years old) had a higher frequencies of HLA-DQA1*0301 (p=0.001) and HLA-DRB1*1303 (p=0.02) and a lower frequency of HLA-DQA1*0101 (p=0.002) compared to healthy control.
Conclusion: These findings provide information of a positive and negative association between certain alleles of HLA class II and breast cancer in our population and also might support that the pattern of inheritance in the early and late onset of breast cancer differ substantially.
Omolbanin Paknezhad, Khatereh Amiri , Marzieh Pazooki ,
Volume 68, Issue 8 (11-2010)
Abstract
Background: Because bronchial hyper responsiveness (BHR) has been shown to be a risk factor for asthma and lung function decline, interest has focused on diagnosing BHR. The aim of our study was to measure the association between airway caliber relative to lung size expressed as the ratio between forced expiratory flow, mid expiratory phase, divided by forced vital capacity (FEF25-75/FVC) and BHR measured by methacholine challenge test (MCT) to obtain a cutoff for this ratio and positive MCT.
Methods: We carried out a cross- sectional study on general Iranian population in 376 subjects aged 7-73 years who were referred to Shariati hospital in Tehran, Iran in an outpatient setting. There were 190 male (50.5%) and 186 female (49.5%) subjects. They had chronic respiratory symptoms such as cough and dyspnea. The physical examination was normal. Baseline spirometry was normal or equivocal. MCT was done for all subjects over a two year period (2009- 2010). Positive MCT was defined by PC 20≤4mg/ml.
Results: The methacholine challenge test was positive in 191 (50.8%) and negative in 185 (49.2%) patients. The mean of FEF25-75/FVC in positive MCT was 0.86±0.27 Vs. 0.91±0.28 in the negative ones (p=0.070). The sensitivity and specificity of FEF25-75/FVC for prediction of MCT results were 57.1% and 60.2% based on cutoff point of 0.85 in all patients, and 87.5% and 70.7% based on cut off point of 1 in allergic patients, respectively.
Conclusion: The FEF25-75/FVC appears to be a useful predictive ratio in allergic patients but not in general population.
Reza Afghani , Ali Aminian , Seyed Rasoul Mirsharifi, Ali Jafarian , Hamid Ghaderi , Morteza Noaparast , Seyed Habibollah Dashti ,
Volume 68, Issue 8 (11-2010)
Abstract
Background: Gall stone is an important health problem in the world for which different risk factors have been characterized. Gall stone and cardiovascular disease have common risk factors. Homocysteine is accepted as one of the risk factors for cardiovascular disease. We aimed to study the effect of homocysteine level on gall stone formation.
Methods: 54 patients with gall stone-related diseases and 54 patients without stone (control group) were studied from January 2007 to December 2008. Control group consisted healthy subjects with ultrasound proven normal gallbladder. Serum homocysteine level was checked in both groups. Homocysteine level of equal or more than 15 mmol/l was considered as abnormally high.
Results: Cases included 43 women (79.6%) and had mean age of 50.76±15.23 years. Homocysteine level was significantly higher in patients with gallstone in comparison to control group (p=0.014). Risk of gall stone increased 3.4 times in persons who have homocysteine level equal or greater than 15mmol/l (p=0.019). The mean level of homocysteine was higher in men than women (p=0.03). The mean level of homocysteine did not differ significantly in patients with simple gallstone and patients with gallstone-related inflammation disorders (cholecystitis, cholangitis, and pancreatitis). Additionally, one unit increase in BMI level was associated with 1.12 times increase in the risk for gall stone formation (p=0.035).
Conclusion: The homocysteine level is increased in patients with gall stone-related diseases. Homocysteine may be considered as a risk factor of gall stone formation.
Mirsalehian A, Akbari Nakhjavani F, Bahador A, Jabal Ameli F, Bigverdi R, Goli H,
Volume 68, Issue 10 (1-2011)
Abstract
Background: Pseudomonas aeruginosa is an important opportunistic pathogen causes clinical infections among
burn patients. Metallo-β-lactamases (MBLs) are important mechanisms of Carbapenem (drug of choice) resistance among Pseudomonas
aeruginosa isolates. The aims of this study were to determine the
antibiotic susceptibility pattern and to detect the prevalence of MBLs among Pseudomonas
aeruginosa
Methods: Initially, the antibiotic resistance patterns of 170 clinical
strains isolated from burn patients in Motahari
Hospital in Tehran, Iran
were determined by Kirby-Bauer disc diffusion method. All of the clinical isolates using two phenotypic and genotypic methods. Pseudomonas
aeruginosa isolates resistant to Imipenem were screened for production of MBL by E test with
Imipenem / Imipenem plus EDTA (E test MBL). PCR assay was performed for detection of blaVIM genes.
Results: Based on the study results, the percentage of
resistance was as below: Imipenem (10 μg) 52.9%, Amikacin (30 μg) 81.7%, Carbenicilin (100 μg) 74.7%, Polymixine B (300 unit) 10%, Ticarcilin (75 μg) 84.7%, Tobramycin (10 μg) 88.2%, Colisitin (10 μg) 34.1, Colisitin (25 μg) 28.3%. Of 90 Carbapenem resistant isolates, 10(11/1%)
isolates were positive by E test, all were sensitive to Colisitin and Polymixine B. All of the
Imipenem resistant Pseudomonas aeruginosa isolates were examined by PCR for the
presence of the blaVIM genes. All MBL-producing isolates carried blaVIM-1 genes.
Conclusion:
Considering the high prevalence and clinical importance of MBL-producing isolates,
rapid identification of them and use of the appropriate infection control
measures are necessary to prevent further spread of infections by these
organisms.
Sattarzade Badkoobeh R, Nozari Y, Larti F, Safari S, Ahmadi F, Emami M,
Volume 68, Issue 10 (1-2011)
Abstract
Background: The role of reactive oxygen
species (ROS) in the pathogenesis
of different cardiac diseases has been documented. Recently, effect of
allopurinol in decreasing the production of ROS and
improving cardiovascular pathogenesis has come into scientific interest. Animal
studies have documented the benefit of allopurinol in improving left
ventricular dilatation, hypertrophy and fibrosis, and myocardial contractility
and in the prevention of systemic vasoconstriction. The aim of this study was
to evaluate the effect of allopurinol in improving diastolic dysfunction in ESRD
patients with hyperuricemia.
Methods: This was an interventional study on 28 patients
(19 males and 9 females)
with ESRD and hyperuricemia. At the end of a one-month
course of allopurinol therapy (100 mg daily),
echocardiographic indices of diastolic dysfunction were measured and compared
to the baseline indices.
Results: The mean level of uric acid was 7.5±0.96 mg/dl. The
mean EF before and after the study were %44.28±%9.8
and %44.64±%9.7, (no significant difference),
Respectively. The two indices of IVCT and
A reversal were shown to have significant
improvement after therapy (p=0.028 and 0.012,
respectively). The grading of diastolic dysfunction didn't improve
significantly after treatment with allopurinol.
Conclusion: Significant
improvement in some of studied indices, reproduced only in male subgroup of
patients that might be related to a better response of males to allopurinol,
however, a longer course of treatment may result in more favorable responses.
Better patient selection in terms of "EF"s
with normal distribution and repeating the study in non-dialysis hyperuricemic
patients may result in more accurate information.
Paknejad O, Hojjati Sa, Pazoki M,
Volume 68, Issue 11 (2-2011)
Abstract
Background: Asthma is a life-threatening disease that can cause death due to bronchospasm. In addition to clinical symptoms such as wheezing, acute paroxysmal dyspnea, chronic cough after exposure to cold air or cough after exercise, spirometry is also necessary for the diagnosis of asthma. The association between respiratory symptoms and a positive methacholine challenge test (MCT) is still controversial. The aim of this study was to determine the association between methacholine test results and respiratory symptoms and allergy.
Methods: One hundred and forty-six patients with respiratory symptoms and normal baseline pulmonary function tests were enrolled in this cross-sectional study. The participants were divided into two groups according to their positive or negative response to MCT. The association between MCT and the clinical symptoms and allergy was later evaluated statistically.
Results: Out of 146 participants of the study 59 (40.4%) were female and 87 (59.6%) were male. The mean age of the participants was 33.8±13.8 years. Sixty-one patients (41.8%) had positive results for the test. There was an association between a history of allergy, wheezing and age with positive MCT results. The other clinical signs had no association with the test.
Conclusion: Methacholine challenge test is the best diagnostic test for ruling out asthma in patients with normal pulmonary function tests in whom we cannot definitely rule out asthma based solely on clinical symptoms. Nevertheless, in adults with a history of allergy, wheezing and also in patients below 30, the probability for a positive MCT is high.
Nakhostin Davari P, Mortazaeian Langrodi H, Ghaemi Hr,
Volume 69, Issue 8 (11-2011)
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Background: Isolated
pulmonary valve stenosis represents 8-10% of congenital cardiac anomalies. This study was performed to
evaluate the late outcomes of Balloon Pulmonary Valvuloplasty (BPV) in children with residual
infundibular stenosis.
Methods : Seventy-eight patients underwent BPV
in Rajaee Heart Center in Tehran Iran, from
2008-2010.
The patients were divided into two groups: with and without infundibular
stenosis. The group with infundibular stenosis was subdivided into two groups:
with and without propranolol administration. Gradient measurement follow-ups by
Doppler echocardiography were done on the first day and 1, 3, 6 and 12 months afterwards.
Results: Thirty five (44.9%) patients were male and
43 (55.1%)
were female. The mean age of participants was 4.29±3.5 years and the mean weight 16.18±8.8
kg 33 patients (43%) did not show residual infundibular stenosis but 45 (57%) did so in the
evaluations. There were no significant differences between the two groups
regarding age, weight, sex, kind of balloon valvuplasty, balloon to body
surface area ratio and pulmonary regurgitation (PR). Propranolol was administered to 27
(60%) patients with residual stenosis for six
months but 18 (40%) did not receive the medication. In both groups, the gradient
significantly decreased immediately after BPV
(P<0.0001). In the propranolol group a constant
decrease in residual gradient was seen. There was a significant relationship
between balloon to body surface area ratio (387±94mm2/m2) with moderate to severe PR (P<0.015).
Conclusion: BPV is a safe and effective procedure
to treat PS. Residual infundibular gradient after BPV decreases over time and
propranolol helps decrease the gradient.
Alizadeh Sani Z, Farhang I, Kiyavar M,
Volume 69, Issue 9 (12-2011)
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Background: The
aim of this study was to evaluate the mid-term outcomes of concurrent total correction of
Tetralogy of Fallot (TOF) after pulmonary valve (PV) replacement and its relation to QRS duration and MRI results.
Methods: In
this study, 51 patients with TOF who
had the TOF surgery and PV
replacement enrolled the study. Demographic data, MRI
results such as, right ventricular end diastolic volume, right ventricular end
systolic volume, systolic and diastolic indexes noted. Moreover, QRS
duration and the patients' cardiac functional class were evaluated immediately
before and 6 months after the surgery.
Results: From
51
patients, 27.5% were female and 72.5%
were male. The mean age of participants was 23.48 (SD=5.82)
years. Functional class changes were statistically different (P<0.001)
comparing the status before and after the surgery. The mean QRS
duration before surgery was 130.20 (SD=16.89) ms
which was in significant contrast with post-surgical states, 122.45
(SD=16.90) ms (P<0.001). Mean QRS
duration before and after surgery was statistically lower in asymptomatic
patients (P=0.028 and P=0.025,
respectively). There was a statistical relationship between pre-surgical
systolic and diastolic indexes to post-surgical functional class as
asymptomatic patients had lower systolic and diastolic indexes (P=0.005 and
P=0.028,
respectively).
Conclusion: This study demonstrated
that QRS duration before and after
surgery can be an indicator to evaluate the cardiac function after surgery for
Tetralogy of Fallot. Moreover, systolic and diastolic indexes are factors
affecting the good prognosis of patients therefore, PVR surgery needs to be done
before the deterioration of systolic and diastolic indexes and cardiomegaly.
Abtahi Froushani Sm, Delirezh N, Hobbenaghi R, Mosayebi Gh,
Volume 69, Issue 11 (2-2012)
Abstract
Background: Recent studies have demonstrated an essential role for IL-17 in the pathogenesis of experimental autoimmune encephalomyelitis (EAE). Furthermore, it has been shown that FoxP3+Treg cells play an important role in the suppression of autoinflammatory reactions. Although, previous studies have determined the immunomodulatory potentials of all-trans-retinoic acid (ATRA), but these immunomodulations have been mostly justified by alteration in Th1/Th2 cytokines. The present study was carried out to investigate the therapeutic effects of ATRA on EAE and its effects on T-helper cells responses.
Methods: EAE was induced by MOG35-55 peptide and complete Freund's adjuvant in female C57BL/6 mice. The mice were allocated to two therapeutic groups (n=7 per group). Treatment with ATRA (500 μg/mouse every other day) was initiated in treatment group on day 12 when they developed a disability score. EAE controls received vehicle alone with the same schedule. Signs of disease were recorded daily until day 33 when the mice were sacrificed. Splenocytes were tested for proliferation by MTT test, cytokine production by ELISA and FoxP3+Treg cell frequency by flowcytometry.
Results: ATRA significantly reduced the clinical signs of established EAE. Aside from decreasing lymphocytic proliferation (P<0.05), ATRA significantly inhibited the production of pro-inflammatory IL-17 (P<0.005) as well as IFN-γ (P<0.0005) upon antigen-specific restimulation of splenocytes. FoxP3+Treg cell frequency and IL-10 levels were not altered significantly. However, IFN-γ to IL-10 and IL-17 to IL-10 ratios decreased significantly (P<0.0005).
Conclusion: Parallel to reducing autoreactive lymphocyte proliferation and cytokine production in favor of pro-inflammatory cytokines, all-trans-retinoic acid ameliorated established experimental autoimmune encephalomyelitis.
Tavassoli A, Abdollahi A, Golmohammadzadeh H,
Volume 70, Issue 5 (8-2012)
Abstract
Background: Regarding the limited number of studies on the feasibility of resection and repair of the small intestine by ligasure, we performed this study to compare ligasure with linear stapler for the previously mentioned operation.
Methods: This phase 1 clinical trial study was performed in Ghaem Hospital, an educational hospital affiliated to Mashhad University of Medical Sciences, from 2010 to 2011. After obtaining permission from the University's ethics committee and a written informed consent from each patient, we recruited 18 patients. The participants who had morbid obesity and were candidates for laparoscopic gastric bypass surgery were randomly allocated to two stapler and ligasure groups. The data were collected and analyzed by three statistical tests, including Mann-Whitney U test, by SPSS 16.
Results: All patients were female with the age range of 20-65 years. Cost in the stapler group ranged between 29,500,000 to 40,000,000 Rial (mean 31,830,000± 3,500,000 Rials) and in ligasure group it was between 24,000,000 to 35,000,000 Rials (mean 26,720,000± 3,290,000 Rials). There was a significant difference between the two groups in cost (P=0.004(. Duration of the operations were 200±3.4 and 240±10 minutes in the stapler and ligasure groups, respectively. The difference in duration was significant between the two groups (P=0.043). No significant differences were observed in complications.
Conclusion: Application of ligasure in resection and reconstruction of small intestine is more cost-effective than stapler, although duration of surgery is longer.
