Tehran University Medical Journal

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Background: Infectious diseases are problematic in all around the world especially in the developing countries and early diagnosis of infections and one etiologic agents has a major role in the treatment of one patients. There are some culturing methods consist of conventional, semiautomatic and automatic. One of automatic methods is BACTEC system worked by fluorescent technology and Co2 production of organisms in culture media.
Methods: This study is based on observational-descriptive method with simple convenient sampling. We analyzed 262 samples of body sterile fluids of patients admitted in pediatric and internal wards of a university (Rasol- Acram) Hospital. They are consisting of 150 blood, 46 synovial, 32 CSF, 24 pleural, and 10 peritoneal samples.
Results: There were no differences between two sex in BACTEC and Conventional methods. Average age of patients with positive and negative culture in two methods had not differences. 72 (27.5%) samples were positive that 32 (12.2%) samples only in BACTEC method, 4 (1.5%) in conventional method and 36 (13.7%) in two methods had statistical differences (p=0.003). That means positive cultures are seeing in BACTEC more than Conventional method. Comparison of two methods in positive blood culture samples had statistical differences (p=0.02) but no statistical differences in other body fluids were seen. i. e. positive cultures were seen in BACTEC more than Conventional method. Positive culture in these two methods had statistical differences in antibiotic utilization (p<0.001). Positive culture in antibiotic utility were seen in BACTEC more than Conventional method. The average time of culture to become positive were 17.5+ 5.88 hours in BACTEC against 62.36+ 13.98 hours in Conventional method. Contamination was seeing in 4 samples in BACTEC and 2 in Conventional method that had no significant differences.
Conclusion: According to these data organism detection in BACTEC culture media from body sterile fluids overall and specially from blood is more successful than Conventional method. It is a better method in antibiotic utilization. BACTEC can isolate organism in shorter duration than Conventional method. BACTEC can facilitate early and accurate diagnosis of infectious etiology, shorten duration of hospital stay and decrease mortality and morbidity and cost.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Macrosomia is a term applied to newborns with a birth weight of >4000g. This condition leads to several maternal and fetal complications including maternal traumas as well as newborn injury. This study was designed to evaluate the risk factors of macrosomia among Iranian women.
Methods: This cross-sectional study performed between July 2001 and July 2002, included 2000 term deliveries involving newborns with birth weights of >2500g. The records of 77 mothers of live born infants weighing >4000g were compared to those of the control group (231 women). Stillborn and neonates who were <2500g were excluded from the study.
Results: Among the 2000 deliveries performed in Imam Hospital, 77(3.8%) of the newborns weighed >4000g and 12(0.6%) weighed >4500g. The mean age of the mothers, maternal BMI, history of diabetes mellitus, multiparity, fetal sex and underling maternal disease were found to be associated with increase risk of fetal macrosomia. There was no significant relationship between prolonged gestation, weight gain more than 16kg during pregnancy and past history of macrosomic delivery and macrosomia.
Conclusions: It is possible to prevent macrosomia by weight and diabetes control before the decision to become pregnant. To prevent pregnancy among multipara mothers aged >35 years old, highly protective contraceptive methods should be used. Furthermore, if a mother is diagnosed with a macrosomic fetus by sonography or other imaging methods, more care should be taken during the delivery to decrease the risk of fetal injury, such as asphyxia and brachial plexus palsy.  

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Stromal tumors of the gastrointestinal tract (GISTs) are uncommon and the cell of origin is actually mesenchymal. Stemming from smooth muscle, 90% of GISTs, or leiomyomas, are found in the lower two thirds of the esophagus. Typically solitary, multiple tumors (leiomyomatosis) are occasionally reported. Remaining intramural during their growth, most of their bulk protrudes toward the esophageal outer wall, with a freely-movable, normal-looking overlying mucosa. In this study, we report a rare case of esophageal leiomyomatosis treated by esophagectomy.
Case Report: A 70-year-old man presented with discomfort upon swallowing, dysphagia, nausea, belching and weight loss. After a barium swallow, only dilatation of the esophagus from the retained food and saliva was seen. CT scan revealed a 10-cm dilatation of the thoracic esophagus. An endoscopy and upper GI series was performed, but no pathology was found. Esophageal manometry and pH monitoring for gastroesophageal reflux were normal. Upon endoscopic ultrasonography, a thickening of the esophageal wall was identified 20-30 cm from the dental arch. The patient was diagnosed with a GIST, referred to surgeon and a transhiatal esophagectomy was performed. The patient was discharged from the hospital in good condition and has had no problem during the one-year period of follow up. 

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Background: Mitral valve prolapse is a relatively common valvular abnormality in most communities and joint hypermobility (JHM) is also seen in many healthy people as well as in certain clinical disorders, such as Marfan syndrome. The present study was designed to investigate the association between joint hypermobility and mitral valve prolapse (MVP) in an Iranian population sample.

Methods: Fifty-seven patients with nonrheumatic and isolated mitral anterior leaflet prolapse (24 men and 33 women, mean age 23.5 +/-2.3) and 51 healthy subjects (20 men and 31 women, mean age 22.9+/-2.3) were studied. The presence of JHM was evaluated according to the Carter-Wilkinson & Beighton criteria. Echocardiographic examination was performed in all subjects and the correlation between the echocardiographic features of the mitral valve and the hypermobility score were investigated.

Results: The frequency of JHM in patients with MVP was found to be significantly higher than that of controls (26.3% vs. 7.8%), with mean JHM scores of 3.1+/-2.2 and 1.9+/-1.7, respectively. The patients in the MVP group had significantly increased the anterior mitral leaflet thickness (AMLT, 3.4+/-0.4 mm vs. 3.0+/-0.3 mm p<0.0005) and maximal leaflet displacement (MLD, 2.4+/-0.3 mm vs. 1.5+/-0.2 mm p<0.0005) compared to the controls.

Conclusions: We detect a statistically significant relationship between isolated MVP and joint hypermobility as well as between the severity of JHM and echocardiographic features of the mitral leaflets. These results suggest a common etiology for MVP and JHM, which should be investigated in future well-conducted studies.

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Background: Penetrating thoracoabdominal stab wounds may cause diaphragmatic and abdominal organ laceration. However, 15-20% of these cases who are stable and managed by conservative treatment might have hidden diaphragmatic injuries, which could ultimately lead to chronic diaphragmatic hernia. Therefore, a safe and exact diagnostic method for the detection of occult diaphragmatic injuries is very valuable. In this study we have assessed the diagnostic value of thoracoscopy in occult diaphragmatic injuries resulting from penetrating thoracoabdominal stab wounds.

Methods: From March 2005 to October 2007, 30 hemodynamically stable patients with penetrating thoracoabdominal injuries, not requiring emergent exploration, were enrolled in this study. All subjects underwent thoracoscopy to evaluate probable diaphragmatic injury. Diaphragmatic injuries were repaired via thoracoscopy or laparatomy. All patients were evaluated for chronic diaphragmatic hernia by CT-scan six months later.

Results: The mean patient age was 26.2 years, with a male/female ratio of 5:1. Using thoracoscopic exploration, we observed five (16.7%) hidden diaphragmatic injuries, three (9.9%) of which were repaired using the thoracoscopic approach and two (6.6%) by laparatomy. Lung parenchymal laceration was seen in two patients (6.6%), for whom the repair was performed using thoracoscopy. Intra-abdominal injury was seen in one patient (3.3%), which was repaired by laparatomy. After thoracoscopy, there were no complications or evidence of chronic diaphragmatic hernia in the chest and abdominal CT-scans performed six months later. Therefore, the diagnostic accuracy of thoracoscopy in occult diaphragmatic injuries in our study was 100%.

Conclusion: With its high degree of diagnostic accuracy, low degree of invasiveness, as well as its utility in treatment, we recommend thoracoscopy for all clinically stable patients with penetrating thoracoabdominal stab wounds.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Pleural malignant mesothelioma is an uncommon but extremely invasive tumor which originates from mesothelial cells and usually occures after prolonged exposure to asbestos. The aim of this study was to clinicopathologically evaluation of 40 patients with pleural malignant mesothelioma and the main factors influencing their prognosis.
Methods: In this study patients with definitive diagnosis, who had been followed up for at least three years were studied based on gender, age presenting symptoms, and clinicopathological patterns.
Results: Male to female ratio of the study patients was three to one any the average age of them was 55 years. Chest pain was the most common symptoms in 34(85%) patients. Most of the study patients were in Buchard stage I (37/5%) and the epithelial form was the most common pathological pattern 25(62.5%). 19(47.5%) of cases received only radiotherapy and chemotherapy. Extrapleural pneumonectomy was performed on eight (20%) patients, seven (17.5%) patients underwent decortication and pleurectomy beside adjuvant therapy and 15% of the cases rejected any type of treatment. Surgical mortality occurred in one patient and the most common surgical complication was wound infection. The average survival rate was 12±1.2 months and the main factors influencing it were the patient's physiologic status, pathological form, stage of the disease and the pattern of pleural involvement.
Conclusions: Because the low survival rate after multimodality invasive treatments in mesothelioma, aggressive therapeutic methods were recommended in selected patients

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Transthoracic needle biopsy is a well established method for obtaining pathologic diagnosis in the lung mass that performed after a previous negative bronocoscopy. The goal of this study is evaluation of the safety and accuracy of ultrasonographic guided transthoracic needle biopsy for diagnosing peripheral lung mass.
Methods: In a descriptive and prospective study from September 2005, 30 patients with peripheral lung mass with greater than 3cm in diameter and less than 5cm distance through the chest wall, underwent ultrasonographic guided transthoracic needle biopsy and it's diagnostic accuracy and complications were analyzed.
Results: The male to female ratio was two to one, the average age of the patients was 61.2 years and 60% of the lesions were located in right side. Adequate biopsy specimens were obtained in all patients, but transthoracic needle biopsy was diagnostic in 86.6% and 13.3% patients because doubtful diagnosis, who underwent thoracotomy for definitive diagnosis. From these four (13%) patient who needed thoracotomy definitive diagnosis were organized embolism, granulomatouse tuberculosis, bronchoalveolar carcinoma, and metastatic adenocarsinoma. Pathological diagnosis were malignant lesion in 83.3% that squamouse cell carcinoma and adenocarcinoma were the most common malignancies and benign lesions were found in 16.6% that granulomatouse tuberculosis was the most common lesion. Complications were observed in 13.3% that included pneumothorax (6.6%) and hemoptysis (6.6%) that managed medically. No cases of mortality were observed.
Conclusion: Transthoracic needle biopsy with ultrasonographic guide due to appropriale diagnostic accuracy and low complication rate with low cost and availability is recommended for the diagnosis of peripheral lung mass.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Post-intubation tracheal stenosis is a serious problem and surgical resection is the method of choice in long segment tracheal stenosis treatment. The aim of this study was to review the results of surgical treatment of long segment post intubation tracheal stenosis and the role of bilateral hyoid bone cutting in supra- hyoid release technique.
Methods: Between 2004 to 2008, 14 patients with proximal long segment tracheal stenosis with resection of more than 40% of trachea length were evaluated regarding surgical technique and post-operative results.
Results: The mean age of patients was 22.2±0.4 years. Etiology in all patients were head trauma and prolonged intubation and all patients had tracheostomy at the time of trearment. Average time between surgery and first admission was 4.5±0.5 months. Average length of stenosis and resected segment were 3.6±0.5 and 4.3±0.5cm respectively. Average increased length of trachea after bilateral hyoid bone cutting was 1.1±0.3cm. Postoperative complications occurred in one patient with wound infection, and 4 patients had stenosis recurrence which was treated in 3 patients using multiple dilation. Quality of life 2 years after surgery in 71% of patients were classified in good and excellent group. We didn't have any mortality.
Conclusion: Based on the fact that surgery is the best method of treatment in long and multi segment tracheal stenosis and tension in suture line is a serious problem, we recommend extended releasing technique including bilateral hyoid cutting in surgical treatment of these patients.

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Background: Pulmonary hydatic cyst is a common parasitic disease and health care problem in developing countries. In our study we assessed treatment outcomes of pulmonary hydatic cyst in our area. Methods: All patients presenting to Ghaem, Omid and Mehr hospitals of Mashhad- Iran since 1981 to 2008 with pulmonary hydatic cyst were enrolled in this study and demographic data, location and number of cysts, diagnostic methods, type of operations, out comes and rate of recurrence were statistically analyzed. Results: One thousand and twenty for patients enrolled in this study. The mean age was 30.6±16.1 years and male to female ratio was 1.2. The most common symptoms were cough (55.1%) and chest pain (33.8%). 53.8% of the patients had right side involvement, 40% had left side involvement and 6.2% had bilateral disease. Inferior lobe was the most common involved lobe. The cyst was intact in 52.6% and the other cases were complicated or perforated. The most common surgical technique was removing the cyst membrane without resection of pericyst and closure of air leaks (67.2%). The cyst was enucleated in 21.2% and parenchymal resection was performed in 10.3%. The mortality rate was 0.2% and morbidity occurred in 8.4% of patients. The most common complications were dead-space in pulmonary parenchyma in 3.4% of cases and wound infection in 1.5%. Conclusion: The best treatment for pulmonary hydatic cyst disease is surgery with low mortality and morbidity. The most common treatment is extraction of cyst membrane and closure of small air ways. Pulmonary resection should be reserved for complicated forms of disease.

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Background: Scorpion envenomation is considered as one of the Public Health problems in some countries in the world including Iran. Annually, approximately 30,000 scorpion stings happen in Iran from which 12% belongs to Hemiscorpius lepturus (special small closely spaced, bead-shaped jointed tail, similar in the shape to a cows tail, and is locally called ‘‘gaodim'' (Gao, cow dim, tail)) with 95% mortality. The main treatment is antiserum therapy which is produced in horse and is the only way to neutralize the venom. Due to the anaphylactic shock of the horse antiserum in some of the stung patients other source of antiserum is recommended. In this study the ability of produced camel antiserum in neutralizing the scorpion venom of Hemiscorpius lepturus was performed in Balb/c model.

Methods: Camel is an animal model that genetically is compatible with human genome utilized in this research to produce antiserum against scorpion venom. Two camels were used for immunization with the venom of Hemiscorpius lepturus. ELISA method was used to confirm the immunity. Antiserum was produced and used for neutralizing test. The precipitated antiserum with saturated ammonium sulfate (SAS) was also used to perform the neutralizing test in mice.

Results: The results indicated that the amount of 200 µl of antiserum and 400 µl of SAS antiserum were able to neutralize the amount of 1 LD100 of the venom and the survived the mice from death.

Conclusion: The result indicated that camel antiserum against scorpion venom is capable to neutralize the crude venom in mice model. Due to the safety of camel serum in human, it is suggested that the produced antiserum in camel can be substitute with the traditional horse antiserum in scorpion stung patients.

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Background: Central venous catheters are useful instruments in monitoring of critical patients and are important roots for total parentral nutrition. The catheters are widely used in general wards and intensive care units. Their use may be associated with serious and rare complications.

Case presentation: We reported a 24 years old woman that admitted to Ghaem hospital Mashhad University of Medical Science, in Mashhad, Iran, because of penetrating chest wall injury and surgical exploration indicated due to massive hemorrhage. Central vein (right jugular vein) was canulated for resuscitation and monitoring. Superior vena cava was injured after canulation and presented with delay massive mediastinal hematoma.

Conclusion: We aim to introduce this rare complication and its management. This management could be conservative or surgical intervention according to severity of the vein damage.

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Background: CD14 is known as a receptor for bacterial LPS (Lipopolysaccharides) and is followed by inflammatory reactions. This receptor on macrophage surface has a major role for recognition and clearance was happen without inflammatory reaction. Prolonged exposure to microbial products decreases the risk of allergic reactions. This is related to high level of CD14 in blood cells. Although the causes of nasal polyposis is not obviously determined but allergy is a potential risk factor for nasal polyposis. CD14 is in 5q31 chromosomal position and CD14 variants have association with asthma. We try to assay association between CD14 polymorphism and nasal polyposis and severity of this disease.

Methods: We had 106 patients with nasal polyps with mean age 41 y old in case group and 87 with mean age 36.7 in control group. We obtained 3 ml whole blood from each patient and then extract DNA by PCR-RFLP method and determined variant genotypes of CD14. Although there is no previous study in this field, the results of this pilot study shown in more detailed below.

Results: There is significant relationship between C allele (CC + CT) in comparison with TT (p= 0.03, odds ratio= 1.87, CI 95% (0.99- 3.55)) and nasal polyposis. Further-more another significant relationship had been shown between asthmatic patients and C allele (CC) in comparison with (CT + TT). (p= 0.01, odds ratio= 3.8, CI (0.99- 13.9). In asthmatic patients with C allele of CD14 incidence of nasal polyposis increased.

Conclusion: Based on the results of this study, C allele of CD14 could play a role in nasal polyposis.

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Background: Efforts have been made worldwide to identify and to study parasites of laboratory animals, aiming at the achievement of proper procedures for eradication of parasitic infestations, considering the important role of these animals in scientific research. There is no sufficient data about parasitic infestations of Laboratory animals which are kept in conventional systems in Iran. In this scope, peresent study was designed to investigate the presence of ectoparasites and endoparasites in conventionally maintained laboratory rats (Rattus norvegicus) and in mices (Mus musculus).
Methods: A descriptive cross-sectional study was performed on 240 randomly selected rats and mice from two different animal houses in Kerman city, Iran. Skin scraping blood samples and alimentary tract contents of all animals were fully examined for the presence of parasitic infections.
Results: In the first animal house, Nosopsylla fasciatus (flea), Hymenolepis dimminuta, Entamoeba muris and Cryptosporidium spp. infestation were diagnosed respectively in 35.41%, 36.1%, 3.57%, and 1.25% of rat colonies but only Entamoeba muris infestation was detected in 4.58% of mice colonies. In the second animal house, 2.5% and 2% of rat and mice colonies were infected by Entamoeba muris.
Conclusion: Based to presence of asymptomatic parasitic infection in conventionally maintained laboratory animals, regular periodical samplings, precise sanitary monitoring of barrier maintained system, environment and food seem necessary in animal houses. Eradication of parasites could eliminate the confounding effects of these infections on researches and additionally decrease the risk of zoonotic disease transmission to investigators and animal house personnel's.

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Background: Alopecia areata, a non-cicatricial form of hair loss, is believed to be an immunologic response that targets hair follicles. Genetic background is important in the pathogenesis of this disorder, although some evidence point to the role of melanocytic antigens. There are some reports on the relationship between alopecia areata and celiac disease. The aim of the present study was to identify antigliadin antibodies in patients with alopecia areata.
Methods: Fifty patients, aged 2.5-50 years, with alopecia areata presenting to the dermatology clinic of Razi Educational Hospital in Tehran, Iran, and fifty healthy individuals, aged 5-48 were matched and enrolled in the study. After signing an informed consent form, blood samples (10 ml clotted blood) were obtained from the participants and sent to referral laboratory for the presence of antigliadin IgA and IgG antibodies. Concentrations of antibodies were measured by ELISA through a full automatic ELISA reader.The data were analyzed statistically.
Results: The study included 29(58%) male and 21(42%) female patients with a mean age of 24.6 years. The control group included 29(58%) male and 21(42%) female individuals with a mean age of 24 years. In the case group, 9(18%) patients were positive for antigliadin antibody, while only one (2%) individual was positive for the antibody in the control group (p<0.001). No other differences were of statistical significance.
Conclusions: Regarding the higher prevalence of antigliadin antibodies in patients with alopecia areata, it would be wise to screen the patients for celiac disease.

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Background: Ewing sarcoma family tumors (ESFTs) are among the most malignant tumors in children and young adults. ESFTs include Ewing sarcoma (ES) and peripheral primitive neuroectodermal tumors (pPNETs). As there seemed to be few studies on the molecular biology of ESFTs, we investigated the frequency of CD99, Ki67, p53 and Fli- 1 protein expression in 15 Iranian patients with ESFTs. In addition, the correlation between expression rate of these proteins and various clinical factors, including age, sex and survival was computed. Methods: The expression of the aforesaid proteins was studied by immunohisto- chemistry in formalin-fixed and paraffin-embedded blocks of 15 ESFTs specimens. Stained sections were classified according to the percentage of stained tumor cells. Results: The results showed the membrane expression of CD99 protein in all of the specimens. The nuclear expression of Fli-1 protein was observed in 86.7% and the over- expression of p53 nuclear protein was seen in 53.3% of the specimens. The expression rate of Ki67 protein was 60%. Although a significant correlation was not shown between the expression levels of Ki67, p53 or Fli-1 proteins with age, sex or survival of the patients, there was a significant correlation between expression levels of p53 and Ki67 proteins (P=0.003). Conclusion: The results underline the role of p53 and Ki67 proteins in the development and progression of ESFTs and suggest the simultaneous immunohistochemical staining of Fli-1 and CD99 proteins for the diagnosis of ESFTs.

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Background: Gastrointestinal mesenchymal tumors are classified as tumors that originate from smooth muscles. Gastrointestinal stromal tumors (GIST) are the most common types of the proposed tumors and can be seen in the GI tract from the esophagus to the anus, but they are mostly seen in the stomach. Mostly from the stomach and asymptomatic, the majority of patients would benefit from surgery as the best method of treatment.

Methods: In this retrospective study we evaluated the data of patients with the diagnosis of esophageal or gastric mesenchymal tumors admitted in Ghaem and Omid Hospitals affiliated to Mashhad University of Medical Sciences in Iran, from 1992 to 2010. We analyzed factors such as age, sex, presenting symptoms and signs, diagnostic methods, types of pathology, types of treatment, morbidity, mortality and 3-year survival rates.

Results: Twenty four patients (16 male, 8 female) with a mean age of 50 were included in the study. The common site of tumor was gastric fundus. The most common symptom at the time of diagnosis was epigastric fullness which was observed in almost 50% of the patients. The most common type of surgery in the patients was subtotal gastrectomy and no hospital mortality was recorded. Paralytic ileus was the commonest complication seen in five patients (20.5%). Adjuvant therapy had been performed in eight patients (33.1%). Following the patients three years postoperatively, there were only three deaths (12.45%).

Conclusion: Regarding to the low mortality and morbidity of the surgeries, surgical treatment, if tolerated, is recommended for all Esophagogastric mesenchymal tumors patients.

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Background: Sexual dysfunction in males is characterized by the inability to achieve or maintain an erection sufficient for a satisfactory sexual activity. Erectile dysfunction is a common disorder in males and intracavernosal injection of papaverine followed by color Doppler ultrasonography of the penis is used to diagnose and treat vascular impotence. In this study, we examined the relationship between changes in peak systolic velocity (PSV) and erectile dysfunction with vascular cause after a cavernosal injection of papaverin.

Methods: We performed this self-controlled clinical trial in Shahid Hasheminejad Hospital in Tehran, Iran during 2010 and 2011. The study population consisted of 90 patients with erectile dysfunction. The peak systolic velocity (PSV) of cavernosal arteries was evaluated before and after injection of 40-80 mg papaverine and it was compared in the patients with and without response to injection.

Results: The mean age of participants was 47.7 13.7 years. Response to papaverine injection was positive in 41(45.5%) patients. The mean PSV values were 14.68+5.65 and 53.74+18.8 cm/s before and after the injection, respectively (P<0.001). A PSV cut-off point of 10 cm/s was determined for the condition before injection. The sensitivity and specificity of the value for diagnosis of arterial erectile dysfunction were calclulated as 50% and 100%, respectively.

Conclusion: A PSV cut-off point of 10 cm/s in flaccid status before papaverine injection has a low sensitivity but high specificity for the diagnosis of arterial erectile dysfunction. Future studies with sufficient cases of arterial erectile dysfunction are necessary for final judgments and suggestion a new cut off point.

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Background: Chlamydia trachomatis is the most common bacterial sexually transmitted infection in the world, but the effect of this infection on male fertility is still controversial. Despite reports of interaction between Mycoplasma genitalium and sperm, this pathogen in semen samples of infertile men is less studied. We studied, the prevalence of Chlamydia trachomatis and Mycoplasma genitalium infection in infertile men.
Methods: Among attending Avicenna Infertility Center, 120 men who had abnormal semen analysis tests were selected and the samples were taken. After detailed analysis of semen quality, DNA was extracted from each sample by chelex. Samples were evaluated for these two pathogens by multiplex PCR. Results were statistically analyzed.
Results: Chlamydia trachomatis and Mycoplasma genitalium was detected in 23/3% and 12/5% of the samples, respectively. Although, Mycoplasma genitalium infection rises by increasing (P=0.640) and decreasing in age of first sexually activity (P=0.203), and also positive cases of Chlamydia trachomatis infection showed increase regarding age increase (P=0.619) and age decrease in first sexually activity (P=0.511), but these differences were not statistically significant.
Conclusion: All in all, regarding to the increased prevalence of Chlamydia trachomatis infection compared with the only similar study in Iran and high prevalence of Mycoplasma genitalium infection in infertile men, this assessment was done. A multiplex PCR protocol rapidly and simultaneously identify these organisms in comparison with uniplex from clinical samples. Based on our results screening for Chlamydia trachomatis and Mycoplasma genitalium infection among infertile men seems to be valuable.

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Background: Gastric cancer (GC) is one of the most common cancers worldwide and in Iran. Conventional therapies are surgery and chemotherapy. Current studies are evaluating natural compounds in inhibiting growth of cancer cell. In this study isolated peptide melittin with 26 amino acids from bee venom and its impact on the viability and proliferation of gastric cancer cells was investigated.
Methods: At first melittin was purified from honeybee venom using a reversed-phase high performance liquid chromatography (RP- HPLC) and C18 column. In order to investigate whether melittin, a 26 amino acids peptide which is the main components of honeybee venom, inhibits proliferation of human gastric adenocarcinoma cell line (AGS cells), MTT ((3-(4, 5-dimethylthiazol-2-yl)-2, 5- diphenyltetrazolium bromide) assay was performed. Hemolytic assay carried out in order to confirm the biologic activity of the isolated melittin. AGS cells were plated in a 96-well plate and treated with serially diluted concentrations of melittin for 6 and 12 hours. The mortality of the cells was measured via MTT assay at 540 nm.
Results: The obtained chromatogram from RP-HPLC showed that melittin comprises 50% of the studied bee venom. SDS-PAGE analysis of melittin fraction confirmed purity of isolated melittin. Hemolytic activity assay indicates that isolated melittin shows a strong hemolytic activity (HD50=0.5). MTT assay showed that melittin strongly inhibits proliferation of gastric cancer cells at concentrations more than 2µg/ml. This inhibitory effect is dependent to melittin concentration and incubation time.
Conclusion: This study provides evidence that melittin inhibits proliferation of the gastric cancer cells. Results showed that isolated melittin from honey bee venom have cytotoxic effect on AGS cell line with a trend of increasing cytotoxicity with increasing concentration and incubation time.

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Background: Arterial insufficiency is a well-recognized etiology of erectile dysfunction. Moreover, nowadays it is appreciated that it can herald silent coronary artery disease in involved patients. However color Doppler study of penis with intracavernosal injection (ICI) of Papaverin, as a helpful diagnostic study, is somehow time consuming and technically demanding, as a result, radiologists are reluctant to accomplish. Hence, in a search for more plausible parameters, we were determined to validate PSV in flaccid state for predicting possible arterial insufficiency in patients.

Methods: In a cross sectional study to evaluate diagnostic tests, accomplished in Hasheminejad Urology center in Tehran throughout 2011, we studied 59 patients with the complaint of erectile dysfunction. They were referred to our ultrasound clinics by urologists in order to undergo color Doppler study of penis by ICI of Papaverin. They were studied comprehensively before and after injection. Primary and secondary diagnostic criteria of arterial disease in color Doppler and consequently the physiologic event of full erection were designated as gold standard diagnostic considerations. The resulted data were matched and analyzed with SPSS software.

Results: Fifty nine patients underwent the study, with the mean age of 45.6 ± 13.1 (24 to 74 year old). Twenty two cases revealed normal study (non-organic causes as 37.3%), 29 were classified as venous leakage, and eight of them demonstrate arterial insufficiency in the study. A flaccid state PSV of 10.5 cm/s as cut off had a sensitivity of 93.8%, specifity of 91.3% and negative predictive value of 93.8% to predict arterial disease.

Conclusion: A flaccid state PSV of 10.5 has a suitable statistical value to proclaim arterial insufficiency in cavernosal arteries in patients with erectile dysfunction as a complaint.