2023 CiteScore: 0.7
pISSN: 0044-6025
eISSN: 1735-9694
Editor-in-Chief:
Ahmadreza Dehpour, PharmD, PhD
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE).
Vol 43, No 6 (2005)
Original Article(s)
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Chronic acquired demyelinating neuropathy (CADP) is heterogeneous ill both clinical and laboratory features. This study was performed to define the clinical. clccuodiagnostic and histological findings. course and response 10 therapy in patients with CADI'. Thirty patients (20 men and 10 women) with CADI' were studied. Diagnostic criteria were based on clinical presentation. clcctrophysiolcgical studies. cerebrospinal fluid (CSF) protein level and sural nerve biopsy findings. Response 10 treatment was assessed by changes in average muscle score (A:vlS). Twenty-one patients conformed to the diagnostic criteria of chronic inflammatory demyelinating polyneuropathy (Cf Dl") and 9 to distal acquired demyelinating symmetric neuropathy (DADS). The course was monophasic in Cl (23~/~-)), relapsing in I0 (40(~/;1) and chronic progressive in 8 (30':••;,): 4( 13°•'()) had ucutc presentation with subsequent progression or relapsing course. Motor nerve conduction velocity (i"--INCV) of less than 70°,-() and greater than 70'~;(, of normal were seen in 18 (60'~';)) and 12 (40{~-;1) patients. respectively. Conduction block was observed in 14 (47(~/o) and CSF protein levels WCl"C elevaled in 19 patients (66':--;)). Demyelination was reported in 61(;--() and 58%) of the biopsies performed in patients with MNCV <: 70'~";l and> 70'}'() of normal. respectively. The association between "•lNCV and histologic findings was no! significant. Twenty-one patients were treated with intravenous immunoglobulin (lVlg). Fifteen patients 83(;-{1) with ClDP had significant improvement in AfvlS following the iuitial fVlg treatment (P n.ol). This study highlights the heterogeneity of clinical and laboratory findings in C:"I)P and the importance of early treatment.
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Although ccsinophils arc frequently found in lymphatic tissues of patients with classic Hodgkin's disease (HD), no substantial data reveals till: relationship between tissue cellular densities of ccsinophils and Hodgkin-Reed-Sternberg cells in involved lymph nodes. In this study, we determined the respective cellular densities of these cells on lymph node tissue sections of XO pediatric patients with different subtypes or classicnl Hl) from 1992 to 200}. The mixed cellularity (Mt") and lymphocyte-rich (LR) subtypes displayed the maximal (67.5m';)) and minimal (2.50%1) percentages of total number of cases. Also the nodular sclerosis (NS) and lymphocyte depletion (LD) subtypes composed 26.25 1%and 3.75~,";, of the cases, respectively. LR and LD subtypes were omitted from correlation studies, owing to their respective suboptimal number or cases and unreliability of statistical results. Eosinophil and Hodgkin cell densities were determined by cell counting on histological slides of two other subtypes (75 patients), separately. The NS subtype revealed a strong positive correlation (I' "" +0.9) and nearly a linear relationship between two density values. Also, a poor correlation (r "" -0.3) was detected between two densities in ivlC subtype. Considering different signal transduction pathways in subtypes of classical I-ID, it was postulated that the proposed correlation of"tissue eosinophilia with poor prognosis in NS is probably related to their role in protection of tumoral Hodgkin cells from apoptosis and subsequent increase of their tissue concentration, a process that is not observed in Me subtype with some other complicating molecular factors.
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Lillie is known about the sexual differences in volume of human insular cortex in normal subjects and those suffering from ncurodcgcncrativc diseases. The objective of this study is 10 investigate the sex difference in volume of the left insular cortex in normal right-handed subjects versus subjects suffering from Alzheimer and Parkinson diseases. This study was performed on 72 normal human brains (38 males. 34 females). II brains suffered from Alzheimer (4 males. 7 females), and 13 brains suffered from Parkinson (9 males, 4 females). The right hemispheres were used for neuropathologic studies. The volumes of the len insular cortex in the male and female normal subjects were 6.65 :.:: 1.55 em: and 5.X3 ,t: 1.12 em'. respectively (P = 0.0 I). The volumes of the left insular cortex in the male and female subjects suffering from Alzheimer were 5.6X :i.: !.49 ern' and 4.49 :i: (l.X6 em'. respectively (P = 0.2 I). The volumes of the left insular cortex in the male and female subjects suffering from Parkinson were 5.99 ± 1.05 em' und 5.37 ::: 0.51 em'. respectively (P =:= O. I8). The present study shows a significant larger left insular cortex volume in normal right-handed males than in females. No significant sexual difference in volume of the left insular cortex in subjects suffering from Alzheimer and Parkinson diseases W,IS observed. Disappearance of the normal sexual dimorphism in the volume of the insular cortex may be due to a more severe degeneration of this conical area in males during thc ncurodcgcncrativc disorders.
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Oral feeding is the best means of nutrition in surgical patients. There arc many reports on early oral feeding after lower gastrointestinal {(il) operations but data regarding upper Gl procedures is rather scant. This limited study rocuses 011 early removal of nasogastric tube and start of oral diet after transhiatal csophagcctomy. We prospectively evaluated 13 consecutive patients (8 males. 5 females) with esophageal cancer who had undergone rranshiatal csophngcctomy from March 100 I to September :lOrn. Nasogustric tube was removed on post-op day 1 and clear liquids started on day 3. Diet was advanced to son regular in tile next 5 days if the patients tolerated it. Mean age of patients was 63 years.
Menu body weight and serum albumin level were 57.9 kg and 3.73 gr/dl., respectively. Tumor pathology was squamous cell carcinoma in 11 cases and adenocarcinoma in I. Location oftumor was at the lower third of the esophagus in 11 cases and middle third in one. All patients ill the study group tolerated tile protocol well. Only one patient had nausea after oral intake, without vomiting. We had one neck wound infection and OIlC pulmonary infection. There was no anastomotic leakage or fistula. A group of I() esophageal cancer patients undergoing trnnshiuta! csophagcctomy in the same period ""'('I'C used as the control group. One anastomotic leakage occurred in control group. We had no significant complication. Early nasogastric tube removal and oral feeding seems to be safe in patients with esophageal cancer undergoing transhiatal csophagcctcmy. -
Several environmental factors have been found 10 affect the process of bone healing including malnutrition and smoking. To our knowledge. the effect or addiction on bone repair process has not been studied yet. This study was designed to investigate the effects or morphine dependency on bone repair process in rats. Filly six rats were divided into two groups randomly, each group containing 28 rats. The rats in study group got morphine by adding morphine powder to their water fer 21 days. Then morphine dependency was confirmed by injecting naloxon intra-peritoneally. Both groups underwent surgery and a fixed round hole was created in antcromcdial aspect of the tibia. Bone biopsy was performed 011 days 3. 6. 10 and 20. on 7 randomly selected rats from each group and the results of microscopic study were analyzed by 1".•1:Inn Whitney test. There was statistically significant difference between the two groups according to neutrophilic exudates percentage and granulation tissue formation on 3nl day (P -: (l.OOS). neutrophilic exudates percentage tP> 0.01) and immature bone formation on 6th day (P'-; 0.(05). immature bone formation (P> 0.(01) and mature bone formation (P < f1.(5) on 10til day and mcscncliyrunl tissue formation on 20111 day (P < 0.05). It is concluded that the process of bone repair in a hole created in the rat tibia is markedly delayed in morphine-dependent rats.
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Gastrocsphagcnl reflux disease (CiERD) is a systemic disease with intraoral manifestations. The aim ofthis study was (0 compare erosion (Loss Ot'IOOlh structure due In a chemical process without bacterial cause) and periodontal indices including: calculus index (Cll. plaque index (PI). gingival index (GI), clinical auachmcnt level (CAL) and probing pocket depth (PPD) in patients with (iERD and in non CiERD subjects that was done in 2002 in Imam Khomeini Hospital. .IS Patients with CiERI) (test group) and .IS subjects without GERD (Control group) were selected randomly for this study. Statistical analysis for comparing differences between the test and Control groups were Performed using chi square and Fisher exact test. Tile results showed that the prevalence or erosion was significantly higher in test group (I,;LV~'n CiERD. 62.(Y~,'() non CiERD). Then: was also a significant difference in (;1, PI. Cl and PPD between test and control groups. CAL did not show any significant difference between the two groups. Also Hcticobnctcr pylori was significantly higher in test group (~()'I,,() test. 54'1,;) control group). According to the results. communication between dentist and internist leads to diagnosis and control of GERD. and prevents changes of teeth and periodontal structures.
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Intravenous administration of dexamethasone before diazepam injection seems "0 reduce the incidence or pain on injection. We conducted a randomized. prospective, double-blind. placebocontrolled clinical trial to compare effect or dexamethasone, mctoclopramidc ami placebo in reducing the injection pain.:" total of 120 ASA class I and ll mcn aged 20-45 years that needed more than one intravenous access were enrolled in the study and were randomly allocated to one of the three groups: group 1, :2 ml intravenous normal saline and 2 1111 dexamethasone (X mgj: group 2. 2 1111 intravenous normal saline and 2 1111 mctoclopramidc l10 mg), and group 3.:2 ml intravenous dexamethasone (X mg) and 2 ml ructoclopramidc (10 mg). After 30 seconds. I ml diazepam (5 mg) was injected simultaneously into each of patients' hand veins and a maximal visual analog scale (VAS) for pain of each venous discomfort was assessed separately. In group I. the mean of VAS for pain was significantly less in dexamethasone pretreatment than saline pretreatment. In group 2. the mean of VAS for pain was significantly less in mctoclopramidc pretreatment than saline pretreatment. In group 3, the mean of VAS for pain was significantly less in dexamethasone pretreatment than mctocloprauudc pretreatment. There were no significant differences in incidence of pain between pretreatment and placebo in three groups. Dexamethasone or mctoclopramidc pretreatments arc effective in reducing the severity of pain on injection of diazepam and dexamethasone pretreatment has greater efficacy in reducing the intensity of pain.
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Acute dissection or the ascending aorta requires immediate surgical intervention. Without surgical treatment II:I,) of the patients will die every hour. In this study we report the result ofoperations on patients with Stanford type A aortic dissection. From 1997 to 2003. 26 patients (16 males, 10 females) aged 30 to 71 years (mean age 4~.9 :i: 2.3 years) underwent surgical treatment. In all of them ascending aorta was replaced and in 16 patients aortic valve was also replaced with prosthetic valve. In 3 patients the aortic valve was repaired, in 7 patients valve was normal. Hospital mortality amounted to 23.07~i(J (6 patients). Only 13 patients could be followed and the rest of the patients did not return for follow up. During this period of time no patient had to be reoperated upon for late complications of the disease and none of these patients died in the follow up. Presence of Marfan's syndrome, renal failure. stroke, cardiac failure, and rcopcration were determinant risk factors for mortality. With early diagnosis and surgical treatment about 771~'~J ofthese patients survived postoperatively.
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The risk of nephrocalcinosis (NC) in prctcrtn neonates is considerable, but conflicting numbers arc given for the actual incidence (I O•65(~..~)). Furosemide induced hypcrcalciuria is said to be the main risk factor. We assessed prospectively the incidence, causes and outcome of NC in very low birth weight (less than 1500 g) prctcrm neonates by serial renal ultrasound scans and urine analysis. Infants born elsewhere and transferred after 24 hours of age were excluded, as those who where discharged or died before 7 days or age. Two infants developed NC, giving an overall incidence of 4°Al ill the study group. The follow-up showed persisting NC in both prctcrm neonates. Urinary investigations showed no consistent findings in infants with NC In conclusion, the incidence of NC was lower in our population than is usually reported. Routine renal ultrasound scanning or very low birth weight prctcrm neonates is valuable in detecting NC.
