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 45, No 5 (2007)
Articles
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In this experiment we used cultured mouse cumulus cell-enclosed oocytes (CEOs) and denuded oocytes (DOs) to study the function of nitric oxide (NO) in mouse oocyte meiotic maturation. CEOs and DOs were cultured in a medium containing 4 mM hypoxanthine (HX) to maintain meiotic arrest, in maturation medium (without HX) supplemented with different doses of sodium nitroprusside (SNP, a NO donor), and in N-omega-nitro-L-arginine methyl ester (L-NAME) (inhibitor of NO synthase). NOS inhibitor suppressed the formation of first polar body (PB1) of the oocytes in CEOs in a dose dependent manner, but no effect on germinal vesicle break down (GVBD) was observed. Treatments of low concentrations of SNP stimulated significantly the oocyte meiotic maturation of CEOs which were inhibited with HX, but had no effect on DOs in the same culture medium. The treatment with high concentrations of SNP (0.1-2 mM) during the CEOs cultured in maturation medium resulted in a lower percentage of oocytes at PB1 stage and a higher percentage of atypical oocytes. A dose of SNP at 1 mM exhibited significant inhibitory effect on the formation of PB1, and the number of atypical oocytes compared with control. The results showed that the treatment with 1 mM concentration of SNP could significantly delay GVBD during the first 5 h culture period. The concomitant addition of L-NAME with SNP did not reverse the inhibitory effect of SNP on CEOs. Pre-incubation use of SNP did not have any effect on oocyte maturation. These data support the idea that NO could act in mouse meiotic maturation depending on its concentration.
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The ascending serotonergic projections are derived mainly from mesencephalic raphe nuclei. Topographical projections from mesencephalic raphe nuclei to the striatum were examined in the rat by the retrograde transport technique of HRP (horseradish peroxidase). In 29 rats stereotaxically injection of HRP enzyme were performed in dorsal and ventral parts of striatum separately. The extent of the injection sites and distribution of retrogradely labeled neuronal cell bodies were drawed on representative sections using a projection microscope. Following ipsilateral injection of HRP into the dorsal striatum, numerous labeled neurons were seen in rostral portion of dorsal raphe (DR) nucleus. In the same level the cluster of labeled neurons were hevier through caudal parts of DR. A few neurons were also located in lateral wing of DR. More caudally some labeled neurons were found in lateral, medial line of DR. In median raphe nucleus (MnR) the labeled neurons were scattered only in median portion of this nucleus. The ipsilateral injection of HRP into the ventral region of striatum resulted on labeling of numerous neurons in rostral, caudal and lateral portions of DR. Through the caudal extension of DR on 4th ventricle level, a large number of labeled neurons were distributed along the ventrocaudal parts of DR. In MnR, labeled neurons were observed only in median part of this nucleus. These findings suggest the mesencephalic raphe nuclei projections to caudo-putamen are topographically organized. In addition dorsal and median raphe nuclei have a stronger projection to the ventral striatum.
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Adenoids and tonsils are active lymphoid organs and play an important role against invading antigens of upper aerodigestive tract in children. The present study analyzes the changes in cellular and humoral immunity of children six months after adenotonsillectomy. The study population consisted of 30 children whit chronic adenotonsillar hypertrophy and 30 age-matched healthy children. In all children serum level of IgM and IgG, percentage of T lymphocytes (CD3), T helper cells (CD4), T cytotoxic cells (CD8) and B lymphocytes (CD20) were measured before surgery. These parameters were remeasured in patients 6 months after adenotonsillectomy. Before the operation, a reduction in percentage of T lymphocytes (CD3),TCD4,TC8 and B CD20 was seen compared to control group. This reduction was only significant in T lymphocytes (CD3).The serum IgM and IgG levels were not different in two groups. Six months after operation, the percentage of lymphocytes T CD3, T CD8 and BCD20 was increased and reached the control group. The IgM level was also significantly decreased in patients after operation. Our results indicate that cellular and humoral immunity decreases in children with chronic adenotonsiller hypertrophy preoperatively and increases to healthy children level, six months postoperatively. It means that chronic adenotosillar hypertrophy affect some parameters of cellular and humoral immunity and adenotonsillectomy by removing chronic stimulations and reverses these changes without any negative effect on immune function of patients.
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During dialysis some trace elements can accumulate while others may be removed from blood, leading to deficiency of some trace elements. For evaluating changes of serum trace elements in children on maintenance hemodialysis we measured copper (Cu), zinc (Zn), cobalt (Co), manganese (Mn), chromium (Cr) and nickel (Ni) in 3 groups of children: Group 1, children with CRF who were on regular hemodialysis; Group 2, children with CRF who were on conservative management, and Group 3, healthy children. For evaluating the impact of duration of dialysis on serum trace elements, group 1 patients were divided into two subgroups: A, patients who were on hemodialysis therapy for shorter than 18 months, and B, patients who were on hemodialysis therapy for longer than 18 months. The technique used for measurement of trace elements was PIXE (Proton Induced X-ray Emission). Mean serum levels of Zn, Mn, and Ni in group 1 were lower than group 2 and group 3. There were not significant differences in serum levels of Zn, Mn and Ni between group 2 and 3. The differences in serum levels of Cr, Co and Cu among 3 groups were not significant. The serum levels of Zn, Mn and Ni were significantly lower in subgroup B compared to subgroup A. Correlation test showed that there were an inverse linear relation between the period of hemodialysis and serum levels of Zn, Mn and Ni. Chronic hemodialysis leads to abnormalities of some trace elements in children, and these derangements increase with duration of hemodialysis.
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While a few studies have excluded ultrasound as a reliable diagnostic tool in screening for gastroesophageal reflux disease (GERD) in infant and children, others have referred to ultrasound as the screening test of choice in symptomatic patients and for patients follow-up. In this study, we evaluated the sensitivity and specificity of ultrasound in diagnosing GERD in children. This caseـcontrol study involved 56 patients and 50 controls. Inclusion criteria were age below 14 years, exhibiting GERD symptoms, having been chosen as a candidate for esophageal endoscopy and biopsy by a pediatric gastroenterology subspecialist, pathology or 24-hour pH-metry result suggestive of GERD, absence of obstructive gastrointestinal tract diseases, metabolic or other systemic diseases and having received no medications prior to the study. Ultrasound examination was performed for both patients and controls; endoscopy and 24-hour pH-metry were done for all patients and those in control group who had abnormal findings in ultrasound exam. Pediatric gastroenterologist's final judgment based on clinical and paraclinical findings constituted the gold standard. Sensitivity, specificity, positive predictive value and negative predictive value of ultrasound in diagnosing GERD were 76%, 100%, 100% and 79%, respectively. The mean length of subdiaphragmatic part of esophagus was 6.36 mm shorter in children with reflux than that in subjects without reflux and the difference was significant. Ultrasound can successfully be used as the first diagnostic approach in children with GERD.
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Prevention of ophthalmia neonatorum (ON) in the delivery room has been recommended by the Iranian Ministry of Health and Medical Education only if the mother is affected by STDs. This study aimed at finding out whether the neonatal wards should do prophylaxis as recommended or it is necessary to revise the previously-related protocols. In a randomized clinical trial, 130 full-term neonates born vaginally were selected on simple method in a period of three months and were divided randomly into control and case groups in such a way to be compatible regarding weight, gestational age, and sex. After obtaining parents' permission, 0.5% erythromycin ointment was used for ON prophylaxis. All the newborns were then examined regarding the presence of conjunctivitis during the third and the tenth day of life. The results showed that totally 8 newborns were affected with conjunctivitis, 7 of whom (87.5%) belonged to the control group and 1 to the case group (12.5%). However, this difference was not significant. This finding might be due to the inadequate frequency of affected subjects in comparison to the whole subjects under study. Considering other studies showing significant effect of drugs used in ON prophylaxis (silver nitrate, tetracycline, erythromycin, povidone-iodine) and based on the results of this study, it is highly recommended that neonatal wards of hospitals in our country carry out prophylaxis of ON in all subjects.
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To prepare Pap smears, the routine practice is to fix the slides immediately in 95% ethanol. This study was performed to evaluate the possibility of routine use of alternative method of air-drying and rehydration prior to alcohol fixation instead of conventional method. Paired cervical smears with at least low cellularity were collected from 117 women who participated in the study. One set was labeled WF (wet fixed or fixed immediately in 95% ethanol) and the other one ARF (air-dried, rehydrated and fixed). The latter further split into 3 subgroups based on the duration of air-drying. The staining quality of the slides was assessed with respect to chromatin, nuclear and cytoplasmic borders, cytolysis, cellularity, cytoplasmic staining, and red blood cells lysis. Then they were graded blindly. The results were analyzed by Chi square test to compare the defined parameters between the 2 groups and also the 3 subgroups. ARF slides were significantly better with regard to clearance of background due to the lysis of red blood cells (P value, 0.000, x2 test; kappa, -0.27). No statistically significant differences were noted between two groups in terms of other cytologic features. Cytologic features of ARF slides were statistically identical to WF smears. However, red blood cells lysis rendered clearer background in ARF slides. Air-drying and rehydration of slides is a superior method for heavily blood stained smears and can be used at least with identical quality for routine practice.
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Cardiac myxoma is generally considered to be a surgical emergency. Surgical excision must be done as soon as possible after diagnosis because of the high risk of valve obstruction or systemic embolization. In this study we report the result of operation in patient with benign cardiac myxoma. From 2001 to 2006, 35 patients (15 men and 20 women) between the ages of 26 and 82 years (mean of 52 ± 14 years) were operated on for cardiac myxoma. In all of them cardiac myxoma was excised with large cuff of atrial septum. The postoperative mortality was 2.9% (1 patient). No patient was lost in 5 years follow up. Emergency operation was performed in 80% of the patients; in the remaining (20%) of the patients, condition was stable and the clinical presentation was less worrying, so elective operation was done. Now as echocardiography can reveal smaller tumors in generally elderly patients, most cases of cardiac myxoma correspond to stable forms. With early diagnosis and surgical excision of atrial myxoma, 97.1% of patients survived post operatively and had an excellent short-term and long-term results leading to eventual cure of nonfamilial myxomas. However, familial myxomas retain a strong tendency to recur after excision.
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While the main goals of surgery for chronic otitis media are elimination of disease and improving hearing, sometimes persistent drainage continues and mandates revision surgery. The aim of this study is to assess the intraoperative findings during revision mastoid surgery and to ascertain the preventable factors. A total of 88 revision mastoidectomies performed from 1996 to 2000 at Amiralam university hospital in Tehran were reviewed. The most frequent findings during surgery were retained infected air cells, cholesteatoma and mucosal inflammation/granulation tissue. The overall success of revision surgery was 97.5%. (Providing a dry and safe ear) While hearing preservation is possible in most cases, improvement of hearing is a difficult goal in these patients. With careful preoperative assessment and performing a complete surgical approach, the primary goal of revision mastoid surgery is obtainable in most patients.
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By determining normal ranges of spinal canal diameters we can make early diagnosis in persons who have lower diameters of spinal canal. These persons are predisposed to spinal canal stenosis that is a major cause of spinal radiculopathies. In different studies performed in several countries, minimum and maximum ranges of spinal canal diameters were different for each population. In this study, we tried to determine the mean values of normal spinal canal diameters and areas in Tabriz and its suburb. 39 healthy, young to mid-age cases were selected. Our study was focused on L3-L4 and L4-L5. The following parameters were measured: the area of cross-section of the vertebral body, the area of cross-section of the dural sac, interarticular diameter, interligamentous diameter, antero-posterior diameter of the lumbar canal, inter-pedicular diameter, and the area of cross-section of the vertebral canal. A correlation between the parameters studied and the height of subjects was significant for interligamentous diameter (for L3/L4 and L4/L5) and interarticular diameter (only at L3/L4), cross-section area of the vertebrae (both L3 and L4), cross-section area of vertebral canal (only at L5 level), area of dural sac (at L3/L4 and L4). It was suggested that these diameters and areas should be interpreted as a unction of height of the subject. Most of diameters studied had smaller means than those in previous studies. This can be attributed to differences between populations and it can be interpreted as predisposition to spinal canal stenosis in our population.
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Asthma is now recognized as a common cause of disability of great economic cost and preventable deaths. In this study we aimed to test our hypothesis based on the relationship between body mass index and bronchial asthma .Among the patients with acute asthma admitted to the emergency ward and pulmonology clinic, we sought to determine the prevalence of obesity, as well as the effect of body mass index (BMI) on asthma severity, in this high-risk group patients. To investigate the relation between body mass index and asthma severity, we con¬ducted a descriptive cross-sectional study of 501 volunteered patients with bronchial asthma. To identify the severity of the asthma's situation, a questionnaire was prepared requesting the following information: age, sex, clinical signs and symptoms. After the participants answered to the questionnaire, all active or ex-smoker patients were excluded. A trained observer assessed airway reversibility, peak flowmetry and spirometry in asthmatic patients. The results showed that the dyspnea is the most common symptom in the asthmatic patients, recurrent episodic wheezing (95.7 %), cough (92.6 %), nasal polyp (29.7%) and dermatitis (16.2%). Mild persistent asthma (step 2) was the most common type of asthma severity classification (139; 27.74%) and 275 (54.87%) of asthmatic patients had normal weight (BMI, 19-25.9), 182 (36.34%) of patients were either overweight (BMI, 26 to 29.9) or obese (BMI > 30; 14.57%) and 44 (8.79%) were underweighted (BMI < 19). Between asthma severities and BMI was a indirect relationship, that there was a significant difference (P < 0.05). We observed negative association between BMI and asthma severity, but no association between the presence of recurrent nocturnal cough, nasal polyp, dermatitis and bronchial asthma.
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The common midline neck masses include thyroglossal duct cyst, lipomas, thyroid tumor or cyst and rarely a midline lymph node, particularly the node just above the thyroid isthmus. Thyroid tuberculosis (TTB) is a rare cause of thyroid disease and therefore only occasionally included in the differential diagnosis. In this study we tried to explain the clinical and paraclinical manifestations of TTB with a case series of 26 patients with definite or suspicious diagnosis of TTB. There were 7 cases with definite tuberculosis involvement of thyroid and 19 cases which were suspicious to have TTB. In fine needle aspiration cytology (FNAC) of 4 definite patients, acid fast bacillus was seen (57.1%). PPD skin test was positive only in 3 patients with definite TTB (42.9%). Microscopically, epithelioid granuloma, Langerhans giant cell and evidences of carcinoma, each was shown in one separate case. It is therefore important to note that tuberculosis should be considered in the differential diagnosis of anterior cervical swellings. FNAC can help in confirming the diagnosis but final confirmation is made by histopathological and biochemical examination; and patients respond well to surgery with antituberculous drugs.
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Measurement of the joint angles is used to assess the joint position sense (JPS). The aim of this study was to introduce a simple, fast, less expensive and objective method of measurement for JPS. In the current research, the accuracy and reliability of a system, consist of digital photography, nonreflective markers and manual analysis were evaluated. For this purpose, digital photos were taken from 72 angles of the knee positions of twenty four healthy subjects. The angles were measured by using transparent sheets and goniometers as manual method. AutoCAD software was used to evaluate the accuracy of the manual results. The values of Pearson correlation coefficient (r), and intraclass correlation coefficients were used to establish reliability. It was noted that the AutoCAD measurements, as a new system, was reliable and precise enough so it could be utilised for evaluating the JPS.
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For high occurrences of upper extremity disorders in working populations and in order to compare the occurrence of musculoskeletal alterations due to ergonomic risk factors such as highly force exertion, repetition, awkward posture between exposed and non-exposed groups, the research was carried out in Tabarestan steel industry. All 526 male workers (316 as exposed group : 132 aged 20-35 years, 184 aged >35 years; 210 as Non-exposed group: 89 aged 20-35 years, 121 aged > 35 years) performing tasks exposed / not exposed to risk factors for WMSDS of the upper limbs underwent a clinical examinations as well as completing standardized Nordic Musculoskeletal Questionnaires. The anamnestic cases were defined on the basis of pain, paraesthesia, hyposthenia, and vegetative disorders during previous months. Mean age of exposed and non- exposed groups were obtained 36.3 years (SD= 5.9) and 37.9 years (SD = 7.3) respectively. There were distinguished differences in occurrences of WMSDS of upper limbs between two mentioned groups. The major occurrence was found for the right and left hands. Nocturnal and diurnal paraesthesia obtained an occurrence of about 54% and 53% respectively. Data bears witness to the greater occurrence of affected individuals in exposed group, with a non- exposed / exposed ratio of 1:7.2. The greater occurrences of affected individuals in exposed group (P = 0.006) and in subjects>35 years (P = 0.002) were significant. Structural, organizational and educational measures can be applied to prevent WMSDS or diminish the relative effects to acceptable limit.
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Self-disclosure, as communication of information about one's affects, behaviors, and cognitions, has been emphasized as one of the central issues of the psychotherapeutic process. Verbal and nonverbal aspects of disclosure are important factors of psychotherapeutic communication, both for therapist and patient. This paper presents an account of the development and reliability of an observational instrument to measure patient's response style to therapist and therapy: the self-disclosure and emotional engagement. One hundred thirty eating disordered patients were interviewed using a semi-structured interview. Videotapes were assessed by two independent raters. Inter-rater reliability was good for both dimensions of the Patient Response Style Scale (PRSS): Self-Disclosure (SD) and Emotional Engagement (EEn).
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A number of innocent rashes occurs in neonates. They are usually transient and self limited and thus require no therapy but early recognition is important to distinguish these lesions from more serious disorders. In this study, our purpose was to determine the frequency of birthmarks in Iranian neonates. The presence of various types of birthmarks was determined in 503 Iranian neonates under 72 hour of age. The physiological skin changes observed in order to frequency were Epstein pearls in 444 (88.27%), Mongolian spot in 409 (81%), erythema toxicum in 272 (54%), sucking blisters in 264 (52.1%), Salmon patch in 262 (52%), milia in 232 (46%), petechia in 41(0.08%) and mottling in 29 (0.06%). Petechia was seen more commonly in vaginal delivery and in babies with more birth weight. Mottling was more common in premature and low birth babies. Our data suggest that the incidence of birthmarks in Iranian neonates is similar to the prevalence reported by others in white neonates.
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Herpes simplex virus accounts for 10 to 25% of sporadic viral encephalitis throughout the world among people of different age with two peaks, one at 5 to 30 and the other at > 50 years of age. Pathologic process includes focal brain tissue inflammation and necrosis (predominantly temporal lobe). Therefore local neurological signs and symptoms will ensue. Although CSF pressure rising due to inflammation is expected, papilledema which is defined as a noninflammatory congestion of optic disk due to raised intracranial pressure has not yet been mentioned as a sign of focal encephalitis. In this article we report a 24 year-old patient with headache, fever and some degree of cognitive disorder who was definitely diagnosed (with MRI and PCR technique) and treated for herpes encephalitis. Unexpectedly he had papilledema which led to more investigation. Most signs and symptoms disappeared during two weeks of intravenous acyclovir therapy as did papilledema to some extent. In this case, positive CSF PCR test for HSV confirmed the diagnosis. However it seems that along with starting acyclovir therapy, performing other supplementary studies (e.g. CT scan, MRI with and without I.V. contrast, CSF cytology and serologic tests for HIV) to rule out other conditions that may be associated with papilledema and focal neurological signs (like malignancies), is mandatory.
