Vol 32, No 1-2 (1994)

Original Article(s)

  • XML | PDF | downloads: 107 | views: 163 | pages: 1-11
    Among 2379 patients with upper urinary tract stones who underwent ESWL (Extracorporeal Shock Wave Lithotripsy) at Sina Hospitál using the Siemens Lithostar, 638 developed Stone Street (SteinStrasse). Of these, 516 (81%) passed all of the stone fragments spontaneously and no treatment was required, 90 cases (14%) had more ESWL sessions to complete the treatment, and 30 (4.7%) required further interventional procedures. Only two cases (0.3%) needed an open ureterolithotomy.
    In this paper, we report the results of our experience in treating Stein Strasse as a complication of the ESWL.
  • XML | PDF | downloads: 103 | views: 207 | pages: 12-20
    Myasthenia gravis (MG) is a disorder of the neuromuscular junction. In children, the disease may be congenital or due to an autoimmune process. Clinical manifestations may be purely ocular or may include generalized weakness, fatigability, dysphagia, and disorders of speech.
    In this article, 27 children (14 female, 13 male) were prospectively studied from birth to age fifteen. Disease presentation was ocular in all the cases, with ptosis and diplopia. In 6 patients (all female), the disease was purely ocular, in the remaining 21, the disease was generalized. There was one case of transient neonatal myasthenia born to a myasthenic mother. Nine patients underwent thymectomy; all were reported as hyperplasia. Clinical consequences of the surgery were satisfactory. Five cases had hereditary myasthenia. In three brothers from one family, and a brother and sister from another family, disease presented from the neonatal period.
    Overall, compared to adults, myasthenia seems to have a more favorable course in children. In the autoimmune form of the disease, thymectomy has a very good result. Thymoma was not observed in these cases. MG in the newborn of myasthenic mothers had a very good prognosis, and treatment is necessary in the first few weeks only in the presence of clinical manifestations. In the congenital form of the disease, there is no indication for administration of steroids, thymectomy, or plasmapheresis.
  • XML | PDF | downloads: 215 | views: 526 | pages: 21-29
    Twenty six patients with double elevator palsy (DEP) (ranging from 25-90 PD), who had undergone either Callahan or Knapp-Modified-Kanpp Procedure from February, 1981 to February, 1994, were reviewed. We achieved acceptable results in correction of hypotropia in primary position. Three patients gained peripheral fusion and after reviewing the results we concluded that in patients having large-angle hypotropia with DEP, especially when it is accompanied by inferior rectus restriction. Callahan procedure is preferrable; however, in coexisting vertical-horizontal deviation, Modified-Knapp Procedure is recommended.
  • XML | PDF | downloads: 135 | views: 202 | pages: 30-34
    This article presents a new technique for weakening the superior oblique muscle by lengthening it's tendon. Lengthening is accomplished by a nasal superior oblique tenotomy, and by inserting a segment of silicone band 240 between the cut ends of the tendon.
    This technique is useful for the treatment of Brown syndrome and cases with superior oblique overaction.
  • XML | PDF | downloads: 161 | views: 319 | pages: 35-41
    Chronic bronchopulmonary disorders occurred in a large number of rustic females who used to bake bread at their dwellings under unhgyienic conditions. Bronchoscopy revealed advanced pathological changes with characterised black areas infiltrating the bronchial walls. Findings in ten patients who referred with acute chronic respiratory symptoms and a positive history of indoor pollution are described with an emphasis on their bronchoscopic changes.
  • XML | PDF | downloads: 156 | views: 317 | pages: 42-50
    Several recent reports reveal that patients develop symptoms of gastorintestinal motility disorders after the standard Whipple procedure. In the Department of Propedeutics of Surgery at Bulgarian Medical Academy in Sofia we observed the same phenomenon in our Whipple-operated group of patients. But the pathogenetic mechanism was so far unclear that prompted us to conduct an experimental study in this area. Eight mongrel dogs weighing an average weight of 15-20 Kg were operated after a Whipple procedure; five dogs survived postoperatively. Microelectrodes were implanted subserously on the muscular wall of the gastric remnant, afferent and efferent loop of the jejunum, as well as in the duodenum which were kept intact to serve the purpose. Bioelectric tracings were conducted twice or thrice weekly for a period of 2-3 hours up to the end of the first postoperative year. Serious rhythmic as well as characteristic disturbances which are believed to be related to the motility disorders after this operative procedure were found in the bioelectric activity of the gastric remnant.
  • XML | PDF | downloads: 141 | views: 177 | pages: 51-59
    The renal transplantation program in Iran had substantially been lagged behind in comparison to hemodialysis until 1985. Between 1979-1984, due to lack of the facilities, over 400 Iranian patients went abroad and underwent renal transplantation there. In order to evaluate the outcome of these transplants, all medical records of a nephrology clinic between the years 1978-1990 were reviewed and the records of 104 patients who had renal transplantation abroad were selected for this study. Out of these, 78 patients were transplanted from living related, 23 from cadaveric, and, 3 from living unrelated donors. Seventy-two percent of the transplants were carried out in England. The duration of follow-up since the date of transplantation, ranged from 3.5-14.8 years. The patient and graft survival rates in recipients of living related kidneys were significantly longer, but 23 cadaveric transplants (performed before cyclosporine) had inferior results. The most common cause of death was coronary artery disease. Four cases of malignancies were seen at an average time period of 70 months posttransplant. Coronary artery disease, septicemia, pneumonia, and hypertension were more common in the recipients of cadaveric kidneys, and urinary tract infection in recipients of living related allografts.
  • XML | PDF | downloads: 113 | views: 179 | pages: 51-59
    Myelolipoma, a rare benign non-functioning neoplasm, is composed of mature adipose tissue and bone marrow elements. Its most common location is adrenal gland; however, extra-adrenal cases have been also reported. It is found in only 0.2% of all autopsies; 96% of the reported cases were detected on postmortem examination. The surgical symptomatic cases having been reported so far are few. In this paper, one case of myelolipoma with clinical presentation will be described and its clinicopathological features, pathogenesis, associated diseases, and diagnostic techniques will be discussed. It must be emphasised that correct diagnosis largely depends on the clinicians and surgeons' awareness of this rare and unique entity. In short, the diagnostic features of myelolipoma include: negative biochemical findings; radioluccency on routine x-ray film; a solid mass in ultrasonography; and, typical patterns on CAT magnifying resonance imaging (MRI).
  • XML | PDF | downloads: 154 | views: 179 | pages: 64-68
    1) Chronic administration of morphine hydrochloride in the drinking water of mice induced physical dependence. Jumping and diarrhea, two signs of withdrawal, were produced by intraperitoneal (IP) injection of naloxone.
    2) Baclofen, bicuculline and picrotoxin decreased the number of mice's jumping episodes and frequency of diarrhea.
    3) Muscimol decreased jumping but not diarrhea.
    4) The data indicate that GABA-Ergic system is possibly involved in the morphine physical dependence, but further studies are required to elucidate the roles of GABA-A or GABA-B receptor sites in physical dependence.
  • XML | PDF | downloads: 158 | views: 204 | pages: 69-76
    The Bender-Gestalt Test was given to thirty mentally-retarded psychiatric patients. The mean, standard deviation, and standard error were 56.73, 26.25, and 4.80 respectively. Rotation was the most frequent major deviation which occurred in all the designs.
    Design # 7 was the most difficult one to be reproduced in the sample. This design by itself, was subject to 47% of distortion, 79% of omission, and 21% of rotation.
  • XML | PDF | downloads: 141 | views: 334 | pages: 69-76
    The technique described below offers temporary crown for the severely damaged vital anterior teeth without resorting to emergency root canal therapy or pin.