Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 40 2 2002 06 15 65 68 "Larijani B Javadi A Shafaee A Mahmoudi M Baradar Jalilli R Hemati P " 2015 09 28 Prompt detection of renal involvement through evaluation of microalbuminuria can both reduce mortality in diabetic patients and significantly reduce the cost of managing these patients. To this end, Micral test strips have been used as a screeing tool in this group of patients though not yet in our country. The present study aimed to evaluate this test and to abtain a simpler and less expensive method of screening for microlbuminuria. In this study, 200 type 1 and type 2 diabetic patients referred to the Endocrine & Metabolims Research Center of the Tehran university of medical Sciences were evaluated for microabluminuria. Entry criteria consisted of a history of recognized diabetes longer than or equal to 5 years. Exclusion criteria included development of urinary tract infection, pyrexia, and a history of uncontrolled hypertension. Every patient first completed a data questionnaire and then provided a first-void urine sample, which was tested for microalbuminuria with a urinary protein test strip (an Iranian-made Uri-Yab and a German-made BM-test-GP strip) and the sulphasalicylic acid chemical method. Negative samples were tested further using Micral test strips (based on gold-lable immunochromatograpy) and the microalbumin measurement kit manufactured by Dako. Germany (based on turbidometry using a Hitachi autoanalyser). 126 women and 74 men were recruited into the study. The average age of the sample was 40.7 years (range=16 to 63 years); 17 patients had IDDM and 173, NIDDM. Average duration of recognized diabetes was 8.75 years. Based on results obtained using chemical analysis and foreign-made tests strips, 46 patients (23%) had macroalbuminuria, though the detection rate using Iranian-made test strips was 18 percent (36 patients). A further 16.2 percent of patients had microalbuminuria, with an average urinary albumin excertion of 28.7 mg per liter. Compared with colorimetric methos, the Micral test yieled a sensitivity of 93% and a specificity of 87 percenct. Furthermore, the negative predictive value of the Micral test was 0.92, compared with a figure of 0.94 for a combination of the sulphasalicylic acid method and the BM-Test-GP strips. The results we obtained for the Micral test as a screening tool concurs with the results of numerous other studies. Diurnal variations in albumin excretion dicatate the performance of screening tests on three different occasions at specified regular intervals. Given the relatively high cost of Micral strips, it seems that a simpler and less expensive method should be devised for our country. We observed a higher negative predictive value for the combined suluphasalicylic+BM-Test-GP method than for the Micral strips. The cost of the latter combination comes to 2,000 Rials (@0.25 USS) , which is easily affordable for most patients; the methodology falls comfortably within the experits of medical diagnostic laboratories in Iran. More detailed studies, using 24- https://acta.tums.ac.ir/index.php/acta/article/view/2582 https://acta.tums.ac.ir/index.php/acta/article/download/2582/2566

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 40 2 2002 06 15 69 72 "Mikaeli J Yaghoobi M Sohrabi M Malekzadeh R " 2015 09 28 Achalasia is a well- defined esophageal motor disorder. Graded pneumatic dilation using Rigiflex ballon is one of the therapeutic modalities that had not been evaluated in a large long-term study. We aimed at evaluating long-term efficacy of graded Rigiflex pneumatic dilation in the treatment of achalasia. Symptomatic patients with achalasia who had been referred to our center were consecutively enrolled. The diagnosis was established by clinical, radiographic and endoscopic criteria. Exclusion criteria included pregnancy, coagulopathy, serious medical illness or malignancy. Initially all patients were clinically scored based on the severity of five main symptoms and then underwent pneumatic dilation wit at 3 cm ballon. Symptom scores were evaluated at 1, 6, 12 .. months. Clinical recurrence was defined as an increase of symptom with 3.5 cm balloon dilation. If recurrence occurred again, third dilation was done with a 4 cm ballon. Over a five-year period, 99 patients [mean age: 35.6 (3.0-72) years.] were followed to an average length of 47.4 (18-20) months. 35 patients needed- retreatment, only 6 of them required third dilation. After third dilation two patients did not reveal improvement and underwent cardiomyotomy. Over this time period, cumulative remission rate was 65% without redilation and 94% with redilation. The mean remission period was 44.7 months (95% CI, 43.52-51.27) for single pneumatic dilation by use of Kaplan- Meier survival analysis. There was no significant predictive value for age, gender, previous treatment and severity of initial score to outcome (P>0.4) by use of Cox regression analysis. Pneumatic dilation by a Rigiflex balloon using a graded approach is effective long-term therapy for achalasia in majority of patients. https://acta.tums.ac.ir/index.php/acta/article/view/2583 https://acta.tums.ac.ir/index.php/acta/article/download/2583/2567

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 40 2 2002 06 15 73 78 "Heidari Z Mahmoudzadeh Sagheb HR Dezfoulian AR Barbarestani M Noori SMH " 2015 09 28 Stereologic methods are used to abtain quantitative information about 3-dimensional structures from histologic sections. The aim of the present study was using new and unbiased stereologic techniques to investigate changes in volume and number of glomeruli after chronic lead acetate intoxication both quantitatively and in 3-dimensional spaces.Lead is one of the heavy metals that has adverse effects on renal function. These effects may involve the renal tubules as well as the glomeruli. Several qualitative histologic studies have been performed regarding the effects of lead on renal tissue and the glomeruli some of which report changes in volume and number of the glomeruli.Male adult wistar rats in four groups (each including 9 rats) were randomly selected. The case groups (treatment groups) were first given 0.5% and then 1% lead acetate in their drining water for 8 weeks. The negative and positive control groups were given distilled water and 0.4% acetic acid solution in the same period respectively.Stereologic analysis was performed based on Cavalierie’s principle to determine the reference volume (VReference), the fraction volume of glomeruli (VVGlom), and total glomerular volume (VTGlom). Furthermore the numerical density (NVGlom) and total number of glomeruli (NTGlom) were estimated using the physical dissector.Results showed that the number of glomeruli in case group which had received 1% lead acetate in drinking water decreased significantly (P0. This study confirms qualitative observational histologic studies with an unbiased and exact method, and expresses the chages in the number and volume of renal glomeruli after lead intoxication.05). on the other hand, glomerular total volume in both 1% and 0.5% groups increased significantly after lead intoxication. Comparing positive and negative control groups (P https://acta.tums.ac.ir/index.php/acta/article/view/2584 https://acta.tums.ac.ir/index.php/acta/article/download/2584/2568

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 40 2 2002 06 15 79 82 Salari MH Badami N 2015 09 28 Females abortion is one of the most important sequela of genital infection with chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum.In this study frequency of Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum was studied in 125 females with habitual abortion by direct and indirect immunofluorescence tests and culture method and compared with 250 normal population. The results obtained were as follow: Mycoplasma hominis was isolated from 18 (14.4%) females with habitual abortion and 18 (7.2%) normal population (P=0.0139). Ureaplasma urealyticum was isolated from 39(31.2%) females with habitual aboration and 48 (19.2%) normal population (P=0.0045). Chlamydia trachomatis was detected by direct immunofluorescence test in 9 (7.2%) of cases and 2 (0.8%) of control groups (P=0.0002). the antibody titer against D-K serotypes of Chlamydia trachomatis was also measured. The valuable titer of antibody (>1/16) was detected in 15 (12% of cases and 8 (3.2%) of control groups (P=0.0004).The results show that chlamydia trachomatis and Ureaplasma urealyticum may be responsible for some cases of abortion. https://acta.tums.ac.ir/index.php/acta/article/view/2585 https://acta.tums.ac.ir/index.php/acta/article/download/2585/2569

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 40 2 2002 06 15 83 87 Eslamian L Asadi M 2015 09 28 Premature rupture of membrane (PROM) is one of the complications of pregnancy which is blamed for increasing the rate of cesarean. Therefore, we studied pregnant women who were admitted in Shariati hospital during March 1996 and March 2000, to determine the rate of cesarean delivery in cases with PROM after 36th week of pregnancy (Term PROM). In a retrospective study, we included pregnant women who had these criteria;1-PROM 2- Gestational age>36 weeks 3- Single pregnancy 4- cephalic presentation and 5- no prior history of cesaren delivery. We extracted their demographic factors, age of pregnancy, induced labor its absence, interval duration between the onset of PROM and induction of labor, interval duration between the onset of PROM and normal vaginal delivery or cesarean delivery, the circumstances of cervix before beginning of induction of labor, type of delivery, indications of cesarean section and new born weight, from their files and entered them in a check list.We reviewed 7544 cases and only 536 cases matched to our criten and were registered. The Rate of PROM and cesarean delivery in the study group was 7.5% and 28.06%, respectively. Indications of cesarean section contained; Fetal distress, 30.8% CPD, 27.3% failure to progress, 18.6% High risk pregnancy, 16.9% and Macrosomia, 6.4% the rate of cesarean section decreased significantly when cervix dilatation or effacement significantly when cervix dilatation or effacement (each alone) increased (Dil, p=5×10-7; Eff, p=7× 107). Interval duration between the rupture of amniotic sac and the onset of induction had no effect on the cesarean rate (p=0.58). An increase in induction cases did not increase the rate of cesarean section (p https://acta.tums.ac.ir/index.php/acta/article/view/2586 https://acta.tums.ac.ir/index.php/acta/article/download/2586/2570

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 40 2 2002 06 15 88 94 "Etebary M Jahanzadeh I Mohagheghi MA Azizi E " 2015 09 28 Involvement of genetic alterations in breast cancer, one of the most common types of female malignancie, has been well documented . Among the possible alterations, mutations in several genes including p53 as an important prognostic factor, have been extensively studied. Mutated p5 Protein has longer half-life than the wild type protein that is detectable by immunohistochemistry (IHC). Our study included 72 tumor samples from unselected Iranian breast cancer patients. Tissue samples were stained with H&E to determin the histopathological type and malignancy grade of patients’ tumors. Nuclear p53 protein levels were also determined in tissue samples by IHC using DO-7 anti-p53 immunostaining and other prognostic factors. Results of our study indicated that the pattern of p53 immunostaining was significantly related to high malignancy grade (p=0.08) and age at diagnosis above 45 years (p=0.03). in conclusion, resultes of the present study indicated the validity and simplicity of application of IHC in determining the status of p53 protein. Our data support the results of other studies that have suggested that over expression of p53 protein can be considered as an indicator of increased malignancy potential and worse prognosis in breast cancer patients. https://acta.tums.ac.ir/index.php/acta/article/view/2587 https://acta.tums.ac.ir/index.php/acta/article/download/2587/2571

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 40 2 2002 06 15 95 99 Safdarian L Azari S 2015 09 28 In a double blind, parallel-group, clinical trial we compared the effects of conjugated estrogen with estrogen plus methyltestosterone in surgically menopausal women. In this study, 251 women were randomly assigned to one of the two regimens: 1-conjugated estrogen 0.625 mg/day +placebo. 2-conjungated estrogen 0.625 mg/day+methyltestosterone 1.25 mg/day (E+A group). Study parameters were psychologic, urinary and sexual symptoms, lipid profile,liver function test (LFT) and side effects. Significantly greater improvement in psychologic, urinary and sexual symptoms was observed in the E+A group .(P https://acta.tums.ac.ir/index.php/acta/article/view/2588 https://acta.tums.ac.ir/index.php/acta/article/download/2588/2572

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 40 2 2002 06 15 100 103 "Ghazi Saidi K Hajipour A " 2015 09 28 In a randomized, double blind study , we compared post operative pain and analgesic requirement in patients undergoing cesarean section with two types of general anesthesia: standardized general anesthesia (control group=26 cases) and preemptive low-dose ketamine (0.2 mg/kg) administered prior to anesthesia induction (keratmine group=27 cases). Postoperative analgesia was provided for both groups using morphine intravenously based on visual analogue scale (VAS). After the operation we found that the time from the end of surgery to the first request for analgesic was longer in ketamine group (10.22±8 hrs) than in the control group (1.65±1.01 hrs0 (P https://acta.tums.ac.ir/index.php/acta/article/view/2589 https://acta.tums.ac.ir/index.php/acta/article/download/2589/2573

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 40 2 2002 06 15 2015 09 28 Biomolecular behavior of tumor cells has become attractive to investigators. p53 as an oncosuppresor gene has been core of various studies and Ki67 is a nuclear protein involved in proliferation process. Stopping of onco-suppressor function theoretically allows proliferative system to get out of any control. In this case-control study we evaluated 50 patients with non small cell lung cancer, considering the association between P53 oncoprotein and Ki67 with rate of tumoral cells differentiation. We found the concurrent move of P53 and Ki67 according to the rate of differentiation and a significant risk (odds ratio) for being poorly differentiated in samples having higher rates of these two factors. We suppose that mutant P53 protein not only may be used as an objective finding for tumor grading, but probably as a practical point of approach for determining prognosis and planning therapy for this patients. https://acta.tums.ac.ir/index.php/acta/article/view/2977 https://acta.tums.ac.ir/index.php/acta/article/download/2977/2958

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 2 2005 04 15 131 139 F. Fereidooni V. L. Fornasier 2015 09 28 The investigation and determination of the significance of neovascularization in the progression of soft tissue sarcoma is currently of increasing clinical importance. Microvessel density is the morphologic evidence of neoangiogenesis in the process of malignant progression of sarcomata. This brief review of the markers commonly used in clinical practice was undertaken to determine the validity of the application of these markers in the quantitation of neoangiogenesis in sarcomata. The material selection was based only on primary material from untreated cases that were part of the inhospital and consultation practices. From this investigation, one can conclude that not all markers have equal value in either the qualitative or quantitative assessment of vascularization in tumors. Laminin was found to have low sensitivity. Factor VIII was found to have extreme sensitivity but lack specificity. A combination of collagen IV, smooth muscle actin, CD34 and CD31 markers were found to represent the most reliable identificators of blood vessels in sarcomata. Morphological identification of vessels may be further supplemented by proliferation markers (e.g. PCNA, Ki67) as indicators for,not only the presence of blood vessels, but also to determine the activity of endothelial cells in blood vessel growth. https://acta.tums.ac.ir/index.php/acta/article/view/2978 https://acta.tums.ac.ir/index.php/acta/article/download/2978/2959

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 2 2005 04 15 140 142 H. Mostafavi 2015 09 28 Graves’ disease is an autoimmune disorder characterized by presence of antibodies directed against thyroid stimulating hormone (TSH) receptor or nearby region. Other serological abnormalities like antibodies to double stranded DNA (ds–DNA) and antinuclear antibodies (ANA) have also been observed. We studied antibodies to ds-DNA and ANA in our patients with Graves’ disease and compared them with control group. Sera of 84 patients (29 males, 55 females) with diagnosis of Graves’ disease were prepared and level of antibodies to ds-DNA and ANA were measured and compared with 41 healthy persons (15 males, 26 females). The level of antibodies to ds-DNA and ANA in patients and control group did not show any significant difference. Our results were different from other studies in other countries. The difference may be explained by difference in our method of antibody measurement or genetic background which needs to be confirmed by HLA studies of our population. https://acta.tums.ac.ir/index.php/acta/article/view/2979 https://acta.tums.ac.ir/index.php/acta/article/download/2979/2960

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 2 2005 04 15 143 146 J. Ahmadi A. Kajbafzadeh M. Kalantari M. Nahvi A. Hadipoor B. Ashjaei V. Mehrabi 2015 09 28 Correlation between sacral ratio and bowel function as well as fecal continence has been well documented in patients with anorectal malformations (ARMs). One hundred and twenty children with ARMs were investigated in this study. Sacral ratio (SR) was measured from pelvic X-rays of patients. Among these, 52 patients (43%) had no pelvic X-ray and were excluded from this study. SR was measured by drawing three horizontal lines, through iliac crests (A), tip of coccyx (B) and inferior point of sacroiliac joints (C). The SR was determined by dividing the distance between lines B and C to the distance between lines A and B. In the normal and well developed children, the average ratio is ≥0.74. The SR was higher than 0.70 in 12 (17.7%) children and less than 0.69 in 56 children (82.3%). Among children with ARMs and abnormal SR, 38 cases (68%) had SR of 0.50-0.69; 12 cases (21.5%)had SR of 0.40-0.49 and 6 cases (10.5%) had SR of 0-0.39. In children with ARMs and normal SR, the fecal incontinence was observed in 2 cases (16%). In contrast, 16 cases (29%) with ARMs and abnormal SR had functional disturbance, either fecal incontinence or soiling (P < 0.12). When the patients had an absent sacrum, they had zero possibility for bowel control and frequently had major urinary problems. The sacral feature and SR appear to have a direct influence on the final functional outcome in ARMs. The abnormal SR < 0.7 correlates with poor bowel function. In patients with ARMs, sacral segment and SR are important factors in post operative bowel function disturbance. https://acta.tums.ac.ir/index.php/acta/article/view/2980 https://acta.tums.ac.ir/index.php/acta/article/download/2980/2961

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 2 2005 04 15 147 150 Z. Keihani Z. Haghshenas K. Daneshjou A. Azarfar 2015 09 28 Seizure is the most common neurologic disorder in the pediatric age. Obtaining thorough history and performing complete examination as well as electroencephalography (EEG) are very important in confirming the diagnosis and finding the cause. Epileptiform activity may be enhanced by activating procedures including sleep deprivation. In this study we performed short duration (up to 8 hours) sleep deprivation in 139 children with history of seizure but with normal or non specific awake EEG. We obtained 70% abnormality, 54% of which was of classic pattern of absence (3 Hz spike and slow wave). Most abnormal EEGs belonged to children in the age range of 5-10 yrs. It seems that short duration sleep deprivation is as useful as long duration sleep deprivation. https://acta.tums.ac.ir/index.php/acta/article/view/2981 https://acta.tums.ac.ir/index.php/acta/article/download/2981/2962

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 2 2005 04 15 151 154 A. Khalvat M. Razavizadeh 2015 09 28 Normal range of joint motion is an important factor in joint examination in clinical practice which is related to factors such as age, sex and geographic region. There is no data in the literature on the range of joint motions in healthy Iranian adults. We studied joint motions in 100 healthy volunteer subjects, 49 men and 51 women, from 19 and 58 years of age. The joint mobility was examined in saggital, frontal, transversal and rotating levels (SFTR). The normal range of motion of all peripheral and axial joint was examined using the standard goniometric technique. There were no significant difference in elbow flexion, shoulder adduction, inward rotation of shoulder and inward and outward rotation of hip, in relation to the age and gender of the studied subjects. There was inverse relationship between joint motion indices and age. https://acta.tums.ac.ir/index.php/acta/article/view/2982 https://acta.tums.