Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 1 2003 03 15 1 10 Najafipour S Mokhtari Azad T Kousari F Mahmoodi M Murray PG Nategh R 2015 09 28 We have analyzed paraffin sections from 55 patients with histologically confirmed Hodgkin’s disease (HD) for the presence of Epstein-Barr virus (EBV) markers using in situ hybridization to detect the EBV-encoded RNAs (EBERs) and immunohistochemistry to identify latent membrane protein-1 (LMP1) expression. Tissue specimens from 55 cases of Hodgkin’s disease included 22-mixed cellularity (MC), 27 nodular sclerosis (NC), one lymphocyte depleted (LD) and 5 lymphocyte predominance (LP). All of the confirmed EBV associated cases were examined and subtyped of the presence of Epstein-Barr virus (EBV) DNA by polymerase chain reaction. In situ hybridization revealed exclusive localization of virus in the tumor cells and FBV markers were present in 30 HD cases (55%) and were mainly confined to the mixed cellularity (MC) and nodular sclerosis (NC) subtypes. 1-MH immunohistochemistry has similar results as in situ hybridization. EBV positivity with regards of HD subtypes were 64% (14/22) mixed cellularity (MC), 44% (12/27) nodular sclerosis (NS), 0% (0/1) lymphocyte depleted (LD) and 80% (4/5) lymphocyte predominance (LP). Epstein-Barr virus-specific DNA sequences were detected by PCR in DNA extracts from paraffin-embedded tissues of all LMP1 positive cases. Twenty-eight cases were type 1 EBV and 2 cases type 2 EBV. There was difference between EBV-positive and EBV-negative HD patients with regard to age. Analysis of age group 1-14 years, 15-49 years and over 49 years, revealed 73% (16/22), 35% (10/29), 100% (4/4) EBV positivity, respectively. These findings compared to the EBV association pattern with HD in developed and developing countries suggest an overall intermediate pattern of EBV association with HD and high incidence of EBV children and elderly HD cases. https://acta.tums.ac.ir/index.php/acta/article/view/2624 https://acta.tums.ac.ir/index.php/acta/article/download/2624/2606

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 1 2003 03 15 11 14 "Ghasemi M Asadi Amoli F Gransar A " 2015 09 28 The histopathologic diagnosis of orbital and ocular adnexal lymphoproliferative lesions is difficult, resulting controversy in classification, determining benignity or malignancy of them and treatment modality selection. We designed the following study to evaluate clinical, histopathologic and if necessary immunochemical features of them in decreasing indeterminate cases. The study includes 51 subjects of biopsy-proven orbital lymphoid lesions and inflammatory pseudotumors from pathologic practices of Farabi and Imain Khomeini Hospitals, from April 1994 to March 2000. We reviewed H&E stained slides. Then we examined clonality of indeterminate cases with evaluation of clonal immunoglobulin light chains (ĸ or λ) expression to find neoplastic cells. CD markers were used for excluding other closed morphologic differential diagnosis. In conclusion we determined 40 cases of lymphoproliferative lesions, divided to the following there groups: malignant lymphoma with sixty-five percent frequency were the most common type of them, reactive lymphoid hyperplasia with twenty percent was the second one and atypical lymphoid hyperplasia with fifteen percent was the third one. The most common site of involvement was orbit (57.5%). Males were affected slightly higher than females. Median age at diagnosis was 62 years. The most common type of lymphoma group was low-grade small lymphocytic lymphoma. It is necessary to note that 11 out of total 51 subjects were excluded under other pathologic diagnosis. On the other hand 4 cases of already diagnosed pseudo-tumors were reclassified into three lymphoid lesion categories above. https://acta.tums.ac.ir/index.php/acta/article/view/2625 https://acta.tums.ac.ir/index.php/acta/article/download/2625/2607

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 1 2003 03 15 15 19 "Tootoonchi P " 2015 09 28 To determine easily identifiable congenital anomalies (CA) prevalence and risk factors in the first 24 hours of life in a cross-sectional study we assessed 2291 live born neonates at four teaching hospitals from September 1999 until March 2000 in the south of Tehran. Data were collected by a structured form which contained neonatal characters including sex, gestational age, birth weight, history of CA in siblings, type of CA if there was any and maternal characters including maternal age, history of chronic illness, history of reproduction (including gravidity, parity, infertility and abortion) and conditions during recent pregnancy (including multiple gestation, vaginal bleeding, drug taking, smoking, exposure to X-ray and gestational illness). The prevalence of CA was 2.3% (55 cases). There were 29 males (52.7%) and 26 females (47.3%). Seventeen cases (30.9%) and 15 cases (27.3%) were low birth weight (LBW) and premature, respectively. There was positive history of CA in siblings of only 2 cases (3.6%). Mother of one case (1.8%) had history of drug ingestion during pregnancy. 14.5% (8) and 9.1% (5) of cases, mothers had chronic or gestational illnesses, respectively. Overall musculoskeletal system (30.59%), central nervous system (18.82%) and genital anomalies (16.48%) were accounted as the most common CA. There was statistical significance between CA and birth weight (Odds ratio [OR] 2.51, Confidence Interval [CI] 1.17-5.37). https://acta.tums.ac.ir/index.php/acta/article/view/2626 https://acta.tums.ac.ir/index.php/acta/article/download/2626/2608

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 1 2003 03 15 20 28 Motamedi M Kaseb MH Raji M 2015 09 28 Since bone marrow has been shown to contain osteoprogenitor cells, an experiment was devised to test its effects when injected percutaneously into osteotomies sites in rabbit radii. In this experimental study, the osteogenicity and its effect on early bone repair of bone marrow grafts were investigated. The purpose of this study was to determine whether bone marrow grafted percutaneously led to increased bone production or had any effect on the early healing of fractures. The parameters tested included, cross-sectional area of callus (XS), breaking load (BL), tensile strength (TS) and callus volume (CV) at the fracture site. At two weeks post grafting four parameters, specially callus volume, were significantly higher 0.001 https://acta.tums.ac.ir/index.php/acta/article/view/2627 https://acta.tums.ac.ir/index.php/acta/article/download/2627/2609

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 1 2003 03 15 29 32 Pasbakhsh P Mehrannia K Barbarestani M 2015 09 28 Lorazepam has in increasingly being used in our country in recent years. Pharmacologically, lorazepam belongs to the benzodiazepines known for their wide neurotropic properties. There have been several studies on the side effects of the drug as stress disorders, tumors, preconvulsive activities in case of epileptic attacks, overdose, and behavioral problems, but little is known regarding the teratogenicity of the drug and its effects on the craniofascial development. In this study, a group of adult wistar rats of definite average of age and weight were selected and exposed to 2 mg/kg/day to 20 mg/kg day of lorazepam after conception (during the organogenesis in the days 9 to 18) in case and control groups. The fetuses were first studied macroscopically regarding gross anomalies, and then histologically and histochemically to exactly inspect the defects of tissue organogenesis. According to the results obtained, there was significant difference in the weight and length of the cases compared to the control group. Several anomalies of the eyes and ears (Coloboma of the eyelids with protruded globes and absence of the auricle and external auditory meatus), anomalies of the skull (Acrocephaly, and large rhombencephalon) were found. The craniofascial organs such as the nasal epithelium, tongue, salivary glands and the palates were also affected. According to the final analysis, there is a significant difference between the case and control groups. It was also found that taking the drug in the second half of pregnancy could affect the migration of the neural crest cells (being very sensitive) and change the mesenchymal structure of the neural crests. It also promotes the synthesis of proteins like growth hormone and growth factors. The fast, uncontrolled growth, defects the normal maturing process of the tissues during organogenesis, which ends in irreversible malformations. https://acta.tums.ac.ir/index.php/acta/article/view/2628 https://acta.tums.ac.ir/index.php/acta/article/download/2628/2610

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 1 2003 03 15 33 36 Khotaii Gh Hadipoor Z Hadipoor F 2015 09 28 Although amebic liver abscess can be a cause of significant morbidity and mortality in all ages, there are few reports dealing with this entity in children. Twenty-four children with amebic liver abscess. Ages ranging between 8 weeks and 14.5 years were managed at the Tehran university hospital of children, Iran, between November 1987, and October 2001. The most frequency presentation was high-grade fever and right upper quadrant pain, associated with tender hepatomegaly, leukocytosis and an elevated erythrocyte sedimentation rate. The diagnosis was confirmed by elevated indirect hemagglutination titers and ultrasonograpy of the liver. Unlike the experience in adult patients, none of the patients had concomitant jaundice and significant derangement of liver enzymes. The abscesses were likely to be solitary (22 of 24 patients). There were 17 males and 7 females. Most patients (80%) were between 8 weeks to 14.5 years of age. In five patients possible predisposing factors were tuberculosis, chickenpox, tetralogy of fallot and thalassemia major. All patients received metronidazole (50 mg/kg/day), followed by a therapeutic course of a luminal amebicide. There was no death despite a mean delay of 15 days before presentation to our hospital. In conclusion a high index of suspicion, early institution of metronidazole therapy and aspiration of abscesses with potential to rupture are believed to have contributed to the better outcome in these children when compared with results in previous reports. https://acta.tums.ac.ir/index.php/acta/article/view/2629 https://acta.tums.ac.ir/index.php/acta/article/download/2629/2611

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 1 2003 03 15 37 44 "Sotoudeh G Mirdamadi SR Siassi F Khosravi S Chamari M " 2015 09 28 Obesity is the common clinical signs in hirsutism, which can cause metabolic disturbances like dyslipidemia, insulin resistance and hypertension. To investigate relationship of overweight and obesity with hormonal and metabolic parameters in suspected hirsute women, in a cross-sectional study, 184 suspected hirsute women were selected in a reproductive endocrinology outpatient clinic in north of Tehran from February 1997 to May 1999. Weight, height, waist and hip circumferences were measured and serum levels of lipids, hormones and glucose were determined. Overweight and overall obesity (OO-body mass index: BMI ≥ 25 kg/m²) and android obesity (AO-waist to hip ratio: WHR>0.85) were calculated. Hirsutism score of OO and AO women was higher than that of non-obese women (NO, P https://acta.tums.ac.ir/index.php/acta/article/view/2630 https://acta.tums.ac.ir/index.php/acta/article/download/2630/2612

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 1 2003 03 15 45 49 "Ghavamzadeh A Alimoghaddam K Mehdipour P Sharifian R Schwanitz G Shamshiri AR " 2015 09 28 Chronic myelogenous leukemia (CML) is a stem cell disorder sometimes associated with lymphoproliferative disorders. CML may precede a lymphoproliferative disorder. There are a few reports showing associating of CML with multiple myeloma and we report a known CML case that transformed into a full-blown multiple myeloma. This patient had more than 69% of infiltrating myeloma cells in her bone marrow and Philadelphia chromosome was detected in 18 out of 42. However, the probable presence of some myeloma cells with classic Philadelphia-positive chromosome could be proposed. https://acta.tums.ac.ir/index.php/acta/article/view/2631 https://acta.tums.ac.ir/index.php/acta/article/download/2631/2613

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 1 2003 03 15 50 54 "Ebrahimi Daryani N Mirmomen Sh Bahrami H Haghpanah B Nayerhabibi A " 2015 09 28 Non-alcoholic steatohepatitis (NASH) is a disease of unknown origin characterized histologically by alcoholic-like liver injury in the absence in the absenc0, 83±13 mmHg) and ETT (96±8, 88±7 bpm and 91±11, 82±9 mmHg) (P< 0.05). Direct stimulation of the trachea appears to be a major cause of the hemodynamic changes associated with tracheal intubation during general anesthesia, but why hemodynamic changes in LMA were smaller than facemask needs further study. In healthy normotensive patients the use of LMA for the airway management during general anesthesia results in a smaller cardiovascular change than FM and ETT. https://acta.tums.ac.ir/index.php/acta/article/view/2768 https://acta.tums.ac.ir/index.php/acta/article/download/2768/2750

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 6 2004 12 15 441 444 H. Mazaher Sh. Sharifkashani H. Sharifian 2015 09 28 Detection of lymph nodes (LNs) involvement by various pathological processes has great therapeutic and prognostic implications. The purpose of this study was to evaluate the usefulness and accuracy of triplex sonography (gray scale, color mapping and spectral Doppler) in differentiating benign from malignant cervical LNs. We used triplex sonography to evaluate 120 LNs in 50 patients. The gray scale features which were considered included LNs margin, nodal shape (length/width ratio) and echotexture. Vascular patterns and arterial resistive index (RI) of the LNs were assessed by color mapping and spectral Doppler. Finally sonographic findings were compared with pathologic results. There was significant difference between benign and malignant LNs in shape, echotexture, RI and vascular pattern. Study results showed that malignant LNs, especially metastatic nodes, are accompanied with significantly high RI, rounded shape, heterogenous echotexture and peripheral vascularity. Among these sonographic findings, nodal shape (L/W ratio) and RI were more accurate for differentiating benign from malignant LNs. LNs with ill-defined margin were all metastatic. In this study triplex sonographic findings had relatively high accuracy in differentiating benign from malignant cervical LNs, however, because of some overlapping in triplex sonographic appearances of benign and malignant nodes, this modality may not have definite diagnostic value. https://acta.tums.ac.ir/index.php/acta/article/view/2769 https://acta.tums.ac.ir/index.php/acta/article/download/2769/2751

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 6 2004 12 15 445 449 M.R. Arab T. Talie-Khoozani Z. Tabei T. Taki 2015 09 28 Nucleolar organizer regions (NOR) are defined as nucleolar components containing a set of argyrophilic proteins which are selectively stained by colloidal silver nitrate staining. Although studies have shown that the number of NOR dots or particles is directly related to the rapidity of cell proliferation in cancer cells, prognostic or diagnostic value of NOR remains controversial. The aim of the present study was to asses the proliferative activity of the NOR in different gastric epithelial lesions. For these purposes 60 biopsy and surgical specimens of stomach from pathology files of Khatamalanbia and Imam Hospitals were chosen. For each patient, 3-5 paraffin sections were prepared and stained by one step colloidal silver nitrate solution. In each section intranuclear dots in 100 cell nuclei were counted by two of authors in randomly selected fields and data were analyzed by ANOVA. Statistical analysis showed significant difference for NOR number between gastritis, different grades of dysplasia and carcinoma. The shape and number of NOR showed a grater variability in carcinoma compared to other lesions. It seems that NOR could reflect the proliferative activity of cells. https://acta.tums.ac.ir/index.php/acta/article/view/2770 https://acta.tums.ac.ir/index.php/acta/article/download/2770/2752

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 6 2004 12 15 450 454 P. Tootoonchi 2015 09 28 Asthma is the most prevalent chronic disease in childhood. To determine the prevalence of asthma and related symptoms in children younger than 5 years, a survey was performed by interviewing mothers of 617 children during spring 2001. The interview comprised of two parts. The first part contained children characteristics including age, sex, maternal age at the child birth, child history of atopy, maternal history of smoking during pregnancy, existence of household smoker, history of family asthma or family atopy. The second part contained asthma section of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The overall cumulative and 12 month prevalences of wheezing were 21.9% and 19.4%, respectively. The prevalences of exercise-induced wheezing, dry cough without respiratory infections or physician-diagnosed asthma were 18.9%, 11.8% and 3.9%,respectively. Multiple logistic regression analysis showed a higher prevalence of history of wheezing or exercise-induced wheezing in male sex and in the children with positive history of atopy. Persistent cough unrelated to respiratory infections was strongly associated with the positive history of atopy in the children or maternal age at the child birth less than 20 yr or more than 30 yr. Furthermore a physician-diagnosed asthma was significantly associated with positive history of atopy in child. The results suggest a relatively high prevalence of history of wheezing or current and exercise-induced wheezing, but underdiagnosis of asthma among studied children needs more studies to be confirmed. https://acta.tums.ac.ir/index.php/acta/article/view/2771 https://acta.tums.ac.ir/index.php/acta/article/download/2771/2753

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 6 2004 12 15 455 457 D. Aghadoost A. Talebian 2015 09 28 Abnormalities of blinking in childhood are not uncommon. To determine the characteristics and causes of excessive blinking, this prospective, non–comparative consecutive case series study was carried out. In outpatient clinics of ophthalmology and neurology of our hospital, 60 children aging 2-16 years old with excessive blinking were examined. Detailed ophthalmologic and neurologic evaluation (history and physical examination) was done and etiology of excessive blinking and demographic characteristics of patients were determined. Of 60 children, 39 (65%) were male and 21 (35%) female. The most common causes were habitual tic in 25 (41.7%), uncorrected refractive error in 20 (33.3%), ocular surface abnormalities such as blepharitis in 6 (10%), psychogenic in 6 (10%) and central nervous system diseases in 3 (5%) cases. Excessive blinking in pediatric age group may occur because of a large number of potential problems. Most cases are caused by benign and self–limiting conditions. The causes can usually be determined after careful history and clinical examination. Neuroimaging techniques are not necessary to be done routinely. https://acta.tums.ac.ir/index.php/acta/article/view/2772 https://acta.tums.ac.ir/index.php/acta/article/download/2772/2754

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 6 2004 12 15 458 460 H. Sharami F. Ghaemmaghami F. Yarandi F. Milani N. Alizadeh 2015 09 28 Lymphangioma circumscriptum is a benign lymphatic malformation which is localized to the skin and subcutaneous tissues. It consists of dilated lymph channels lined by normal endothelium.Primary vulvar involvement is very rare and only 28 cases have been reported till 2002. Here we report a case in an 18 years old girl who was referred to our gynecologic clinic with symptoms of pain,swelling and erythema of both labia majors of 5 years duration. She had taken various drugs but all had failed and the lesion was exterminated only after wide local excision surgery. Histological examination revealed multiple dilated vascular channels with an inflammatory infiltrate in papillary dermis and diagnosis of vulvar lymphangioma circumscriptum was made. After ten months follow up, there was no evidence of recurrence. Wide local excision may be the best treatment for extensive vulvar lymphangioma circumscriptum. https://acta.tums.ac.ir/index.php/acta/article/view/2773 https://acta.tums.ac.ir/index.php/acta/article/download/2773/2755

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 6 2004 12 15 461 466 H. Nasri A. Baradaran 2015 09 28 In this report we explain a case of primary hyperparathyroidism in a 45 years old diabetic woman that was initially presented with recurrent nephrolithiasis of more than 10 years duration leading to right complete and left partial nephrectomy and complicated by end-stage renal failure. After diagnosis of primary hyperparathyroidism and parathyroid adenectomy, she developed severe hypocalcaemia due to severe and advanced osteitis fibrosa cystica. Despite starting hemodialysis and treatment by high dose calcium the general condition did not improve and the hypocalcemia was not corrected. Severe hungry bone syndrome did not get better and the patient died finally. https://acta.tums.ac.ir/index.php/acta/article/view/2774 https://acta.tums.ac.ir/index.php/acta/article/download/2774/2756

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 6 2004 12 15 467 470 Sh. Hashemzadeh M. Safari 2015 09 28 Although splenic metastasis is fairly common in disseminated cancer, solitary splenic metastasis in the absence of diffuse dissemination is rare. We report a case of 44 year-old man who developed isolated splenic metastasis of colon cancer. The patient had undergone right sided hemicolectomy for colon cancer in 1988. In 2001, he underwent reoperation because of local recurrence of tumor in the anastomotic site. The patient was admitted to our hospital on Sep 2003 with abdominal pain. Chest X-ray was normal. Abdominal CT scan showed a large cystic lesion in the spleen. Splenectomy was performed for the patient. The spleen was enlarged, firm and irregular. Histological examination showed metastatic mucinous adenocarcinoma. Based on this case, we recommend that clinicians consider possibility of metastasis in cystic lesions of spleen, especi