Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 4 2003 12 15 202 206 R. Yazdanparast H. Sadeghi 2015 09 28 Cytotoxicity evaluation of Daphne mucronata (Thymelaeaceae) extract and one of its active purified components, using seven different cancerous cell lines, revealed the strong antiproliferative activity of the plant. Using flow cytometry technique, it was found that treatment of the most responsive cells (K562) with the plant extract or the active component inhibited the progression of cells through G1 phase by almost 15% compared to the untreated cells. Based on the extent of [3H]-thymidine and [3H]-uridine incorporation into DNA and RNA, respectively, the major metabolic effects of D. mucronata were found to be mainly on DNA and to a less extent on RNA synthesis. These data strongly support the flow cytometry observation and provide a mechanism for the antiproliferative activity of D. mucronata. https://acta.tums.ac.ir/index.php/acta/article/view/2665 https://acta.tums.ac.ir/index.php/acta/article/download/2665/2647

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 4 2003 12 15 207 213 H. Ansari Hadipour A. Allameh A. Kazemnejad 2015 09 28 In this study the plasma levels of lipid peroxidation (LP) products, protein carbonyls and antioxidant capacity of plasma as judged by ferric reducing ability of plasma (FRAP assay) were compared in adult and weanling rats treated with vitamin K1 phylloquinone). https://acta.tums.ac.ir/index.php/acta/article/view/2666 https://acta.tums.ac.ir/index.php/acta/article/download/2666/2648

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 4 2003 12 15 214 219 H. Mehrani R. Rezae 2015 09 28 Patients with diabetes mellitus (DM), experience significant morbidity and mortality from microvascular retinopathy, nephropathy and neuropathy. Hyperglycemia can induce diabetic complications through multiple pathways. Activation of protein kinase C (PKC) by hyperglycemia is one of the pathways which causes diabetic complications. Effect of nifedipine (a calcium channel blocker), and polymyxine B sulphate (a Protein kinase C inhibitor) was studied in adult male Sprague- dawley rats, who was made diabetic with streptozotocin. PKC activity was determined in tissues and serum enzymes and metabolite level was measured in all controls, diabetic and drug treated animals. The results showed that, levels of the, urea (two –fold), creatinine (60%), triglyceride (two-fold) and liver alanine transaminase (ALT) activity (two-fold), were significantly increased in diabetic group. In nifedipine, treated diabetic group, although urea and creatinine level was increased, but liver enzymes were not significantly different from those of control group. In diabetic group which was treated with polymyxine, all the measured metabolites and enzyme levels were the same as the control group, except glucose level which was increased and liver glycogen was decreased significantly. Protein kinase C activity in the cytoplasm of diabetic liver was increased comparing to its control group (5.73 ± 0.56 Vs, 4.00 ± 0.62). The enzyme activity in the plasma membranes of untreated and nifedipine treated diabetic groups was significantly increased (6.2 ± 0.42 and 3.66 ± 0.31 Vs 2.38 ± 0.36). These results show that polymyxine is more effective than nifedipine against protein kinase C activity in diabetic complications. In conclusion our results show that, liver and kidney damage in DM are related to PKC activation. The fact that polymyxine prevents diabetic related increase in PKC activity more than nifedipine, support the hypothesis that different PKC isozymes may play different roles in the development of diabetic complications. https://acta.tums.ac.ir/index.php/acta/article/view/2667 https://acta.tums.ac.ir/index.php/acta/article/download/2667/2649

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 4 2003 12 15 220 226 A. Ghavamzadeh M. Iravani M. Jahani B. Bahar A. Mousavi S. Gholibeikian M. Jafari F. Safavifar 2015 09 28 In this center, from 1991 to 2002, 89 chronic myelogenous leukemic (CML) patients, age ranging between 8-48 years with a median age of 29, underwent hematopoietic stem cell transplantation. Eighty-eight patients were in the first chronic phase of disease. Twenty-three patients received bone marrow transplantation (BMT) and 66 patients received peripheral blood stem cell transplantations (PBSCT). Transplantation was performed at a median interval of 19 months post-diagnosis. All with five exceptions received busulfan + cyclophosphamide (Bu Cy) conditioning regimens. To maintain graft vs. host disease (GVHD) prophylaxis, all with three exceptions received cyclosporine + metothrexate. Administration of granulocyte colony stimulating factor (G-CSF), per protocol, was included in post-transplantation regimens from the year 1999 on 48 patients. All patients received marrow transplantations from sibling donors. Fifty seven of transplanted patients are alive. Disease free survivals (DFS) from 6.2 to 9.5 and from 2.2 to 6.2 years for BMT group were 38.2% and 47.8%, respectively. DFS for PBSCT group was calculated as 54.3% in a period of 1.9 to 4.6 years. https://acta.tums.ac.ir/index.php/acta/article/view/2668 https://acta.tums.ac.ir/index.php/acta/article/download/2668/2650

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 4 2003 12 15 227 232 Gh. Toogeh A. H. Najafi M. Keyhani 2015 09 28 Cytogenetics has now been well established as one of the most valuable prognostic factors in acute myeloid leukemia (AML). This is the first study to describe the cytogenetic findings in Iranian AML patients. During 1998 to 2001, 104 patients with adult de novo AML (excluding M3) were diagnosed and treated with the standard protocols in our center. Adequate cytogenetic analysis performed on bone marrow at diagnosis was available in 39 of these patients. Clonal chromosomal abnormalities were detected in 74.4% of the patients. The chromosomal changes seen in this study in order of frequency were: t(9;22), trisomy 11 [n=4, 10.3%], trisomy 8, Abn (3q)[n=3, 7.7%], trisomy 22, monosomy 7/del (7q), monosomy X, complex karyotype [n=2, 5.1%], and t (8;21), t (6;9), trisomy 21, monosomy 5/del (5q), monosomy Y, and Abn (11q) [n=1, 2.6%]. We also categorized the patients into favorable (2.6%), intermediate (74.4%), and unfavorable (23.1%) prognostic groups based on the criteria defined by Grimwade et al in MRC-AML-10. The frequencies of different clinical and paraclinical indices were studied in these groups. Notably, complete remission (CR) rates after one cycle of chemotherapy were 60.0% and 25.0% in intermediate and unfavorable prognostic groups respectively. The overall CR rates were 83.3% and 66.6% in the mentioned groups. These findings are somewhat comparable to the results of the larger studies in other countries, suggesting the importance of cytogenetics in Iranian patients. The differences could be due to methodological variations (notably exclusion of AML-M3 in this study), and the small sample size, although ethnic and geographical differences should not be disregarded. To further clarify these results with statistical significance a larger analytical study with a greater sample size is certainly needed https://acta.tums.ac.ir/index.php/acta/article/view/2669 https://acta.tums.ac.ir/index.php/acta/article/download/2669/2651

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 4 2003 12 15 233 237 A. Kocharian M.Dalir Rooyfard R. Aghanouri 2015 09 28 Thalassemia major patients require repeated transfusions of packed cell and their lysis lead to iron deposition especially in the cardiac walls such as septum and posterior wall, so make thickening and cause cardiac disorders. In this case-control study, our object was to appoint if QT and QTC and Te dispersions were predictors of cardiac disorders in thalassemia major patients or not. 34 thalassemic patients who had no cardiac sign or symptom and 34 normal subjects between 16-18 years old of age were referred for evaluation of their QT, QTC, and Te dispersions in their ECGs. All standard 12-lead ECGs were obtained from them and were digitized by a single observer blinded to the assigned groups. As references, QT and Te were measured and QTC was calculated by Bazett,s formula.Results showed highly significant differences in QT and QTC dispersions between thalassemic patients and control group (P-value = 0.004 and 0.001 respectively); but it was moderate for Te (P-value = 0.086). About the means of QT, QTC and Te, there were highly significant differences between two groups too (P-value = 0.001, 0.000, and 0.000 respectively). QT and QTC dispersions are significantly higher in thalassemic patients than normal persons and may be predictors of cardiac disorders such as arrhythmias or sudden death in thalassemic patients in future. https://acta.tums.ac.ir/index.php/acta/article/view/2670 https://acta.tums.ac.ir/index.php/acta/article/download/2670/2652

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 4 2003 12 15 238 242 N. Ataei A. Madani S. T. Esfahani A. Kejbafzadeh M. Kamali A. Safa 2015 09 28 The prevalence of vesicoureteral reflux (VUR) among siblings of children with VUR has been reported to be from 4.7% to 51%. The incidence of VUR in the general population is less than 1% but it is high in risk groups. In a prospective study we started identifying the incidence and severity of VUR and renal parenchymal lesions in the siblings of patients known to have urinary tract infection (UTI) with reflux. Between October 1994 and February 2002, 31 siblings of 26 index patients were screened with direct voiding cystography. Technetium -99m dimercaptosuccinic acid (DMSA) nuclear renal scans were performed in siblings with VUR to detect renal scarring. The cystograms were interpreted as showing the presence or absence of VUR and the DMSA scan as symmetrical or asymmetrical differential function, with or without renal scar. Sixteen of 31 siblings were found to have vesicoureteral reflux representing an incidence of 51.61%. Mean age at presentation of the 8 boys and 23 girls was 2.5 years (range 6 months to 12 years). The majority of them were asymptomatic. Reflux was unilateral in 11 siblings and bilateral in 5. Of 16 siblings with reflux, 6 (37.5%) had a history of symptomatic UTI. The frequency of VUR was equal in siblings over 6 years and those younger. Fifteen of the 16 siblings with VUR had DMSA scintigraphy, of whom 5 were normal and 10 (66.66%) showed abnormalities (nine asymmetrical differential function and one parenchymal defect), which was bilateral in 7 and unilateral in 3. This study confirms a significant overall incidence of VUR in the siblings of patients with known reflux. The prevalence of reflux in older siblings is similar to those in the younger ones. The high rate of reflux in this population, especially girls, over 6 year old might be attributed to bladder dysfunction. https://acta.tums.ac.ir/index.php/acta/article/view/2671 https://acta.tums.ac.ir/index.php/acta/article/download/2671/2653

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 4 2003 12 15 244 247 M. H. Harirchian M. Ghaffarpour M. H. Shahbazi 2015 09 28 Primary hypokalemic periodic paralysis is a familial channelopathy inherited as an autosomal dominant trait. The first attack of paralysis may be evolved at any age, but has been reported to be most common in the second decade, so that some authorities believe that an episodic weakness beginning after age 25 is almost never due to primary periodic paralysis. In this retrospective study, we reviewed 50 patients admitted in two hospitals of Tehran University of Medical Sciences during 1992-2001 with acute flaccid weakness and hypokalemia, twenty-three of whom fulfilled our inclusion and exclusion criteria. Two patients showed first attack below age 15, 8 in 15-20, 4 in 20-25, 3 in 25-35, 4 in 35-45, and 2 beyond age 45. In our study, in contrast to previous ones, the first attack was beyond age 20 in 13 patients (56.5%) and beyond 25 in 9 (39 %). Age at first attack is more than other studies, which seems to be due to a difference between our epidemiological characteristics compared to that in the West. In other words, in our epidemiological condition, periodic weakness, although started beyond second decade of age, could be due to primary periodic paralysis if secondary hypokalemia had been ruled out. https://acta.tums.ac.ir/index.php/acta/article/view/2672 https://acta.tums.ac.ir/index.php/acta/article/download/2672/2654

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 41 4 2003 12 15 248 253 F. Ghaemmaghami M. Modarres Gilani M. Marjani A. Mousavi N. Behtash R. Moghimi 2015 09 28 This study has been designed to compare visual inspection of cervix with acetic acid (VIA test) with cytology as an accepted method for screening of cervical carcinoma and its precursors. 1200 eligible women were examined by both Pap-smear and VIA tests in Imam Khomeini Hospital, a referral general hospital in Tehran, Iran. Those who had abnormal results in one or both of the screening tests (n = 308) and those who had clinically suspicious lesions even if the tests were negative in addition to 10% of otherwise normal patients with negative tests (totally 290 patients) were referred for colposcopy and biopsy if mandated. From 598 patients who were introduced to colposcopy services, 355 patients0, 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