Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 5 2006 10 15 291 298 I. Ragerdi Kashani M. Barbarestani F. Etesam M. A. Shokrgozar M. A. Abdolvahabi P. Haddad M. H. Noori Mokohi M. Hosseini 2015 09 28 Cancer cell-stromal cell interaction plays a crucial role in the growth and invasion of tumor cells of various organs. It has been recently suggested that adipocytes and preadipocytes, two specific types of stromal cells, affect the biological behavior of variety of breast cancer cell lines. In spite of few investigations, there is a controversy in the literatures about the effects of adipocytes and preadipocytes on tumor growth. In this study, we compared the proliferation of MCF-7 breast-cancer cell line in culture with or without presence of primary isolated human adipocytes and preadipocytes by MTT colorimetric assay in 2, 4 and 6 days of culture experiments. Human adipocytes increased the proliferation of MCF-7 cells in the co-culture about 8.6%, 12% and 12% more than MCF-7 monoculture in 2, 4 and 6 days after cell culture respectively. Human preadipocytes decreased the proliferation of MCF-7 cells in the co-culture about 7.7%, 16.9% and 21% lesser than MCF-7 cell monoculture in 2, 4 and 6 days after cell culture, respectively. Proliferation of MCF-7 cells in co- culture with adipocytes were 17.7%, 35% and 42% more than MCF-7 cells in co-culture with preadipocytes after 2, 4 and 6 days of culture, respectively. We concluded that human adipocytes increase the proliferation of MCF-7 breast cancer cell line but human preadipocytes inhibit proliferation of MCF-7 breast cancer cell line. https://acta.tums.ac.ir/index.php/acta/article/view/3203 https://acta.tums.ac.ir/index.php/acta/article/download/3203/3181

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 5 2006 10 15 299 305 M. R. Nikoobakht G. Pourmand A. Amidi H. Hashemi A. R. Abedi 2015 09 28 Biological effects extracorporeal shock wave lithotripsy (ESWL) is not precisely known. We have evaluated two urinary enzymes activity N-acetyl-B-D-glucosamine (NAG) and alanine amino peptidase (AAP) before and after unilateral ESWL as markers for renal parenchymal damage. Forty eight patients with kidney stones (mean age 39) who had presented for the first time or at least one year after their previous lithotripsy underwent ESWL. Urinary specimens were collected before and after first, third and seventh days of lithotripsy and NAG, AAP were evaluated. These enzymes displayed the greatest activity 24 hours after ESWL with significant difference compared to the control group, (P < 0.05 versus 0.02). Elevation of urinary enzymes activity correlated with stone size particularly stones larger than 2 cm. These data suggest that there is some tubular and parenchymal damage induced by ESWL that needs time to get improved. The higher urinary enzyme activity in patients with larger stones ( > 2 cm) is probably related to injury resulting from passage of smaller stones, produced after lithotripsy of a large stone, and it is suggested that these patients are treated with a safer procedure. https://acta.tums.ac.ir/index.php/acta/article/view/3204 https://acta.tums.ac.ir/index.php/acta/article/download/3204/3182

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 5 2006 10 15 305 309 M. K. Sharifi-Yazdi H. Darghahi 2015 09 28 The lethality of pulsed ultra-violet (UV) rich light for the inactivation of pathogenic bacteria has been investigated. A low pressure xenon filled flash lamps that produced UV intensities have been used. The pulsed operation of the system enable the release of electrical energy stored in the capacitor into the flash lamp within a short time and produces the high current and high peak power required for emitting the intense UV flash. The flash frequency was adjusted to one pulse per second. Several types of bacteria were investigated for their susceptibility to pulsed UV illumination. The treated bacterial populations were reduced and determined by direct viable counts. Among the tested bacteria Pseudomonas aeruginosa was the most susceptible to the pulsed UV- light with a 8 log10 cfu/ml reduction after 11 pulses, while the spores of Bacillus megaterium was the most resistant and only 4 log10 cfu/ml reduction achieved after 50 pulses of illumination. The results of this study demonstrated that pulsed UV- light technology could be used as an effective method for the inactivation, of pathogenic bacteria in different environments such as drinking water. https://acta.tums.ac.ir/index.php/acta/article/view/3205 https://acta.tums.ac.ir/index.php/acta/article/download/3205/3183

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 5 2006 10 15 309 315 A. Mehr-Aein M. Sadeghi M. Madani-Civi 2015 09 28 Tranexamic acid is now used on a routine basis for on-pump coronary artery bypass grafting (CABG). We assessed the hemostatic effects of tranexamic acid to decrease bleeding tendency and transfusion requirements in patients undergoing off-pump coronary artery bypass surgery (OPCAB). A total of 66 patients were enrolled to elective OPCAB in a double-blind, prospective randomized study. Of these, 33 patients received tranexamic acid (15 mg/kg before the infusion of heparin and 15 mg/kg after protamin infusion), and 33 patients received only saline. Preoperative hematologic variables, postoperative bleeding and allogeneic transfusions were considered. D-dimer plasma levels were also evaluated to monitor the activation of fibrinolysis. Postoperative bleeding was significantly lower in the tranexamic acid group compared with the control group (320 ± 38 mL vs. 480 ± 75 mL at 12 hour, P < 0.001). The tranexamic acid group had significantly lesser need for allogeneic blood products (0.46 units/patients vs. 0.94 units/patients, P < 0.001). They had also lower post-operative D-dimer plasma levels. No postoperative thrombotic complications were observed in either group. The defective hemostasis occurs even in the OPCABG. Tranexamic acid effectively reduces postoperative blood loss and the need for allogeneic blood products after OPCAB is decreased. https://acta.tums.ac.ir/index.php/acta/article/view/3206 https://acta.tums.ac.ir/index.php/acta/article/download/3206/3184

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 5 2006 10 15 316 322 F. Sajedi Z. Kashaninia M. Rahgozar L. Radrazm 2015 09 28 Pain in neonates can be associated with various risks and it seems essential to find a simple and acceptable method for relieving pain. Pharmacologic agents are not recommended in neonates for pain relief in minor procedures but orally administered glucose solution is found to be effective. The objective of this study was to assess the efficacy of oral 30% glucose during intramuscular injection in term neonates. Sixty-four healthy term neonates were recruited for this study during 1 month. The inclusion criteria were gestational age 37-42 weeks, birth weight 2500-4000 gr, and Apgar score > 7. The intervention consists of administration of either 2 ml of oral 30% glucose or 2ml of sterile water 2 minutes before injection. The primary out come measure was the cumulative Neonatal Infant Pain Scale (NIPS) score at 3 minutes after injection. Thirty-two neonates received 30% glucose and 32 neonates received sterile water. The cumulative NIPS score at 3 minutes after injection for neonates given 30% glucose was significantly (P = 0.000) lower than for neonates given sterile water. The heart rate immediately after injection for neonates given 30% glucose was significantly (P = 0.002) lower than for neonates given sterile water. Oral 30% glucose given 2 minutes before injection was effective in reducing neonatal pain following injection. It is a simple, safe and fast acting analgesic and should be considered for minor invasive procedures in term neonates. https://acta.tums.ac.ir/index.php/acta/article/view/3207 https://acta.tums.ac.ir/index.php/acta/article/download/3207/3185

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 5 2006 10 15 323 328 A. M. Haji-Zeinali M. Alidosti S. E. Kassaian M. Salarifar 2015 09 28 To minimize the risk of embolic events, several protection strategies have been introduced. We have evaluated the short-term outcome of patients who underwent carotid stenting with the routine use of cerebral protection devices. In our center, 36 successful carotid stenting procedures (of 38 attempted) were performed in 37 patients (23 men; age mean [SD] 667 years). Cerebral protection involved distal filter devices (n = 36). The protection device was positioned successfully in 36 of the 38 attempted vessels. Neurologic complications included 1 major stroke and 1 minor stroke and there wasd 1 sudden cardiac death. The rate of stroke or death was 2 for symptomatic lesions and 1 for asymptomatic lesions, and 2 in patients aged < 80 years and 1 in those aged 80 years. Protection device-related vascular complications were mild spasm occurring after 3 procedures (8%) but none led to neurologic complications. There were another four cardiogenic deaths in 30 day follow up. In this uncontrolled study, routine cerebral protection during carotid artery stenting was technically feasible and clinically safe. The incidence of major neurologic complications in this study was lower than in previous reports of carotid artery stenting without cerebral protection. https://acta.tums.ac.ir/index.php/acta/article/view/3208 https://acta.tums.ac.ir/index.php/acta/article/download/3208/3186

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 5 2006 10 15 329 332 R. Zaree Y. Eslami G. Fakhraie F. Ghannadi R. Varmazyar 2015 09 28 There are reports from different countries that some types of glaucoma are associated with blood groups. This cross-sectional study was performed on 400 glaucomatous patients [100 patients in each group of Primary open angle glaucoma (POAG), chronic angle closure glaucoma (CACG), pseudoexfoliative glaucoma (PEXG) and primary congenital glaucoma (PCG)] and 400 blood donors as control group to assess the association between blood groups and glaucoma. All patients underwent ABO and Rh blood group testing. The prevalence of blood group A was 30% in the control group, 27% in POAG, 33% in CACA, 38% in PEXG and 36% in PCG. The prevalence of blood group B was 24% in the control group, 19% in POAG, 20% in CACG, 15% in PEXG and 34% in PCG (P < 0.025). The prevalence of blood group AB was 8% in the control group, 9% in POAG, 5% in CACG, 12% in PEXG, and 8% in PCG. The prevalence of blood group O was 38% in the control group, 45% in POAC, 42% in CACG, 35% in PEXG and 22% in PCG (P < 0.001). The prevalence of Rh+ was 88% in the control group, 84% in POAG, 87% in CACG, 86% in PEXG and 87% in PCG. Compared to control group, blood group B was more prevalent and blood group O was less prevalent in PCG. There was no association between other types of blood groups (ABO and Rh) and PCG. There was no association between blood groups (ABO and Rh) and other types of glaucoma. https://acta.tums.ac.ir/index.php/acta/article/view/3209 https://acta.tums.ac.ir/index.php/acta/article/download/3209/3187

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 5 2006 10 15 333 340 J. Salimi M. Karbakhsh M. R. Zarei 2015 09 28 Abstract- Studies of the epidemiology of civilian vascular trauma in developing countries are rather few. This is a prospective study of our experience with vascular trauma in a referral university hospital in Tehran, Iran. The aim was to study the etiology, pattern of injuries and the mortality and morbidity rates due to vascular trauma in our population. In this cross-sectional study, all trauma patients suspicious of having vascular injuries who were admitted to Sina Hospital between March 2002 and May 2003 were included. Among 123 studied cases, there were 109 males and 14 females.Blunt injuries were more common than penetrating ones (56.1% vs. 43.9%). The most common anatomical site of vascular injuries had been knee and lower leg. In fact, cases with lower extremities vascular trauma were twice as common as those with vascular trauma in upper limbs (59.1% vs. 27.3%). The commonest injured vessels were popliteal artery followed by femoral artery. Arterial repair with graft interposition was done in 23 cases and bypass graft in 13 cases. Procedures on veins were performed in 24 cases. Five patients (4.06%) died and in 3 cases the patients died because of non-vascular reasons. The present study allows an understanding of the epidemiology of vascular trauma in the one of the major trauma centers in the metropolitan city of Tehran. The majority of our cases were young males sustaining vascular injuries due to road traffic accidents or being stabbed with knives. It also has important implications for vascular injury prevention in our community. https://acta.tums.ac.ir/index.php/acta/article/view/3210 https://acta.tums.ac.ir/index.php/acta/article/download/3210/3188

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 5 2006 10 15 341 344 S. M. Rakei M. Taghipour M. Mirchi M. Mosallaei 2015 09 28 The seasonal and diurnal variations in the incidence of hypertension, cerebrovascular accident, coronary heart disease were well documented, but the relation between season and daytime on the onset of aneurysmal subarachnoid hemorrhage (ASAH) was a subject of controversy. In the present study we aimed to evaluate the role of season of year and diurnal changes on the onset of ASAH. The time was categorized into two intervals of daytime and night time. Also patients

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 4 2006 08 15 263 268 A. Nourbakhsh M. G. Mohseni Z. N. Hatmi 2015 09 28 Opium use is one of the most common forms of substance abuse in Iran and there are some evidence indicating it is a risk factor of transitional cell carcinoma (TCC) of the urinary bladder. The majority of opium users are also cigarette smokers, so consideration of the high prevalence of smoking which is the most important risk factor of TCC of the urinary bladder among opium users is essential to assess the role of opium use as a possible risk factor of TCC. This study was done to evaluate the role of opium as a risk factor of TCC. A case-control study was performed on 255 individuals diagnosed with TCC of the urinary bladder by pathologic light microscopic examination of the tumor biopsies. Control population was chosen from individuals who had no history or presenting signs or symptoms of urinary problems. Case and control groups were matched by sex and age and also by cigarette smoking habits. Forty-one (18.1%) of the cases and 12 (5%) of controls were recognized to be opium users. Mantel-Haenszel analysis showed an odds ratio of 3.88, with 95% confidence interval of 1.99-7.57 and P value of < 0.001. Results indicate that opium use is a risk factor for TCC. The majority of opium users are also cigarette smokers, which is another important risk factor for TCC. Routine urine cytology and early evaluation in the patients presenting with any of the symptoms of urinary bladder malignancy by means of cystoscopy and urine cytology are highly recommended. https://acta.tums.ac.ir/index.php/acta/article/view/3196 https://acta.tums.ac.ir/index.php/acta/article/download/3196/3174

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 4 2006 08 15 268 272 S. Hashemzadeh M. Banazadeh F. Kakaei 2015 09 28 Mediastinal tracheostomy is a complex surgical procedure for the management of airway reconstruction in patients whose distal trachea is not sufficiently long to be reconstructed as cervical tracheostomy after tracheal resection for malignant diseases. In this article (study), we present our 10 year experience of this uncommon procedure in thoracic surgery ward of Imam Khomeini's Hospital, Tehran. Sixteen patients (87.5% male, 12.5% female, 58.4±1.4 y/o) underwent this procedure because of thyroid cancer (31.3%), SCC of cervical trachea (12.5%), postcricoid esophageal cancer (12.5%), and laryngeal cancer (43.8%). The procedure was associated with cervical exenteration in 12.5% and total laryngectomy (44%), thyroidectomy (6.2%), laryngopharyngoesophagectomy (12.5%), resection of neck mass (18.5%) and repair of cervical esophageal fistula with myocutaneous flap (6.2%).They had history of total thyroidectomy (25%), total laryngectomy (25%), cervical tracheostomy (13%), and hemi-laryngectomy (6%). Six percent of patients died because of uncontrolled intraoperative hemorrhage, and 94% were complicated with postoperative hypocalcemia (31%), osteomyelitis (13%), fistula (13%) and necrosis of the flap (13%). https://acta.tums.ac.ir/index.php/acta/article/view/3197 https://acta.tums.ac.ir/index.php/acta/article/download/3197/3175

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 4 2006 08 15 273 276 H. Mahmood-Hashemi 2015 09 28 Most often in the posterior of the mandible of patients who need implants, the inferior alveolar nerve (IAN) is too high to insert the implants, and the surgeons have to reposition IAN. In conventional techniques (to make the windows in the buccal aspect of the mandible) removal of the corticocancellous bone may cause weakness of the mandible. Here we present a new technique in which the bone is removed to a lesser extent and the IAN is best protected by the curet. This new technique is called the guard technique. As a primary report, evaluation of 11 patients (who were treated by this technique) is reported. There were few complications and IAN function was preserved in all patients. The mean time which the patients had temporary anesthesia was 7.3 days and the mean time that complete function of the nerve was returned was 3.3 months. Meanwhile the surgeon should also make an effort to make surgery and osteotomy far from the IAN. Most of the surgeons always avoid involving the IAN in a mandibular surgery; therefore, sometimes, they have to replace the IAN. Primary results of the new technique are promising. https://acta.tums.ac.ir/index.php/acta/article/view/3198 https://acta.tums.ac.ir/index.php/acta/article/download/3198/3176

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 4 2006 08 15 177 280 M. Naraghi M. Kazemi 2015 09 28 Amyloidosis of the upper aerodigestive tract is rare in the pediatric age group. We present two cases of pediatric laryngeal amyloidosis. Both of them had hoarseness as the presenting symptom. Diagnostic evaluation included flexible nasopharyngoscopy, rigid laryngoscopy, biopsy, computed tomography scan and laboratory tests. The results of Congo red staining of the specimen were characteristic of amyloid. The most common area of reported laryngeal involvement have been the vestibule, followed by the false cords, the aryepiglottic folds and subglottic region. In our cases, the masses were limited to supraglottic larynx. Management depends on the severity of the symptoms regarding the individual patient. https://acta.tums.ac.ir/index.php/acta/article/view/3199 https://acta.tums.ac.ir/index.php/acta/article/download/3199/3177

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 4 2006 08 15 281 284 M. Gharebaghian 2015 09 28 Treacher Collin’s syndrome (TCS) is a rare inherited condition characterized by bilateral and symmetric abnormalities of structures within the first and second bronchial arches. Patients with TCS present a