Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 11 2015 11 29 669 675 EN Somayeh Mahmoodi Department of Medical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mahdieh Rahmatollahi Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Shahsavari Department of Oral and Maxillofacial Pathology Dental Branch, Islamic Azad University, Tehran, Iran. Hamed Shafaroodi Department of Pharmacology and Toxicology, Pharmaceutical Sciences Branch and Pharmaceutical Sciences Research Center, Islamic Azad University, Tehran, Iran. Siyavash Grayesh-Nejad Department of Medical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ahmad R. Dehpour Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 11 28 Increased nitric oxide (NO) formation is mechanistically linked to pathophysiology of the extrahepatic complications of cirrhosis. NO is formed by either enzymatic or non-enzymatic pathways. Enzymatic production is catalyzed by NO synthase (NOS) while entero-salivary circulation of nitrate and nitrite is linked to non-enzymatic formation of NO under acidic pH in the stomach. There is no data on salivary excretion of nitrate and nitrite in cirrhosis.  This study was aimed to investigate salivary levels of nitrate and nitrite in a rat model of biliary cirrhosis. Cirrhosis was induced by bile duct ligation (BDL). Four weeks after the operation, submandibular ducts of anesthetized BDL and control rats were cannulated with polyethylene microtube for saliva collection. Assessment of pH, nitrite and nitrate levels was performed in our research. We also investigated NOS expression by real time RT-PCR to estimate eNOS, nNOS and iNOS mRNA levels in the submandibular glands. Salivary pH was significantly lower in BDL rats in comparison to control animals. We also observed a statistically significant increase in salivary levels of nitrite as well as nitrate in BDL rats while there was no elevation in the mRNA expression of nNOS, eNOS, and iNOS in submandibular glands of cirrhotic groups. This indicates that an increased salivary level of nitrite/nitrate is less likely to be linked to increased enzymatic production of NO in the salivary epithelium. It appears that nitrate/nitrite can be transported from the blood stream by submandibular glands and excreted into saliva as entero-salivary circulation, and this mechanism may have been exaggerated during cirrhosis. https://acta.tums.ac.ir/index.php/acta/article/view/5209 https://acta.tums.ac.ir/index.php/acta/article/download/5209/4710

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 11 2015 11 29 667 668 EN Mehdi Zeinalizadeh Brain and Spinal Cord Injuries Repair Research Center (BASIR), Imam Khomeini Hospital, Tehran, Iran. AND Department of Neurological Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Zahid Hussain Khan Brain and Spinal Cord Injuries Repair Research Center (BASIR), Imam Khomeini Hospital, Tehran, Iran. AND Department of Neuroanesthesiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 11 28 No Abstract https://acta.tums.ac.ir/index.php/acta/article/view/5208 https://acta.tums.ac.ir/index.php/acta/article/download/5208/4709

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 11 2015 11 29 725 727 EN Mozaffar Aznab Department of Internal Medicine, Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Naser Kamalian Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran. Jaffar Navabi Department of Internal Medicine, Taleghani Hospital, Kermanshah, Iran. Kaveh Kavianimoghadam Department of Paramedical, School of Medicine, Kermanshah of University Medical Sciences, Kermanshah, Iran. 2015 10 20 2015 10 20 Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is an idiopathic, self-limiting disorder and predominantly affects young women. We report a 35-year-old female who presented with soft to firm cervical lymphadenopathy and neck pain. She had multiple enlarged cervical nodes. Examination of other systems was normal. Lymph node biopsy was performed, and the histological features, and immunohistochemistry confirmed the diagnosis. The Patient was treated with non-steroidal anti-inflammatory drugs and low-dose prednisolone. A significant decrease in the size of lymph node and relief of neck pain occurred. During four years of follow-up, the patient developed no malignant disease or systemic and autoimmune diseases such as systemic lupus erythematosus. Kikuchi-Fujimoto disease is rare, clinicians should be aware of this condition as early diagnosis of the disease will lessen concerns of the patient's family. https://acta.tums.ac.ir/index.php/acta/article/view/5019 https://acta.tums.ac.ir/index.php/acta/article/download/5019/4690

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 11 2015 11 29 676 680 EN Mehrdokht Mazdeh Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Abbas Taher Department of Anesthesiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Saadat Torabian Department of Public Health, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Soroush Seifirad Department of Pediatric Cardiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 11 28 Oxygen therapy might increase damaged tissue oxygenation, turn on the aerobic pathway, and save neurons from death and could improve clinical outcome of the patients with stroke and head trauma. Hyperbaric oxygen therapy is accompanied by some unfavorable effects. Results of normobaric oxygen therapy on clinical outcomes of patients with stroke were controversial up till now.  This study was therefore designed to evaluate effects of normobaric hyperoxia on clinical outcomes of patients with severe acute stroke. A total of 52 consecutive patients with stroke who meet the inclusion criteria of the study were entered into this randomized controlled clinical trial. The patients in the case group underwent oxygen therapy with Venturi mask for first 12 hours of admission. The patients were examined for neurologic defects at the time of discharge and after six months using both Barthel and modified Rankin Scale (mRS) neurologic disability scoring systems. There was no significant sex difference between the two groups (P=0.5). There was no statistically significant difference between ischemic-hemorrhagic stroke constitutions of two groups (P=0.2). There were no significant difference in Barthel index scores of both groups at the time of discharge as well as the follow-up examination (P=0.7) According to the mRS scoring system, there was no difference between the patients of both groups at the time of admission (P= 0.8), however after treatment there was a significant difference between mRS scores of the treated group compared to the controls (P=0.04). According to the results of this study, normobaric oxygen therapy in the first 12 hours of accident could improve long time outcome of the patients with either ischemic or hemorrhagic stroke. https://acta.tums.ac.ir/index.php/acta/article/view/5210 https://acta.tums.ac.ir/index.php/acta/article/download/5210/4711

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 11 2015 11 29 728 730 EN Pedram Paragomi Digestive Diseases Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran. Kamran Moradi Digestive Diseases Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran. Pejman Khosravi Digestive Diseases Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran. Reza Ansari Digestive Diseases Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran. 2015 11 29 Crohn’s disease (CD) is rarely presented with lower GI bleeding (LGIB) which eludes the clinician. A 25-year-old lady with severe rectorrhagia was presented with no history of constipation, diarrhea or abdominal pain. Colonoscopy revealed ulcers in the rectum, sigmoid colon, and terminal ileum. Crohn’s pathologic features were detected in the terminal ileum. The bleeding was controlled via supportive care and IV corticosteroid. Recurrent LGIB was managed by prednisolone and azathioprine. The patient had an uneventful recovery. The clinicians should consider CD as a possible diagnosis in severe LGIB. Prednisolone and azathioprine efficiently control acute bleeding episodes and prevent the recurrence. https://acta.tums.ac.ir/index.php/acta/article/view/5218 https://acta.tums.ac.ir/index.php/acta/article/download/5218/4719

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 11 2015 11 29 681 685 EN Alireza Abdollahi Department of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Thrombosis Hemostasis Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ramesh Omranipour Department of Surgery, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2015 11 28 Patients with malignancy are at higher risk of thrombotic complications due to the hypercoagulability state. Our objective in this study was to assess the serum concentrations of Homocysteine, anti phospholipid antibodies, and anti cardiolipin in patients with benign and malignant breast tumors and study the effect of chemotherapy on the serum levels of these markers. A case control study was carried out on 100 women with malignant breast tumor and 100 age matched control with benign breast tumors.Serum concentrations of heomocystein, anti cardiolipin antibody (IgG and IgMaCL) and anti-phospholipid antibody (IgG and IgMaPL) were measured in all cases. The malignant group was followed for six months, and serum levels of abovementioned markers were measured again after surgical removal of breast tumor and chemotherapy. Current results showed a significantly higher serum concentration of Homocysteine, IgG and IgMaPL, IgG and IgM aCL in patients with malignant tumor before chemotherapy compared with benign tumor patients. We found a significant decrease in these markers after chemotherapy (P Value<0.05).We propose performing these tests (Homocysteine, IgG and IgM aPL, aCL) in patients with breast malignancy and starting prophylactic anti-thrombotic treatment in those with high serum levels of the markers. In addition, since the serum levels of the markers in patients with malignancy reduce after adjuvant therapies, we strongly recommend using adjuvant chemotherapy in these patients. https://acta.tums.ac.ir/index.php/acta/article/view/5211 https://acta.tums.ac.ir/index.php/acta/article/download/5211/4712

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 11 2015 11 29 731 732 EN Khadijeh Arjmandi Department of Pediatric Hematology and Oncology, Ali-Asghar Hospital, Tehran, Iran . AND Department of Pathology, Ali-Asghar Hospital, Tehran, Iran. Tahereh Rostami Department of Pediatric Hematology and Oncology, Ali-Asghar Hospital, Tehran, Iran . AND Department of Pathology, Ali-Asghar Hospital, Tehran, Iran. Saeed Yusefian Department of Pediatric Hematology and Oncology, Ali-Asghar Hospital, Tehran, Iran . AND Department of Pathology, Ali-Asghar Hospital, Tehran, Iran. Ghasem Miri-Aliabad Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. Azadeh Kiumarsi Department of Pediatric Hematology and Oncology, Ali-Asghar Hospital, Tehran, Iran . AND Department of Pathology, Ali-Asghar Hospital, Tehran, Iran. Mitra Mehrazma Department of Pediatric Hematology and Oncology, Ali-Asghar Hospital, Tehran, Iran . AND Department of Pathology, Ali-Asghar Hospital, Tehran, Iran. 2015 11 22 Wilms’ tumor is the most common abdominal tumor of childhood, and its cerebral metastasis is apparently very rare. The authors report an 18-month-old girl with Wilms’ tumor and brain metastasis. https://acta.tums.ac.ir/index.php/acta/article/view/5182 https://acta.tums.ac.ir/index.php/acta/article/download/5182/4708

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 11 2015 11 29 686 689 EN Seyed Mehdi Ahmadi Health Policy Research Center, Shiraz University of Medical Sciences, Fars, Iran. Sareh Keshavarzi Department of Epidemiology, School of Health and Nutrition, Shiraz University of Medical Sciences, Fars, Iran. Seyed-Ali Mostafavi Psychiatry Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Kamran Bagheri Lankarani Health Policy Research Center, Shiraz University of Medical Sciences, Fars, Iran. 2015 11 28 Overweight/obesity and depression are common among women especially in the elderly and can lead to unfavorable outcomes. We aimed to determine the association of overweight with depression and also to find any correlation of depression with some anthropometric indices in old women. A total of 94 depressed elderly women were compared with 99 non-depressed controls. The structured diagnostic interview based on DSM-IV were performed to diagnose depression, and Geriatric Depression Scale (GDS) was completed to rate it. Anthropometric indices were measured and compared between groups. Pearson correlation coefficients were determined for linear relations between variables. Odds Ratio of obesity and overweight in depressed subjecf left internal mammary artery (LIMA) was opened by the same length and was anastomosed along the LAD course through normal and diseased parts. In group B instead of complete opening of LAD, a small arteriotomy was done only in areas where the wall of the vessel was nearly normal (especially the anterolateral wall), and LIMA was anastomosed to these areas in a sequential (Jump) method. The patients were then followed for post-operation results. The two groups showed equal results regarding early mortality, post-operation bleeding, and infection, pleural and pericardial effusion. There were two cases of myocardial infarction (MI) in group A with one mortality after 18 months, while no MI was reported in group B. Group B demonstrated significantly superior results regarding the rise in ejection fraction and the improvement in functional class. In this study it was demonstrated that diffuse coronary artery lesions of LAD should be preferably operated using LIMA with the sequential-jump anastomoses method and the surgeon should avoid long arteriotomy with single long anastomosis because of lower chance of long-term patency. https://acta.tums.ac.ir/index.php/acta/article/view/4875 https://acta.tums.ac.ir/index.php/acta/article/download/4875/4531

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 6 2015 06 15 373 375 EN Sayena Jabbehdari Students' Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Omid Hesami Department of Neurology, Imam Hosein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mehdi Chavoshnejad School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 10 11 Epilepsy is one of the most common neurological disorders which a physician might come across in his career life. On the other hand, migraine is common disorders in society chronic headache such as migraine in epileptic patients give ride to difficulties in seizure treatment due to altering the sleeping pattern and calmness disarrangement. Therefore, early diagnosis and suitable treatment in epileptic patients is definitely inevitable, and it will help in a more desirable patients' treatment. So we aimed to evaluate the prevalence of migraine in epileptic patients and relation between these two disorders. Number of 150 epileptic patients attended to neurology clinic of Shohadaye Tajrish Hospital and Iranian Epilepsy Association between June 2010 to May 2011 were fulfilled the questionnaire, and the data has been assessed by SPSS software. In this study, we used MS-Q (migraine screening -questionnaire) designed for early diagnosis of migraine in the general population. From all patients filling the questionnaire, the prevalence of migraine (with or without aura) was as follows: 23 persons had criteria compatible with migraine with aura; 26 patients had migraine without aura. Migraine was more common in these patients: persons with academic degrees, women, patients who were used 2 antiepileptic drugs, and patients with high BMI. In this study, we showed that migraine in epileptic patients is more prevalent than the general population. Thus, early diagnosis and efficient treatment of migraine headache in these patients is mandatory. More studies are needed for evaluation of this issue. https://acta.tums.ac.ir/index.php/acta/article/view/4874 https://acta.tums.ac.ir/index.php/acta/article/download/4874/4533

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 6 2015 06 15 376 379 EN Azar Nickavar Department of Pediatric Nephrology, Aliasghar Childrens' Hospital, Iran University of Medical Sciences, Tehran, Iran. Niloofar Hajizadeh Department of Pediatric Nephrology, Childrens' Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Arash Lahouti Harahdashti Department of Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 2015 10 11 Vesicoureteral reflux (VUR) is one of the most important causes of urinary tract infection and renal failure in children. It is a potentially self-limited disease. The aim of this study was to evaluate the clinical course and significant factors in children with primary VUR. The medical charts of 125 infants and children (27.2 % males, 72.8% females) with all grades of primary VUR were retrospectively reviewed. Mean age at diagnosis was 22.3 ± 22.9 months. 52% of patients had bilateral VUR. Mild reflux (Grade I, II) was the most common initial grade. 53.6% of patients achieved spontaneous resolution. 30.1% of patients had decreased renal function on initial DMSA renal scan, significantly in males and severe VUR. Reflux nephropathy occurred in 17.6% of patients, especially in renal damage and male sex. No significant association was observed between recurrent urinary tract infection with the severity of VUR, and the presence of renal damage at admission. Age at diagnosis, gender, grade, laterality, the absence of recurrent urinary tract infection and renal damage had a significant correlation between spontaneous VUR resolution. Spontaneous resolution of primary VUR occurred significantly in female patients, age ≤ 30 months at diagnosis, mild-to-moderate VUR, unilateral reflux, the absence of recurrent urinary tract infection, and renal damage. https://acta.tums.ac.ir/index.php/acta/article/view/4873 https://acta.tums.ac.ir/index.php/acta/article/download/4873/4536

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 6 2015 06 15 380 386 EN Sanambar Sadighi Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. Amanolah Keyhani Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. Iraj Harirchi Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. Ata Garajei Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. Mahdi Aghili Radiotherapy Oncology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. Ali Kazemian Radiotherapy Oncology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. Maziar Motiee Langroudi Department of Ear, Nose and Trout, Valiasr Hospital, Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran. Kazem Zendehdel Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. Nariman Nikparto Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 To evaluate the effect of adding neoadjuvant chemotherapy to surgery and radiation therapy for locally advanced resectable oral cavity squamous cell carcinoma, 24 patients with T3 or T4a oral cavity squamous cell carcinoma were randomly assigned to surgery alone or Docetaxel, Cisplatin, and 5-FU (TPF) induction chemotherapy followed by surgery. All patients were planned to receive chemoradiotherapy after surgery. The primary end-points were organ preservation and progression-free-survival. SPSS version 17 was used for data analysis. Median follow-up was 16 months. The median age of the patients was 62 years old (23-75 years). Man/woman ratio was 1.13. The primary site of the tumor was the tongue in most patients (48%). No significant difference was observed between pathologic characteristics of the two groups. Chemotherapy group showed 16% complete pathologic response to TPF. No significant difference in organ preservation surgery or overall survival was detected. However, the patients in the chemotherapy group had longer progression-free-survival (P=0.014). Surgery followed by chemoradiotherapy with or without TPF induction results in similar survival time. However, progression-free-survival improves with the TPF induction chemotherapy. Studies with more patents and new strategies are recommended to evaluate organ preservation improvement and long-term outcomes. https://acta.tums.ac.ir/index.php/acta/article/view/4872 https://acta.tums.ac.ir/index.php/acta/article/download/4872/4540

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 6 2015 06 15 387 388 EN Seyed Hossein Shahcheraghi Infectious and Tropical Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Jamshid Ayatollahi Infectious and Tropical Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2015 10 11 Brucellosis is the most widespread zoonotic infection in the world. The disease is endemic in countries bordering the Mediterranean Sea. It is an important re-emerging infectious disease. This disease is closely associated with the evolution of mankind as an agrarian society linked to the practice of shepherding and popularization of animal husbandry. The patients with this disease are typically present with chills, fever, asthenia and sweating. This paper describes a patient with brucellosis and skin rashes on the leg. A 41-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd. The patient reported the loss of appetite, arthralgia and weight loss during previous five months. Finally, he was diagnosed with brucellosis by positive blood culture and high titer for Brucella agglutination test. The clinical manifestation of brucellosis is very broad, ranging from asymptomatic infection to serious debilitating disease. Current patient had skin rashes on his leg. Brucellosis must be considered in the differential diagnosis of acute infections, especially if there is a history of fresh milk product ingestion and living in an endemic region. https://acta.tums.ac.ir/index.php/acta/article/view/4871 https://acta.tums.ac.ir/index.php/acta/article/download/4871/4542

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 6 2015 06 15 389 391 EN Sezgin Zeren Department of General Surgery, School of Medicine, University of Dumlupınar, Kutahya, Turkey. Ugur Kesici Department of General Surgery, School of Medicine, University of Giresun, Giresun, Turkey. Sezvgi Kesici Department of Anesthesiology and Reanimation, School of Medicine, University of Giresun, Giresun, Turkey. 2015 10 11 Hydatid cyst locates in the liver (70%), lungs (25%) and rarely in other body tissues. Cases with gluteal muscle localized hydatid cyst are rarely seen in literature. In this case report, a woman with hydatid cyst that was located in gluteal muscle was discussed. After the patient had been diagnosed, complete surgical excision was performed with the patient. Albendazole treatment was applied in preoperative and postoperative period to decrease local recurrence risk. https://acta.tums.ac.ir/index.php/acta/article/view/4870 https://acta.tums.ac.ir/index.php/acta/article/download/4870/4545

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 6 2015 06 15 4869 4869 Mohamad Reza Haji Amousha Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. acta@tums.ac.ir. Nastaran Sabet Kish School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Tavangar@ams.ac.ir. Ramin Heshmat Department of Epidemiology and Biostatistic, Endocrine and Metabolism Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tavangar@ams.ac.ir. Afsaneh Rajabiani Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tavangar@ams.ac.ir. Hiva Saffar Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tavangar@ams.ac.ir. Vahid Haghpanah Endocrine and Metabolism Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tavangar@ams.ac.ir. Seyed Mohammad Tavangar Department of Pathology, Shariati Hos