Razi Journal of Medical Sciences
Year:2005 | Volume:11 | Issue:43|Papers Count:29

Acute promyelocytic leukemia (APL) is a sub-type of acute myelogenous leukemia (AML) which occurs in about 10-15% of patients with AML. Approximately 20-30% of these patients, who are treated with the current standard All trans retinoic Acid (ATRA) and anthracyclines-based chemotherapy regimen, suffer relapse in less than a year. Arsenic trioxide (ATO), as a single agent, can induce complete remission even in refractory and relapsed patients with few adverse effects. Studies conducted by investigators to elucidate the mechanisms of action underlying these clinical responses have shown that Arsenic apparently affects numerous intracellular signal transduction pathways and causes many alterations in cellular function among which differentiation induction with low dose and apoptosis induction with high dose are the most prominent mechanisms. Despite previous in vitro studies, which mostly revealed that Fas/Apo 1 expression is unchanged during ATO treatment, in vivo expression of this classical receptor for apoptosis induction has not been evaluated yet. In order to study the apoptotic pattern in leukemic cells of these patients, a single-laser triple-color flowcytometric method was conducted by Annexin V and 7AAD technique, to detect leukemic apoptotic cells in a heterogeneous population of bone marrow samples. Fas/Apo 1 expression was also evaluated in promyelocyte population cells in a dual color panel. A substantial apoptosis was selectively detected in promyelocytic cells during the first and the second weeks following treatment and the concurrent Fas expression indicated its involvement in apoptosis induced by arsenic trioxide. .

The objective of the present study was to compare P53 protein expression in aggressive and non-aggressive Basal Cell Carcinoma (BCC). BCC is the most common skin cancer in whites and is seen in men more than in women. P53 is a tumor suppressor gene and has role in cell growth control. Mutation in this gene leads to loss of cell growth control and, therefore, malignancy. Various studies have reported that 40-90% of BBCs show at least focal immunopositivity for P53.This cross-sectional study was performed on 33 specimens. BCC pathology reports of all the patients whose specimens were referred to pathology ward of Hazrat Rasoul-e-Akram Hospital, during 2000-2001 were investigated. Necessary data regarding age, gender, site of involvement, previous radiotherapy and other skin lesion history were collected. Prepared slides were then divided into invasive and noninvasive by pathologists depending on pathologic criteria. Paraffin blocks of specimens studied by immunohistochemical methods were assessed for P53 protein positivity. Intensity of P53 staining positivity was higher in histologically invasive BCCs (Morphea form, Infiltrative) than in non-invasive ones (Superficial, Circumscribed) and this difference was statistically significant (Pvalue<0.05). In conclusion, early detection of P53 protein in primary stages of BCC can help to a better prediction of "tumor prognosis.

During the first 3 months of life, febrile infants are subjected to sepsis workup which includes evaluation for Urinary Tract Infection (UTI) and meningitis. The present study was undertaken to investigate the existence of concomitant meningeal inflammation in infants younger than 90 days affected with UTI. In this retrospective study, 75 out of 249 infants younger than 90 days had positive urine culture (30%). A lumbar puncture was done in 44 infants. 6 (10.3%) out of 44 infants with UTI had concomitant urinary and CSF positive culture and Ecoli was the most common urine and CSF pathogen. 28 (63.6%) (M: 12, F: 16) out of 44 infants did not have any positive culture for urine and CSF. 10 infants (M: 7, F: 3) had concomitant positive urine culture and sterile pleocytosis in CSF (WBC>=35, >=21, >=15cc/mm3) during the first, second and the third month of life with negative blood culture, respectively. An infant who received oral antibiotic before admission was excluded from the study. On the whole, 20.4% of total 44 infants had concomitant sterile pleocytosis with urinary tract infection. We concluded that sterile meningeal inflammation can follow UTI in neonates and infants at least up to the age of 3 months. Ecoli was the most common urine pathogen associated with aseptic meningitis. This finding suggests that treatment could be directed only to UTI although careful observation of such cases is required until adequate experience is accumulated.

Distinction between reactive mesothelial and metastatic adenocarcinoma cells in serous fluids is very important and sometimes very difficult. CEA, which is a tumor marker, is positive in 50 to 80% of metastatic adenocarcinoma and negative in reactive mesothelial cells. In the present study, 85 samples of body serous fluid were selected and then referred to laboratory of Alzahra Hospital in Isfahan. Cell blocks were prepared from samples. Hematoxylin-Eosin and immunohistochemical staining with CEA monoclonal antibody was then performed. In simple morphology, negative, positive and suspicious samples were respectively 68.2%, 21.2% and 10.6%. In immunohistochemical staining with CEA monoclonal antibody, 94.8% of previous negative results in simple morphology was negative and 5.2% was positive. Of positive and suspicious samples, positive CEA results were 44.4% and 50%, respectively. According to this study, in samples that Hematoxylin-Eosin stain is negative and positive, immunohistochemical staining is not needed, because this method is expensive and not helpful in these samples and, therefore, is recommended for suspicious cases.

The pathophysiology and pathogenesis of congenital self-healing reticulohistiocytosis (CSHRH) as well as the other types of langerhans' cell histiocytosis is not well understood. Some authors postulate a possible imbalance of the immune mechanisms that results in production of cytokines. We introduce a 41-day-old male infant who had a plaque of 0.5´1cm with mild discharge at proximal part of right forearm at birth and spontaneous regression within the first 3 months of life.

Colorectal cancer is the most prevalent GI cancer that leads to 10% of due to cancer deaths. The object of the present study was to determine colorectal cancer prevalence in patients referred to Imam Khomeini Hospital and to compare it with that of western countries. In a retrospective-descriptive study, records of 900 patients hospitalized in Imam Khomeini Hospital during 1981 and 2001 were studied. Extracted information about patients' age, sex, stage of disease, smoking and family history was then analyzed via SPSS software. Of 900 colorectal cancer cases, 522 (58%) were male and 378 (42%) were female with mean age of 51.07 years (SD=14.87). 668 cases (74%) were above 40 and 232 cases were below 40 years old. 69.9% of patients were non smoker and 30.1% were smoker. 763 cases (96.7%) had negative and 26 cases (3.3%) had positive family history. In the study of CRC stage, stage I had lower (0.9%) and stage II had higher percentage of patients (42%). Rectum was the most common anatomical site in two genders (64.65%). Regarding the high prevalence of this cancer in under 40-year-old population (in contrast to western countries' reports and the young population), potential unknown environmental-genetic factors should be taken into consideration. Evaluation of these risk factors (regimen, life style, low physical activity ...) and exact screening should be started from younger ages. Furthermore, due to high incidence of recto-sigmoid masses in this study, screening with fiberoptic sigmoidoscope can help us in diagnosing and early treatment of patients.

Abortion techniques are divided into two groups: surgical and medical. Finding drugs with least side effect and more potency is the aim of many researches in the latter technique. In recent years, prostaglandins have been one of the methods of choice in the induction of abortion. However, with recent studies on the mechanism of uteric contraction and cervical dilatation and by recognizing Nitric Oxide as an important mediator of this process, NO donors are object of many studies. With regard to few studies in this field, this research was conducted to compare the effect of intravaginal isosorbide dinitrate (an NO donor) and vaginal suppository of prostaglandin on cervical dilatation. 148 pregnant women with indication of therapeutic abortion in the first trimester were studied in two groups. The two groups were similar in terms of gestational age, parity and cervical dilatation. Cervical dilatation changes in each group during treatment were statistically significant (from 2.26±0.68cm to 4.57±1.62cm in PG and from 2.18±0.63cm to 3.63±1.11cm in ISD group). Also, the cervical dilatation difference between the two groups after treatment was statistically significant (P<0.05) (3.63±1.11cm vs 4.57±1.6cm in ISD and PG group, respectively) Furthermore, abdominal pain was more common in PG group (P<0.05). In conclusion, these two types of treatment are found to produce cervical dilatation, but the efficacy and also incidence of abdominal pain with PG is more common than ISD.

Anesthetic procedure is an important factor in the extent of blood loss during operation and can determine pre and post-operative complications. Finding an anesthetic procedure to reduce the extent of blood loss is a major goal for most surgeons. This study was undertaken to compare two anesthetic procedures and their extent of blood loss in patients undergoing endoscopic sinus surgery. 46 ASA I patients, who referred to ENT ward of Rasoul-e-Akram Hospital for endoscopic sinus surgery, were selected and then randomly assigned into two groups of 23 patients each. In the first group the induction of anesthesia was accomplished by propofol and remifentanil and cis-atracarium. Maintenance of anesthesia in this group was accomplished by using propofol and remifentanil infusion. In the second group the induction of anesthesia was accomplished by using propofol and remifentanil and cis-atracurium. Maintenance of anesthesia in this group was accomplished by using isoflouran and infusion of remifentanil. All patients received 7 ml/kg crystalloid solution before induction of anesthesia and their systolic blood pressure was maintained at 90 mmHg using TNG if needed. Blood loss determinants were: the extent of blood loss in suction (per bottle), the extent of blood in the surgical field, pre and post-operation hemoglobin levels, and surgeon's satisfaction of blood loss extent describing as: very extensive, obvious but acceptable and mild. The obtained results showed that there was no significant statistical difference in the extent of blood loss between two groups. There was also no significant statistical difference in pre and post-operation hemoglobin levels between two groups. In summary, the two procedures remarkably reduced the extent of bleeding (28cc±6), but this extent is not statistically different between the two groups.

In a cross-sectional study over a period of two years (Dec.2001- Dec.2003), 68 children with cerebral palsy (CP) and seizure aged 1-12 years were evaluated prospectively in Hazrat Rasoul Hospital. A control group of 60 children with seizure but no cerebral palsy at the same age group was also studied. The objective of the study was to find out the relationship between cerebral palsy and epilepsy and to determine the occurrence, associated factors, nature and prognosis of seizure in children with cerebral palsy. The mean age of seizure onset was 13±5.5 months in children with CP and 32±7.2 months in control group. In 42(61.7%) children with CP, seizure onset was during their first year of life while in control group this was only in 18(13.3%) ones. The incidence of neonatal seizure in CP children was considerably higher than that of control group (22.5% and 3.3%, respectively). 95% of children with cerebral palsy and 20% of children in control group had developmental delay. Generalized seizure was the most common type of seizure in both groups but the incidence of infantile spasm was higher in children with CP (11.7% vs. 1.6%). The incidence of status epilepticus as well as refractory seizure was higher in CP group. Furthermore, seizure control in CP children especially those with spastic tetraplegia was difficult and usually required polytherapy.

Preterm delivery is the main cause of perinatal morbidity and mortality throughout the world. Many complications such as neonatal intraventricular hemorrhage, cerebral palsy and high cost have increased the importance of preterm delivery; therefore, it is important to detect high risk women early in pregnancy in order to prevent this problem. All of the methods used for preterm delivery prediction have not been successful. The main purpose of this study was to determine the accuracy of cervicovaginal beta human chorionic gonadotropin (b-hCG) levels for preterm delivery prediction. This study was undertaken on 354 pregnant women with gestational age (GA) of 24-28 weeks attending health centers of Sari in Iran between 2000 and 2004. Provided samples from cervicovaginal secretions were sent to laboratory and b-hCG titers were measured by the ELISA method and were documented in relative sheets. Then, all pregnant women were followed until their deliveries. GA at delivery was determined in the first post partum visit. Pregnancy women were called in case they did not come to the health centers and after referring, necessary information was acquired and relative sheets were completed. For statistical analysis, a cut off value of 30 mIU/ml for b-hCG titers was considered and (preterm or term) sensitivity, specificity, positive and negative predictive values of this test for preterm delivery prediction were calculated in the post partum visit after recognizing the time of delivery. Out of 354 persons 68(19.2%) pregnant women had delivery before 37th week of gestation. The b-hCG levels had a range of 0-196 mIU/ml with a mean of 37.5. 75% of subjects in preterm delivery group and 10.5% of women in term delivery group had a cervicovaginal b-hCG level higher than 30 mIU/ml. Sensitivity, specificity, positive and negative predictive values of b-hCG for preterm delivery prediction were 75%,89.5%, 63.96% and 93.77%, respectively. The high negative predictive value of cervicovaginal b-HCG for preterm delivery prediction (particularly in high risk women) may limit unnecessary hospitalization and potentially harmful manipulations.

The object of the present study was to investigate the association between common CETP polymorphism, TaqI in intron 1, and high density lipoprotein levels in Tehran population. In order to examine the relationship between 62 allele and HDL-C level, 356 people with the lowest, medium and highest deciles of HDL cholesterol levels were selected out of 993 healthy subjects from TLGS. Factors known to influence HDL cholesterol level, such as smoking, body mass index and blood pressure were then studied. A segment of mentioned gene was amplified with PCR and then polymorphism was revealed with RFLP. The allele frequency distributions of the TaqI (intron1) polymorphism differed significantly between the groups with low (<28mg/dl) and high (>50mg/dl) HDL cholestrol. Homozygotes for the B1 allele had lower HDL-C levels (36±11mg/dl) than subjects carrying 62 allele (46±13mg/ml) (P<0.001). The percentile of B2B2 allele in high HDL-C groups was more than low HDL-C groups (17.3%, 5.5% respectively). In conclusion, it was found out that TaqI polymorphism at the CETP gene is correlated with HDL cholesterol levels.

Osteoid osteoma is a benign bone tumor that rarely involves scaphoid and other carpal bones. The patient of the present case report was a young man with chronic wrist pain and normal radiographs and CT scan who underwent surgery with probable diagnosis of osteoid osteoma. The pain was relieved after removal of osteoid osteoma. The significance of this case is due to the rare involvement of scaphoid by steoid osteoma, problems with clinical diagnosis and its unusual radiographic presentation. Osteoid osteoma should be considered in the differential diagnosis of chronic wrist pain in young patients.

The objective of the present study was to compare the maximum width of the third ventricle (V3) in brain computed tomographic (CT) scans of patients with Major Depressive Disorder (MOD) and normal healthy controls in psychiatry clinics and wards of Iran University of Medical Sciences and radiology Department of Hazrat Rasoul Hospital. First, during a pilot study, interrater and intrarater reliability of the researcher in obtaining CT values were assessed. Then, patients consequently admitted to the psychiatry clinics were included if they met MOD and inclusion criteria, and if they had filled informed consent. Controls who met inclusion criteria were selected from healthy persons admitted to CT department using planimetric and densiometric methods. CT scans of 30 patients and 30 age and sex matched controls were assessed and linear values and ventricular brain ratio (VBR) were measured. Data was assessed by using independent sample, two-tailed t-test and Pearson's correlation coefficient. The mean width of V3 showed significant difference between all age and sex subgroups of patients and controls (P<0.5). There was a significant difference between patients and controls younger than 40 in linear values of frontal lobe, Huckmann number and VBR (P<0.5 in all cases), but no difference was observed in older groups. Correlation assessment showed that the sooner the illness began and the longer its duration was, the greater the maximum width of V3 (r=-0.37 and 0.37 respectively) and interhemispheric fissure (r=-0.39 and 0.39 respectively) were. Also, number of episodes was positively correlated with VBR and maximum width of V3 (r=0.5 and 0.52 respectively). Based on the findings, it could be hypothesized that there is an enlarged third ventricle of the brain in patients with MDD. Also, MDD can accelerate age-related decrease of the brain tissue of the fronal lobe, but does not increase it.

Breast cancer is the most common site-specific cancer and is the second cause of mortality due to cancer in women. There are different prognostic factors including: axillary nodal status and tumor size (the most important factor), ER activity, PR, tumor grade and the type of histology. Other incompletely defined risk factors are: protease, catepstin, Her-2, etc. Her-2 is subtype 2 of EGF (Epidermal Growth Factor) receptor which may be presented in 10-34% of tumoral cells and is assumed to be a poor prognostic factor (probably because of high-power invasion of Her-2(+) tumors). The purpose of this study was to determine the correlation between Her-2 and invasion to axillary lymph nodes. For this purpose, all breast cancers operated between 2001-2003 in Imam Khomeini Cancer Institute were evaluated for size, age, menstrual status, ER, PR, P53,Her-2 and axillary lymph node status. Of 134 patients, 50 cases (37.3%) were T1 (Size<2cm), 62 cases (46.3%) T2 (Size=2-5cm), 18 cases (13.4%) T3 (Size>5cm) and 4 cases (3%) T4 (any size with skin or chest wall involvement). All T3 and T4 cases had axillary lymph node involvement. Thus, there was no correlation between Her-2 and lymph node status. In T1, of 32 Her-2(+) patients, 21(67.7%) were LN+ (Lymph-node positive) and 11(32.3%) patients were LN-(Lymph-node negative) and of 18 Her-2(-) patients, 3(16.3%) were LN+ and 15(83.7%) were LN-. In T2, of 37 Her-2(+) patients, 29(78.3%) were LN+ and 8(21.7%) were LN- and of 25 Her-2(-) patients, 7(28%) were LN+ and 18(72%) were LN-. T1 and T2 tumors had direct correlation between Her-2 and lymph node involvement, (Pv<0.05), and this correlation was independent of age, ER, PR, P53, histology and menstrual status.

Hepatitis B virus (HBV) is a major cause of viral hepatitis, cirrhosis and liver cancer worldwide and it is estimated to cause one million deaths worldwide annually. This virus is the second hazardous carcinogen in the world after smoking. According to WHO report 37% of the people in the world are infected by HBV. Healthcare workers (HCWs) are one of the high risk groups in affecting and transmission of Hepatitis B(HB)and also there is high probability of HBV transmission from HCWs to general population. The best way of preventing hepatitis B is three-dose vaccination schedule. Thus, we decided to determine Anti-HBs titer among HCWs in Firoozgar Hospital in Tehran. In this descriptive cross-sectional study, 102 HCWs of Firoozgar Hospital including faculty members, residents, interns, students, nurses and clerks were selected and enrolled through convenience sampling. All participants had to complete three-dose vaccination schedule. After blood sampling the samples were transferred to Firoozgar Hospital libratory. Checklist was consisted of age, sex, marriage status, occupational group, history of smoking and alcohol abuse, chronic renal and hepatic failure, diabetes, marriage age and duration after the last dose of vaccine. Statistical analysis was done with SPSS 11.5 software. Some statistical tests such as t, Chi2, Levene's KS, one way ANOVA and Pearson correlation coefficient were also used. Frequency, mean, SD and SEM indexes were applied to report statistical information. P<0.05 was considered statistically significant. Multiple linear regression model was used to predict effecting factors on Anti-HBs titer. 102 Anti-HBs titers of HCWs were determined and the mean was 70.43(95% CL, 57.02-83.84). Also, Anti-HBs titers ono individuals(29.4%) were less than 10 mIU/ml and 72 individuals(70.6%) were equal or more than 10mIUjml. There was a significant statistical correlation between Anti-HBs titer and age and duration after the last dose 'of vaccine (P<0.05). The permanent response time to HB vaccine is not clearly definite. Following-up for complete three-dose injection, vaccination before or at the onset of working in this centers and effecting factors influencing response to HB vaccine should be attended, HCWs who are one of the high risk groups in affecting and transmission of HBV, are recommended to determine their Anti-HBs titer after three-dose vaccination.

Continuous ambulatory peritoneal dialysis (CAPD) is a well-known model of renal replacement therapy for end-stage renal disease patients in developed countries. This model of treatment has widely been used in our country in recent years. The present study was undertaken to investigate the efficacy of CAPD in Iran, patient population, medical and surgical complications and the etiology of discontinued treatment in the patients. This retrospective study reviewed patient population in terms of age, sex, etiology of primary disease, selection criteria and rationals, complication and reasons for discontinued treatment. 37 patients (13 females, 24 males) who had been under CAPD treatment were studied between Jan. 1997 and Jan. 2004. The patients were between 16-75 years of age. Primary etiology was judged to be diabetic nephropathy in 17 patients; chronic glomerulonephritis in 8, nephrosclerosis hypertension in 5, amyloidosis in 3, reflux nephropathy in 2 and in 2 remaining cases was unknown. 17 cases lacked a satisfactory vascular access for hemodialysis after multiple attempts. 9 cases were selected on the basis of old age and history of myocardial infarction. Five patients volunteered for switching to CAPD from Hd in order to revert to a home dialysis modality. A double Cuff steright, Tenckhoff peritoneal catheter was inserted as a minor surgical procedure under brief general anesthesia. The minimum duration of treatment was one week in a patient whose CAPD catheter had no functioning even after replacement. The longest period of treatment was 5 years in a patient who ultimately received a successful renal transplantation. Presently, of 37 patients, 13 are still under treatment and 3 mortalities occurred after approximately 8 months due to septicemia following peritonitis. Treatment discontinued in 4 patients because of catheter malfunction and in 4 other ones upon the patients' own request. In 9 cases successful kidney transplantation was done and CAPD catheter was removed in the time of transplant operation. The experience accummulated in our department over 7 years contradicts preceding reports according to which CAPD is impractical in the developing countries due to cultured constrains in observing sterile technique. CAPD is a method of choice for treating diabetic and elderly patients suffering from vascular problems. The most common cause for discontinuing treatment is patient's frustration over peritonitis need. CAPD can thus be of value when short periods are envisioned particularly during preparation interval preceding kidney transplantation.

In this study histological and clinical data of 57 cases of IgA nephropathy in Hashemi-Nejad hospital diagnosed between 1998 and 2002 were reviewed. There were 43 men (75.4%) and 14 women (24.6%), ranging from 17 to 68 years (mean age 31.8±10.5 years). Each biopsy specimen was sub classified according to WHO classification as follows: class I: no case, class II: 8 cases (14%), class Ill: 18 cases (31.6%), class IV: 21 cases (36.8%) and class V: 10 cases (17.5%). The analyzed clinical parameters were serum creatinine, proteinuria, hypertension and degree of hematuria (micro or macrohematuria). There was a significant statistical correlation between histopathologic classes and serum creatinine (P<0.001, r=0.6 using Spearman's test) proteinuria (P=0.037, r=0.276 using Spearman's test), and hypertension (P=0.036, X2=4.397 using chi-squared test). There was no significant statistical correlation between histopathologic classes and degree of hematuria (P=0.725, X2=0.635 using chi-squared test).

The objective of the present cross-sectional study was to evaluate the risk factors for gestational diabetes mellitus. A case-control study was performed on 62 pregnant women with gestational diabetes mellitus and 80 normal pregnant women at Firooz Abadi Hospital during 1998-1999. The patients in two groups were compared according to age, parity, pre-pregnancy weight, family history of diabetes mellitus, history of macrosomia in their previous pregnancies, history of hypertension, previous malformed fetus, history of IUFO and abortion. Based on the obtained results there was a statistically significant difference between two groups in terms of age (P<0.0002), parity (P<0.0001), pre-pergnancy weight (P<0.0001), family history of diabetes mellitus (P<0.0002), previous macrosomia (P<0.0004), history of hypertension (P<0.0002), previous malformed fetus (P<0.0003) and previous IUFO (P<0.0002), but abortion was not significantly different. Older age, parity (3 or more) obesity, family history of diabetes mellitus, history of macrosomia, hypertension, malformed fetus and also previous IUFO are risk factors for gestational diabetes. Therefore, these women should be screened and handled for gestational diabetes in their pregnancies, and controlled for possible diabetes mellitus in the future.

Hypertension is an important health problem in developed and developing countries. This descriptive study was undertaken to determine the prevalence rate of hypertension in over 18-yearold population in Zabol. 1530 cases including 841(55%) females and 689(45%) males were selected through random stratified cluster sampling. Based on JNC-VI &WHO definition, people suffering from hypertension are those who have systole BP>140mmHg and Diastole BP>90mmHg after two intermittent time within 3-day interval or those who are under antihypertensive medication. BP was recorded in two positions (dorsal and sitting) from either left or right arm and high BP was considered as the constant BP. At the first time, in addition to BP, height and weight were also measured. Then, within 3-day interval the second and the third stages of BP was then measured. Data was collected via physical examination and completing a questionnaire. Based on the obtained results it was found out that the prevalence of hypertension was 15% in females, 12.5% in males and 13.9% in total case population. Age adjusted prevalence was 13.4% in females, 11.09% in males and 12.24% in total case population. Results also showed that 36% of females, 52% of males and 44% of total case population were not aware of their illness. Chi-squared test with 99% coefficient of certainty showed a significant difference between hypertension, obesity and age. However, no significant difference was seen between hypertension and sex. On the whole, hypertension is considered as a risk in modern and industrial societies; thus, population screening people's awareness of life style, nutrition and follow-up are necessary for hypertension control.

Healthy eating index (HEI) has been developed to track the quality of diet in different societies. The aim of this study was to determine the HEI score and its relation with nutrients intake and the number of servings from each food group in adolescents residing in district 13 of Tehran. The present study, which was conducted within the framework of Tehran lipid and glucose study (TLGS) and was part of a dietary intake assessment, was carried out according to the food guide pyramid of individuals residing in district 13 of Tehran. In this study 465 adolescents, aged 10-18 years old, were chosen. Dietary intake assessment was undertaken with 2-day 24-hour recalls. HEI was calculated based on 9 components (food guide pyramid groups: components 1 to 5, the precent of fat and saturated fatty acid intake, cholesterol consumption: components 6 to 8 and dietary variety score: component 9). The score range of each component was 0 to 10 and therefore, the sum score of this index was 90. Also, HEI score was modified with regard to HEI of previous studies. Dietary variety score was determined according to the number of consumed foods in the sample size of this study. The HEI score was categorized into three groups: less than 45(poor diet), 45-72(needs improvement) and more than 72 (good diet). Partial correlation was used to show the relation between HEI score and nutrients intake and the number of servings from each food group. The score of each component was calculated and grouped into three categories: <5, 5-8 and >8. The percentage of people according to each component of HEI was determined. The mean score of HEI was 64.9±9.6 in boys and 64.8±9.4 in girls. The results showed that the serving number of food groups in those with good diet was significantly higher than two other groups (P<0.001). On the contrary, the percent of saturated fat intake and cholesterol consumption in those with HEI>72 was lower than other groups (P<0.001). Approximately all nutrients intake and number of food items in adolescents with HEI score> 72 was significantly more than others (P<0.001). There was a significant positive correlation between the serving number of grain group (r=0.2, P<0.001), vegetable(r=0.3, P<0.001), fruit(r=0.2, P<0.001), dairy (r=0.3, P<0.001), meat (r=0.1, P<0.001) and HEI. There was a significant negative correlation between fat intake score (r=-0.2, P<0.001), percent of saturated fatty acids(r=-0.1, P<0.05) and cholesterol consumption(r=-0.1, P<0.05) and HEI score. The number of food items had a strong significant positive correlation with HEI (r=0.5, P<0.001). There was a I significant positive 'correlation between HEI and nutrients intake. The results showed that 74% of adolescent's diet needed improvement, 23% was good and 3% was poor. In conclusion, HEI is an appropriate tool for I assessment of diet quality in adolescents and since the diets of most adolescents need improvement, nutrition education is necessary in this age group.

Primitive Neuroectodermal Tumors (PNETs) are common tumors in children and are mainly intracranial in location. They frequently disseminate throughout the central nervous system via CSF (cerebrospinal fluid) and may rarely have metastasis outside the neuraxis. Rare cases of primary intraspinal PNETs have been reported so far and most of which are located intradurally in cauda equina. In the present case report, the clinical, radiological and pathological features of a primary intraspinal PNET are presented which all occurred intraspinally in T9 nerve root and radiologically resembled a nerve sheath tumor.

Changes in Cu and Zn ion levels have been reported in many nervous system disorders such as Alzheimer's disease, Wilson's disease and Pick's disease. The relationship between ion levels and polarization/depolarization of cell membrane is important since ion levels affect the state of polarization and depolarization of the cells. In this study, synaptosomes from different brain areas including cerebellum, hypothalamus, stratum, midbrain and cortex were prepared and the rate of copper and zinc was measured in depolarized or Ca++ deficiency condition. In an interventional study, rat brains were taken out of their skulls immediately after killing them and the synaptosome of various brain areas was prepared according to standard procedures. Prepared synaptosmes were incubated with potassium ion (55m molar) or EGTA (as calcium chelators). At the end of incubation period synaptosomes were burnt to ashes and remaining Zn and Cu were measured. The results were analyzed by student's t-test and significant values were calculated and reported. Based on the obtained results it was found out that in the presence of K+, the level of remaining copper in synaptosome of midbrain and cortex was higher than that of controls while Cu and Zn levels in cerebellum, hypothalamus and stratum were lower compared with those of controls. In this condition, the amount of remaining Zn was higher in cerebellum comparing with that of controls, while it was lower in hypothalamus, midbrain, stratum and cortex. In samples treated with EGTA the amount of Cu in cerebella, hypothalamus and stratum regions were higher but hypothalamus and midbrain showed decreased level. This study showed that there is a relationship between neural activity and Cu and Zn content of neural cells; therefore, disequilibrium in each ion level can lead to neural activity disorders presenting as a variety of neural disorders.

Chlamydia pneumonia is a common cause of lower respiratory tract infection and causes about 10-20% of community acquired pneumonia. It is seen in any age group and reactivates the asthma, so it needs specific treatment. Chlamydia pneumonia hardly grows in culture; therefore, serologic diagnosis is used. The goal of the present study was to determine the frequency of acute and previous infection of Chlamydia pneumonia and the mean age of infection in under 14-year-old children with pneumonia. Successful treatment of these patients with erythromycin and other macrolides not only decreases the rate of pneumonia in children but also dramatically decreases the asthmatic attacks in predisposed children and hospital admission. This case-control study was conducted on 73 children aged under 14 years (35 case and 28 control). For detection of specific IgM & IgG in serum enzyme, linked immunoassay was used. Mean age of children was 3.87±3.7 years (48.6% male; 51.4% female). Acute infection (IgM) was positive in 48% of all children and 57% of children with pneumonia. The highest rate was seen in 2-3 age groups (40%) with mean age of 3.7. Previous infection (IgG) detected in 27.4% of all children with highest rate (50%) was in over 5-year-old age group. Acute chlamydia infection (IgM) was significantly higher in case group (P>0.001), but no significant difference in previous infection was seen between case and control groups. In conclusion, acute C. pneumonia infection (IgM) is seen in 50% of the 3-year-old children population either with or without pneumonia. Additionally, treatment with oral erythromycin is a successful way to decrease the rate of pneumonia, asthmatic attacks in predisposed children and hospital admission. All of the children would be seropositive (IgG positive) up to the age of 5.

This retrospective, cross-sectional and descriptive study was performed on 599 burned patients who referred to Mottahari Hospital during one year (20.3.2002-20.3.2003) to determine the incidence of different kinds of burns in children and adolescents. The age of 15 years old or less was the basis of selection. Studied variables were patients' age. and sex, cause of burning, duration of hospitalization, burned surface percentage and mortality rate of patients. Of these 599 patients (mean age: 5.8), 167 were hospitalized and 432 were outpatient. In hospitalized group, 97.6% of patients had thermal burn, 2.4% had electrical burn, but nobody had chemical burn. In outpatient group, 98.8% had thermal burn, 0.9% had electrical burn and 0.3% had chemical burn. This study showed that burning occurred in male patients more than females (58.6% vs. 41.4%). Children younger than 5 years old were the most affected group. Most of the patients had burned surface area (BSA) less than 10% and a few patients had BSA more than 90%. The mortality rate was 4.8%.

Dermatophytes are a group of keratinophilic fungi falling within the genera of epidermophyton, microsporum and trichophyton. The genus trichophyton is particularly important and complex which comprises at least 24 recognised species. Additionally, molecular strain typing of trichophyton rubrum isolated within single nail specimens from patients with onychomycosis indicates involvement of multiple strains. In this study, nail specimens from patients with onychomycosis were cultured and 10 specimens from different patients with 5 colonies per culture plate were selected. Deoxyribonucleic acid (DNA) was extracted from these isolates and subjected to a PCR-based typing method that analysed variations in numbers of repeats in the non-transcribed spacer (NTS) region of the ribosomal ribonucleic acid (rRNA) gene repeats. In 6 out of 10 specimens, there were 2 or, more strain types. This suggests that in the majority of cases of fungal nail infections by trichophyton rubrum. Multiple strains are involved. This has important implications for epidemiological studies.