JOURNAL OF MEDICAL RESEARCH (JMR)
Year:2003 | Volume:1 | Issue:3|Papers Count:14

Background: Cutaneous leishmaniasis is an important parasitic disease, which prevails worldwide. The etiological agents of this disease differ widely in different geographical areas. In Iran, L. tropica and L. major are the main causative agents. Microscopic diagnosis of Leishmania species and strains is not possible. Epidemiological and clinical findings accompanied by precise and sensitive molecular and biochemical methods are necessary to characterize various species and strains of Leishmania. Isoenzyme characterization using multiloci enzyme electrophoresis is one of the most suitable techniques which can differentiate unknown isolates in comparison with reference strains. For cost-effectivity of this advanced method, determining superior enzymatic systems in various regions is rational. Materials and Methods: Mass cultivation of reference strains and unknown isolates were carried out in suitable liquid medium. After harvesting in logarithmic phase of growth and extracting in special conditions, the isoenzyme profiles of 13 enzymatic systems were studied using cellulose acetate electrophoresis. Results: The comparison of isoenzyme relative factors, in nucleoside hydrolase 1 (NH1) and 2 (NH2), malate dehydrogenase (MDH), glucose phosphate isomerase (GPI), phosphoglucomutase (PGM) and 6-phosphogluconate dehydrogenase (6-PGDH) showed considerable differences between L. major and L. tropica isolated in Iran. The numbers of isoenzymatic bands were also different in these systems. Conclusion: The above mentioned enzymatic systems are superior for characterization of species and strains of L. tropica and L. major. In order to minimize time consumption and costs related to isoenzyme electrophoresis, superior enzymatic systems should be used. Extra systems are useful in complex situations in which identification of unknown isolates are not possible using the above mentioned systems.

Background: Blastocyst formation and implantation in the uterus is a complicated aspect of embryology. Any abnormal implantation in this critical stage may lead to pregnancy failure. There are still some ambiguities regarding the implantation process. The aim of this study was to investigate blastocyst development along with changes in the endometrium. Materials and Methods: One hundred and fifty outbred mice were kept under standard conditions with an appropriate light cycle (12 hours dark, 12 hours light). Then, every two female mice were placed in a cage with one male mouse overnight. Observation of the vaginal plug was considered as the first day of pregnancy. The mice were then killed from the fourth to seventh day of pregnancy at three different hours (8,12 and 18) by cervical dislocation. The uterus was then dissected, and tissue processing was done. The blocks containing specimens were cut serially and stained by hematoxilyn-eosin. The specimens were later studied under the light microscope and photomicrographs were prepared. Results: Results showed that blastocyst attachment took place at the antimesometrial zone. The endometrial changes also occurred at the primary decidual zone and then extended toward other zones. The endometrial changes observed included edema, leukocyte infiltration and decidua-trophoblast adhesion. Conclusion: Considering the fact that access to human specimens is not easy, most of the studies carried out so far have focused on mice, and although this study has also been conducted on an animal model, the results may be generalized to humans as well.

Background: Mammographically visible lesions are categorized according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon of the American College of Radiology. Lesions in category III are "probably benign" and short interval follow-up is suggested. Materials and Methods: Between March 2000 and March 2001, 3570 women, underwent mammography at Nemazee and Faghihi hospitals in Shiraz. Four-hundred- thirty-two patients were placed in category III according to BI-RADS, as having "probably benign" lesions and for whom short interval mamographic follow up was recommended. Out of the 432 women who underwent first-round screening, 298 women underwent follow-up mammography. An attending radiologist reviewed the breast images for changes in size, density and border of the initial lesions. Open biopsy or fine needle aspiration was performed in suspicious lesions. Results: Out of the 298 probably benign lesions included in this study, malignancy was diagnosed in 6 cases (2%).Decrease in size or obliteration of lesions was observed in 153 (51.3%) cases. No changes were noted in 139 (46.7%) patients. Conclusion: The frequency of cancer among cases with "probably benign lesions" was 2%. Short-term mammographic follow-up is a safe alternative to immediate tissue diagnosis for the management of "probably benign" breast lesions

Background: Carbamazepine is one of the most effective anticonvulsant drugs for tonic-clonic convulsions, with a daily maintenance dose of 600-1600 mg.  Materials and Methods: Over a 5-year period, from 1997to 2002, brain CT scan and/or MRI of 1832 epileptic patients with an age range of 18-70 years were reviewed. All of the patients had tonic-clonic convulsion and only used carbamazepine. Results: Out of 1832 patients, 496 (315 males, 181females) had abnormal findings in CT and/or MRl including cerebrovascular disease, idiopathic atrophy, brain trauma, primary brain tumors, post-encephalitic findings, gliosis, brain vasculitis, idiopathic calcification, porencephaly and findings related to neurocutaneous syndromes. Effectiveness of carbamazepine in the control of symptomatic seizures were graded into 3 categories. Good; for control of seizures due to calcification, gliosis, trauma, cerebrovascular accident and idiopathic atrophy. Moderate; for control of seizures due to tumors,encephalitis, vasculitis and neurocutaneous syndromes.Poor; for control of seizures due to porencephaly. Conclusion: About 70% of patients with abnormal findings in brain CT scan and/or MRI were controlled by carbamazepine. Carbamazepine is not a suitable drug in the control of tonic-clonic convulsions in porencephaly.

Background: High risk pregnancies are among the most significant factors determining the mortality and morbidity rates of neonates. Awareness of and prevention of these factors may have an effective role in the prognosis and survival of neonates. Materials and Methods: This study was performed on 310 newborns who were referred to the neonatal intensive care unit (NICU) of Zeinabieh Hospital from April to September 1999. Maternal and neonatal data including demographic information, prenatal care history, mode of delivery, delivery-related problems, gestational age, birthweight, 5th minute Apgar score, outcome and duration of admission were sought. Results: Among 2480 neonates who were born at Zeinabieh Hospital, 310 (12.5%) were admitted to the NICU ward. 44.5% of the neonates were product of cesarean section. 47.5% of the neonates were premature and 49% of them had a birthweight less than 2500 grams. The most prevalent causes of admission to the NICU were prematurity and respiratory distress syndrome (43.9%), asphyxia (20.6%) and meconium aspiration (11.9%). The higher the Apgar score in the, the lower the mortality rate. According to their outcome, 74.5% of the neonates were discharged from the NICU, 8.1% were transferred to other medical centers and 17% expired (out of which 88.7% had a birthweight of less than 2500 gm). The duration of admission was between I to 49 days. Conclusion: Good prenatal care and appropriate attention to the delivery and labor processes can be very effective in reducing mortality and morbidity rates and can lead to fewer admissions to the NICU.

Background: Locoregional recurrence is the most common pattern of treatment failure in locally advanced gastric cancer which occurs in 67% to 90% of patients treated with surgery. Assessment of post-operative radiotherapy in locally advanced gastric cancer, was the aim of this study. Materials and Methods: From 1985 to August 1995, fifty-eight patients with gastric cancer and serosal and/or nodal involvement and/or positive or close margins of resection were treated with post-operative external radiotherapy. The radiation was delivered by cobalt 60 machine through anteroposterior and posteroanterior portals up to 54 Gray. Results: After a minimum of five years follow up, 41 patients (70.7%) died. Out of this group, 21 (36.3%) patients died trom locoregional recurrence, 18 (31%) patients trom distant metastases and 2 (3.4%).patients from both. Local control rate was 42.5% and overall 5-year survival rate was 29.3% with a mean of 15 months. Conclusion: This retrospective study, as compared to other studies, suggests favorable effects of post-operative radiotherapy in the control of locoregional recurrence in high risk gastric cancer.

Background: Afferent and efferent pathways of F wave and efferent pathway of H reflex are composed of alpha motor neurons. Afferent neurons of H reflex are large sensory fibers. Despite the well-accepted opinion that sensory fibers generally conduct impulses faster than motor fibers, histologic examination of the peripheral nerves have revealed similar diameters for both motor and sensory nerves suggesting similar conduction velocities. Materials and Methods: In this study tibial nerves of eighty-one healthy volunteers with an age range of 20 to 30 years were stimulated in order to measure Hand F wave latencies of soleus muscles.. Electrodes of electromyography were in8erted in the popliteal fossa of the patients. Maximum height of H reflex was measured with an increasing direct current starting with 1 milliamper for one millisecond. H reflex latency was measured from the time of stimulation. In the same way, F wave and its latency was also measured. Results: Mean latency of F wave was 28.3 millisecond (23.2-35.6 millisecond). Mean latency of H reflex was 27.6 millisecond (22-30.8 millisecond). Mean difference of F and H waves (F-H) was 8 milliseconds. Turn around time for motor neuron reactivation in the spinal cord was 1 millisecond, which is at least 0.3 milliseconds shorter than synaptic transmission time of H reflex. Conclusion: It can be concluded that H wave conduction velocity is faster than F wave in healthy subjects. The findings also shown that large sensory neurons are faster than motor neurons.

Giant cell tumor of tendon sheath is common although the malignant form is only rarely reported and some investigators still do not believe that such a transformation really exists. This is a case report of a giant cell tumor of tendon sheath which has transformed into a malignant form. The patient was a 49-year-old male who had referred with pain and swelling of the distal region of his left leg for a few-weeks duration. In physical examination, edema as well as a mass in the soft tissue of that area was observed. CT-scan showed a moth- eaten pattern without periosteal reaction at the calcaneus. The soft tissue tumor was 2x2x 1.7 cm in size and after excision, the histopathological diagnosis was giant cell tumor of tendon sheath. Seven months later, pain and edema recurred at the same site and multiple nodules were seen on the ankle area. A biopsy was taken from the calcaneus and the soft tissue mass was totally resected. Histopathological and histiochemical examination revealed a malignant giant cell tumor of tendon sheath. Therefore, it seems that in rare instances this benign process can transform into a malignant counterpart.

Vitiligo is a melanocytic disorder characterized by depigmentation of skin and hair, which may be accompanied by neuro-ophthalmo-labyrinthic disorders. Association with several autoimmune disorders such as diabetes mellitus, thyroiditis and gastric parietal cell disease has been observed. Previous studies have demonstrated that the association between vitiligo and thyroid function abnonnalities is about 4.3%. This cross-sectional study was performed on 96 vitiligo patients who had been consecutively referred to our Dematology Clinic. Overall thyroid function abnormalities were seen in 20.8% of patients with vitiligo, significantly higher than those seen in the normal population (1.1-2.6%). Factors such as age, sex and duration of disease showed no significant positive correlation. The prevalence of thyroid function abnormalities in cases with vitiligo are higher than ranges observed in the general population.