Jundishapur Scientific Medical Journal
Year:2005 | Volume:4 | Issue:2 (45)|Papers Count:14

Objective: The colony from inner cell mass of embryo has potential to proliferation unlimitedly in vitro and remain undifferentiated. These colonies can maintain their normal karyotype in eupleuidy in a cell population. In order to prepare the embryonic stem (ES) cells, we cultured the blastocyst and evaluated the morphology of inner cell mass during the outgrowth, disaggregation, expantion and production of the cell colonies. The karyptype of these cells was studied in the early passage.Methods: For this purpose, 20 mitomycin C-treated intact blastocyst, taken from 15-day rat embryos, were transferred to a layer of embryonic fibroblasts. The outgrowth of inner cell mass was mechanically disaggregated and the cells were passaged every 2-3 days in DMEM 1000 IU/ml containing LIF and 20% FBS. The cells were sub-cultured for up to nine passages. The colony of the cells during the 7th and 9th passages were processed for karyotyping by Giemsa staining.Results: The results showed that in the expantion stage the coloney appeared as a flat monolayer mass with strike boundaries and nondistinguished cytoplasm with a few nuclei. In coloney formation stage, the undifferentiated colonies of cell change their morphology to a round multilayer colony with clearly defined boundaries. Chromosomal status showed normal karyotype in 86% of cells at the 7th passage and in 67% of cells at 9th passage. The anupleuidy of the chromosomes was mostly observed as monosomy and metacentric.Conclusion: The overall findings from this study demonstrated that the ES undifferentiated colonies could be distinguish by morphological criteria, passage acceptability and division diplication rate. Furthermore, detection of ES cell colonieo during the expantion stage is the first signs of success in isolation of ES cell coloneies.

Objective: Henoch Schoenlein Purpura (HSP) is a vasculitis of small vessels (capillaries, arteries and veins) with unknown etiology. In this report, we studied this disease in 194 children with HSP who admitted in the Pediatric Medical Center between (March 1986- to Feb 2004).Methods: Patients with mild to moderate severity form of the disease, the majority of cases, who are normally managed on out-patient basis were excluded from this study. The patients characteristics, clinical state, para-clinical findings and the type of treatment intervention were recorded.Results: The results showed that the minimum age at onset of the disease was 2 years and maximum was 14 years with mean age of 7.6 with (SD ± 2.982). Male to female ratio of 1.81:1 (M:F 64 : 36%), with maximal seasonal occurrence, similar to European countries, was in Autumn and Spring. The mean duration between our visits and their last attack of disease was 48 months. History of infectious diseases, as possible predisposing factor, prior to HSP, mostly URI, was positive in 61.4 % of cases. While infections due to ß-hemolytic type A infections was 26 % which was lower than reported among European population. In addition, there was a history of prior drug consumption in 69.7 % of patients. The common signs and symptoms were: skin manifestation in 95%, artheralgia and arthritis in 91%, gastrointestinal involvement in 74.4 %, renal involvement in 47.7 %, of all patients. The latter findings were relatively higher to European estimates. Para-clinical data: Anemia was detected in 38% of cases, increase of ESR in 64.9%, positive CRP in 64% Culture of pharynx was positive for Streptococcus ßhemolytic Group A in 20 % of results: ASOT more than 625 in 14%, serum IgA was abnormal in 24.2% and elevated BUN in 9.7% and serum creatinine in 6% of patients. Complications occurred in 47.7% and renal problems in 30% of cases. Haematuria was found in 23.7%, proteinuria in 18% of cases. Gastrointestinal manifestation such as pain occult blood in stool was found in 74.7% and severe gastrointestinal and hemorrhage in one case. Approximately 38 % of 194 patients were managed conservatively, 22% were treated with NSAIDs, 53.6% with oral prednisolone, 12.3% cytotoxic drugs and in 5% of cases were managed with intermittent administration of pulses of methylprednisolone and cyclophosphamide.Conclusion: Since in this study we did not include mild and moderate forms of HSP, who are the majority of cases and are managed out-patiently, therefore, in order to gain more accurate picture of this disease in our community the results of this study suggest children attending both private and emergency departments to be included in future studies.

Objective: This study was performed to determine the frequency and degree of osteopenia and other radiographic abnormalities in children with acute lymphoblastic leukemia at presentation and after completion of chemotherapy.Methods: For this purpose, in this prospective investigation, patients, aged one to ten years, with acute lymphoblastic leukemia (ALL) were studied by radiographic evaluation of left hand, wrist and foreman at presentation of their disease and three to eight months after completion of induction chemotherapy. This study was conducted in Shiraz University hospitals and two radiologists reviewed the radiographs separately with single blind method.Results: Twenty seven patients (14 boys and 13 girls) were the subjects of this study. The mean age was 4.8±2.4 years. Osteopenia, with varying degrees of severity, was observed in 26-59 % of patients with ALL at presentation of their disease and in 35-80% of them after completion of chemotherapy. Dense methaphyseal band was observed in 7.4 to 11.1% of patients and radiolucent methaphyseal band was observed in 3.7% of patients at presentation.These findings increased to 25-55 % and 5-20% consecutively after completion of chemotherapy.Conclusion: These results demonstrate that children with ALL are at risk of developing osteopenia especially after chemotherapy. Therefore, it is reasonable to evaluate bone mineral density especially after the completion of chemotherapy to identify patients at risk for osteopenia and appropriate interventions be undertaken to prevent further decrease in their skeletal mass.

Objective: Uterine adnexal torsion is a significant cause of acute lower abdominal pain in women. If the torsion is complete and the diagnosis is delayed, it may lead to necrosis, peritonitis and death. Usually the medium-sized, non-adherent masses undergo torsion.Initially the venous and lymphatic circulations are involved and this can lead to oedema, ovarian enlargement and hemorrhage. The ovary can be saved if venous or arterial thrombosis has not occurred.Methods: In this study 50 cases of adnexectomy for ovarian adnexal torsion, incurred over 10 years, were studied form patients files in order to find out the pre-existing pathological causes which predisposed adnexal twist.Results: The results showed that the average age was 20 (ranged 16 to 25 years), with a history of sudden and sharp pain in 100% of cases, accompanied by nausea and vomiting in 72% of cases, followed by leukocytosis in 66 % and temperature of 38°C and above in 26 % of cases. Benign tumor size ranged from 4x6 cm to 25x30 cm. In 62 % of cases the right ovary was involved. The pathologic findings included: follicular and corpus lustrum cyst (34%), dermoid (26%), mucinous cystadenoma (4%), dysgerminoma (4%), adenofibroma (2 %) and in 30% of cases the pathology was not diagnostic due to severe necrosis.Conclusion: The findings from this study conclude that average-sized benign cysts are amenable to adnexal torsion.

Objective: Schizophrenia is an important and common psychiatric disorder with unknown etiology. This disorder involves the brain and one common theory- on its etiology is the development of structural brain changes. Brain imaging techniques are among diagnostic modalities, which have made direct observation of human brain anatomy. Most suitable is brain CT scanning. Previous studies reported diverse and sometimes controversial findings on the structure of brain in schizophrenic patients. Our main aim was to study the anatomical structural changes in schizophrenic patients.Methods: For this purpose, in this case-control study, 15 different anatomic parameters from the brain CT scans from 60 schizophrenic patients were compared to CT scans taken from 60 normal subjects. Quantitative and qualitative data were analyzed using Z-score and Chi square tests respectively. Furthermore, sensitivity, specificity, positive predictive values and data negative predictive values were calculated separately for each variable.Results: Our results revealed higher rate of frontal lobe atrophy (P<0.05), larger maximum diameter of lateral ventricle and left temporal horn (Z= 2.5 and 3.8 respectively), and higher rate of pineal calcification (P<0.05) in schizophrenic patients.Conclusion: The results point to the conclusion that a simple diagnostic method, such CT scan, might provide us with relatively reliable evidence for schizophrenia and act as a helpful diagnostic acceptable for psychiatrists.

Objective: The pathogenic basis of gastroesophageal reflex (GERD) is multifactor. The role of lower esophageal sphincter has been studied extensively. Since peristalsis governs esophageal acid clearance, recently researchers paid attention to the role of esophageal peristalsis in GERD. This study evaluates the relationship between esophagitis, esophageal acid exposure and manometric indicators of esophageal motility.Methods: A total of 55 patients were divided in three groups according to endoscopic, manometric and on a 24 hr pH values: group 1- patient with esophagi is (n=18), group 2- patients with GERD without esophagi is (Non-erosive reflex disease, NERD, n=17) and group 3- patients without GERD (control, n=20)..Results: Manometric data collected included measurement of the lower esophageal sphincter (LES) pressure, amplitude and duration of esophageal contractions and ineffective esophageal motility (defined as amplitude of contraction less than 30 mmHg at distal esophagus or non transmitting contractions after> 30% of wet swallowing) were compared in all these groups.The results showed that mean resting LES pressures were 24.49, 33.47 and 32.91 mmHg in groups 1, 2 and 3 respectively, showing no significant differences between the three groups (p>0.05). Furthermore, there were no significance differences in mean duration of contractions between the groups (p>0.05). However, the amplitude of contractions was lower in esophagi is group and NERD group relative to control group (p<0.001). In addition, non peristaltic contractions were more frequent in esophagitis and NERD groups than in the control group. Ineffective esophageal motility was seen in 72.2 % of patients in esophagitis group, 23 % of NERD group and 5 % of controls (P<0.001).Conclusion: These results show that the resting LES pressure has no significant role in GERD. Furthermore, esophageal hypomotility was more prevalent in GERD and may have an important role in pathogenesis and severity determinant of GERD.

Objective: Acute myocardial infarction (AMI) is one of the most common diagnoses in hospitalized patients in industrial countries. Today it is revealed that microorganisms may be mplicated in the pathogenesis of AMI. One of these organisms is Chlamydia pneumoniae.The aim of this study was to evaluate the relationship of this organism with development of MI.Methods: In this case-control study 116 individuals were recruited and divided into two groups: 40 patients with diagnosis of AMI (test group) and 76 individuals (control group) who had no pervious history of myocardial infarction and/or ischemic heart disease. Serum antichlamydial antibody was measured in both groups. Odd's ratio was used for statistical companion.Results: The results showed that 32.5 % of patients with acute myocardial infarction and 18.4 % of control group had positive anti-Chlamydia antibody, which was not significantly different (OR = 2.3).Conclusion: The findings from this study demonstrated that there was no significant relationship between Chlamydia pneumonia and AMI. These findings come in agreement with other similar findings conducted in Taiwan, Ostrich and Seri Lanka.

Objective: Nonhodgkin Lymphoma is the most common lymphoma in children and is due to malignant proliferation of lymphoid linage cells. This disease involves 60% of childhood lymphoma and is the third most common malignancy in children. Early diagnosis of this disease is detrimental in its treatment. The goal of this cross sectional study was to evaluate the presentation and the variants of this disease among children admitted to Shafa hospital Ahwaz Iran.Methods: The data were collected from medical documents of all children with lymphoma over five years from 1996 to 2001.Results: The results of this study showed that the commonest non-Hodgkin lymphoma was Burkit lymphoma followed by lymphoblastic lymphoma. Large cell lymphoma was the third most common type. The most common presentations were abdominal pain and adominal mass. While lymphadenopathy was the next common presentation and mediasternal involvement with dispnea was the third most common presentation. In this study, 74 % of patients were males and 60% of patients were at stage III of their disease at first presentation, suggesting delayed diagnosis.Conclusion: The findings of this study suggest the in order to come to correct and early diagnosis of non-Hodgkins lymphoma complete examination should be undertaken in children who present with abdominal pain with especial attention should be direct to enlarged lymphnodes and notified systemic signs, such as fever, weight loss and anorexia.Furthermore, for ruling out mediasternal involvement, chest radiography is very helpful in diagnosis in children with dyspnea.

Objective: Marked variation exists in the incidence of urolithiasis in children worldwide. Urolihiasis may be declared by the passage of stone, but is more commonly revealed during the investigation of a child for urinary tract infection (UTI). The aim of this study was to determine the rate of renal calculi in patients with symptomatic UTI. Methods: Over an eight months period, 196 children (aged two months to 15 years) admitted with symptomatic UTI; were evaluated for renal calculi by plain abdominal x-ray and ultrasonography.Results: The results showed that 15 (7.6 %) had urolithiasis which was more common in boys. Fever and dysuria were the commonest clinical features in 80% of cases. The implicated organisms isolated in both UTI and urolithiasis was as following: E.Coil (67 %), Klebseilla (26 %) and Proteus (7%). Obstructive hydronephrosis was detected in 40 % of cases leading to surgical intervention. The sites of stones were as follow: upper urinary (67 %), bladder (20 %), and urethra (13 %). Stone analysis was done in 12 cases revealing calcium oxalate in 8 (53 %), cysine in 2 (13 %), struvite and uric acid 1 (6.7 %) in each. In 80 % of patients, the stones were multiple and 66.6 % were bilateral. In 50 % of cases, the underlying disorders were identified. Two cases had distal renal tubular acidosis, Two brothers had cystinuria and one child had a staghorn struvite. On admission, 40 % of our cases had an obstruction and 27 % of them had ARF who on discharge had better renal function following treatment with antimicrobial drugs.Conclusion: These findings suggest that early diagnosis and management of renal stones in children with UTI is necessary to prevent the development of renal failure.

Objective: The global incidence of hemophilia is almost uniformly distributed and is estimated to be 1:10000. It is therefore logical that increase in birth rate has a direct influence on the incidence of hemophilia in a given community. At best conditions of control, with presume for legalization of abortion of all affected male fetuses, the female carriers will still transfer the genes in a given community and the problem persists. Therefore, the only other option that is left to control the incidence of this disabling and resources consuming disease is birth control.Methods: In this retrospective study which was designed to find out the degree of impact of implementation of birth control law as well as the effects of administration of factors VIII and XI, and Blood, Bank, Productions, Material as Cryoprecipitate FFB in the treatment of this disease, on the incidence of birth of hemophiliac children over 30 years among 100 affected families (86 hemophic A, 14 hemophic B Family) in Khozestan. All patients in these families (113 hemophilia A, 24 hemophilia B) (totally 137) were participated in this study. Others 534 none hemophilic children (alive, dead, or aborted) were used as hemophilia patients indicators.Results: The results showed a dramatic decrease in both the mortality and morbidity in years between 1972 to 2000, following the administration of factors VIII and XI and Blood, Bank, Productions, Material as Cryoprecipitate FFB for treatment of this disease. Correspondingly, due to low standards in implementation of family planning, birth rate in both hemophiliac and normal population increased during these years. With implementation of family planning in 1992, birth rates dropped resulting in decrease in incidence of hemophilia.Conclusion: These findings confirms that the first step in the control of incidence of hemophilia is better implementation of family planning programmers as set by WHO standard scale of one or two child/family with 3 to 4 years apart. Strict implementation, possible by better educational propaganda, can have important impact on our community and can facilitate using the limited health funds in other more important fields of health promotion.

Here we present a case of a patient with vaginal atresia who was operated on by posteriorsagital technique. The patient was a 13-year girl who previously visited her first physician with the main complains of primary amenorrhea, periodic lower abdominal pain and a lower abdominal mass. The mass had enlarged gradually and her period pain increased in severity.There was no history of gastrointestinal symptoms.She had urinary frequency but no evidence of burning or fever. She previously under went three unsuccessful operations. She was operated on by posterior sagital technique. This operation successfully removed all the fibrotic tissues and reconstructive surgery was undertaken. After 3 years, the patient has no specific complains and has normal defecation and monthly periods.