Researcher Bulletin of Medical Sciences
Year:2008 | Volume:13 | Issue:1 (61)|Papers Count:16

Background: Breast cancer is the most common malignancy among women worldwide. Recently, there is a growing number of prognostic factors in breast cancer. A conceptual framework is now emerging that outlines how certain principles of EGFR may be employed in the future management of patients with breast cancer. In this study, we want to show the status of EGFR and malignancy grading and involvement of axillary lymph nodes in primary breast cancer.Materials and Methods: In a cross-sectional double-blind study conducted between 2000 and 2003, fifty seven paraffm-embeded blocks from patients with breast cancer were obtained from the pathology department of "Shaheed Mostafa Khomeini" hospital, and 3 micron sections were provided from each one. One of the tumor sections along with a lymph node section were stained by H&E. We determined the size and type of the tumors, numbers of involved axillary lymph nodes and grading according to Nottingham modification of Bloom-Richardson criteria. We studied EGFR on the other sections by me. Simultaneously, we studied 10 more paraffin-embeded blocks without breast cancer.Results: There were 89.5% positive versus 10.5%negative cases for EGFR. Majority of patients were in Grade III (43.9%) and a minority were in Grade I (22.8%). 66.7% had axillary lymph nodes involvement. In this study, we did not find significant correlation between EGFR and the involvment of axillary lymph nodes. Conclusion: High expression of EGFR in patients with breast cancer is important to note as a prognostic factor, but further investigations on further specimens and long time follow-up are required to clarify the exact role of EGFR in prognosis of breast cancer.

Background: Considering progressively increasing number of myocardial perfusion scan using 99mTc-MIDI and the importance of probable cytogenetic effects yielded from administration of high dose 99mTcin this scan, this study was carried out on patients referred to nuclear medicine department of Taleghani hospital to investigate the effects of total dose of 40 mCi 99mTcon chromosomal damage induction.Materials and Methods: This clinical trial study was performed on 25 consecutive patients who were referred for myocardial perfusion scan, and signed written agreement to be involved in study. Patients' Blood samples were assessed for chromosomal damage before and 48 hours after administration of 40 mCi 99mTc-MIBI, using micronucleus assay. The number of binucleated lymphocyte containing micronucleus and apoptotic cells were counted and compared by paired t-test.Results: Among 25 patients (52% male) with mean age of 54.6±8years old, the means of binucleated cells with micronucleus and apoptotic cells per 100 lymphocytes altered from 10.9±3.8 to 11.3±4.2 and 16.4±7.8 to 16.6±7 in secondary blood samples, respectively. Conclusion: It seems that myocardial perfusion scan does not induce chromosomal damage in Iranian race.

Background: Diarrhea continues to be the second cause of morbidity and mortality among children less than 5 years. Knowing the etiology of diarrhea is an important factor for epidemiological surveillance and (in somecertain cases) for being led to an appropriate treatment.Materials and Methods: Between May 2003 and September 2005, Diarrheagenic E.coli, Shigella spp., Salmonella spp., Campylobacter spp. and Yersinia spp., were investigated in 1087 children less than 5 years of age with acute diarrhea isolated from 4 hospitals and 13 clinical centers in Tehran.Results: Shigella spp. was the most prevalent one and was found in 148 (13.6%) samples. STEC was isolated in 105 feces sample. EAEC, EPEC, Campylobacter, Salmonella and ETEC were detected in 92, 70, 60, 42, and 38 cases, respectively. In this study Yersinia was not found in any of cases. The majority of children (n=464) in the present study was less than 1 year of age. Conclusion: Further information about the prevalence of Shigella and STEC-related diarrhea would facilitate the control and management of diarrhea diseases among infants and children in Iran. Applying certain vaccines to control diarrheagenic E.coli, especially STEC infections, is now recommended in developing countries and its usefulness in Iran merits consideration.

Background: Effect of different storage and distribution conditions on the quality of diet drinks was studied. Ongoing demand for low calorie soft drinks requires special attention to this matter.Materials and Methods: To realize this research, 42 numbers of soft drinks produced using Aspartame as sweetener were prepared and stored at different storage conditions for 6 months. The samples were stored at cold temperature (4°C), room (20°C) and incubator (45°C). Chemical Compositions including Aspartame, DKP and Formaldehyde were measured every month.Results: Obtained results showed the after-production amount of Aspartame in diet soft drinks decreased from 513±6.2to 412±7.4, 296±8.4, and 0 after 6 months stored in frig (4°C), room (20°C) and incubator (45°C), respectively. The amount of DKP formed in diet soft drinks after 6 months stored in frig (4°C), room (20T) and incubator (45°C) was 20.2±3.2, 102±5.8, 167±4, respectively. The amount of formaldehyde formed in diet soft drinks increased from 0 to 0.75±0.40, .83±0.03 and 0.92±0.06 in above mentioned storage conditions, respectively. Conclusion: Diet soft drinks stored at cold room maintained their quality up to 4 months without any significant changes. However, those stored at higher temperature and/or longer times had lost their quality versus temperature and time.

Background: Myocardial infarction (MI) is one of the most common causes of morbidity and mortality with an increasing prevalence. There has been no documented report on the long-term outcomes of patients with MI in Iran.Materials and Methods: Patients who were discharged from Loghman hospital in a one-year period (November 2003-2004) were enrolled in this cohort study. They were called for a follow-up visit one year after discharge and outcome measures including: rehospitalization, current medications, coronary anatomy appearance in angiography, percutaneous coronary interventions, coronary artery bypass graft surgery, cerebrovascular accidents and mortality were assessed.Results: 132 studied patients (76.5% male) with a mean age of 59.2±13.1 years enrolled in this study. Type of MI was non ST-elevated MI (NSTEMI) in 20.5% and ST-elevated MI (STEMI) in 79.5%. Only 58.1% of patients with STEMI received thrombolytic therapy. Reasons for withholding thrombolytic therapy were: patient delay in 26 (24.8%), contraindications in 10 (9.5%) physician error in 8 (7.6%). Coronary angiography was performed in 56 (90.3%) of candidates. Revascularization (PCI or CABO) was recommended to 39.4% of patients. Rehospitalization was needed in 14.3% of patients during the one-year follow-up. Eight patients (6.1%) had died, all of whom were male and aged over 60. Compliance with the administered drug regimen was 98.5% for Aspirin, 74.2% for  b-blockers, 71.2% for ACEI and 67.4% for Statins.Conclusion: Patients with MI can be followed with a satisfactory compliance in long-term. Our mortality rate was relatively low, but further studies are warranted to address the reasons for it and its risk factors.

Background: Spinal cord tumors comprise between 10 and 15% of all central nervous system tumors. In review of the recent literature there are several case reports but few case series. In this retrospective study, we evaluated the records of patients in whom resection of these lesions had been performed.Materials and Methods: Surgical results of 104 patients among 204 serial cases with spinal cord tumors operated from1970 to 2006 are presented. Age, sex, duration and type of symptoms, topographical locations, radiological and surgical results, histological features and outcome are analyzed and compared with other series.Results: This study is based on the clinical data of 104 surgically treated cases among 204 serial patients visited in the senior author's clinic. 50.0 % of the patients were male. The average age of our patients was 37.1 y (range: 4-75 y). The most common tumor locations were the thoracic region (30.8%), followed by cervical (27.9%). In 74.1% of our patients the tumor was extramedullary, while in 25.9% it was intramedullary. Among extramedullary cases, the most common histological type was nerve sheath tumors (58.4%) followed by meningioma (18.2%).In patients with intramedullary tumors the most common histological type was Astrocytoma (55.6%) followed by Ependymoma (25.9%). Gross and near total removal of the lesion was possible in 78.9% of cases. Patients were followed between 1to 209 months (mean=29 months). In 84.6 % of patients the outcome was improved. Complications of surgery occurred in 5.8 % and the mortality was 0.9%. Conclusion: With the use of modem microneurosurgical techniques the surgical results in our patients were comparable with the reported results in developed countries. Determinant predictors of a good outcome after surgery for spinal cord tumors were histological type of lesion, extension of tumor and a satisfactory pre-operation neurological status.

Background: Chronic intractable childhood constipation is a debilitating disease that need multidisciplinary approach care of these patients, typically consists of diet modification, cathartic agents, enema, biofeedback training, psychotherapy and the last surgical intervention. Rectal myectomy is one of them.Materials and Methods: In our hospital, we have investigated more than 540 children (aged between 2 and 12 years, M/F=298/242) with chronic constipation that have not responded to current treatment by pediatricians and pediatric gastroenterologists. We excluded all children with known neurological, hormonal, drug, diet and anatomical causes of constipation. All cases had barium enema study and half of them underwent anorectal manometry. The number of bowel movements was one every 3 to 15 day. 65 patients with typical findings of Hirschsprung's that were proved by rectal biopsy were excluded. Posterior rectal myectomy (3 cm. length x 1 cm. width) was done in 475 of causes and the specimens sent for histological study. NID and Hirschsprung's were reported in 75 of them that deleted from our study and finally, 400 (M/F, 212/188) children were followed.Results: Constipation resolved in 65% (260) patients in whom there were intermittent or no application of cathartic agents and their bowel movements increase eight or more over a 15 day period. 35% of children did not experience any significant changes in their defecation pattern, in which other methods of management were applied (e.g. Daily enema, biofeedback, colon resection, Melon procedure).Conclusion: Children with chronic idiopathic refractory constipation may be subsided to rectal myectomy in approximately 65% of them. There were no significant complications through in this procedure.

Background: Arterial hypertension is one of the most prevalent diseases, as well as an important risk factor for coronary artery and cardiovascular-induced morbidity and mortality, and end organ damages (such as cerebrovascular disease, renal failure, and congestive heart failure). On the other hand elevated blood pressure and its effect on intensity and velocity of blood flow can increase oxidation and peroxidation reactions. The aim of this study was to evaluate the serum level of Ox-LDL and the activity of superoxide dismutase (SOD) among hypertensive patients.Materials and Methods: 70 hypertensive patients with no history of CHF, cardiomyopathy, liver disease, diabetes mellitus, renal and thyroid disease, to gather with 70 matched control ones (in terms of gender and age) enrolled in this study. The amount of Ox-LDL and activity of SOD in serum were measured with ELISA and enzymatic colorimetric methods respectively.Results: Data obtained from patients (mean age 52.2±14) and controls (mean age 45±13) showed that the level of SOD activity in patients group was 100±27U/ml, whereas it was 105±11 U/ml in control group. In addition, the level of Ox-LDL in patients and controls group was 14±4 mul L, and 7.7±3 mu/L, respectively. Conclusion: We concluded that the elevation of Ox-LDL versus the reduction of SOD activity in hypertensive group might be the result of oxidation processes.

Background: urinary tract infection (UTI) is one of the most important diseases in children, as respect to its complications; every patient with UTI should be followed. Diagnosis and management of complications can decrease its morbidity and mortality. This study was carried out in Mofid children hospital to determine the important factors in emergence of cortical defect after UTI.Materials and Methods: all patients who were diagnosed as cases of pyelonephritis were enrolled in this cross-sectional study. Pyelonephritis was diagnosed on the basis of clinical and para-clinical criteria. In addition, cortical defect was diagnosed by DMSA scan. Incidence of kidney defect in each kidney, vesicouretral reflux, age, white blood cell count, ESR, positive history of UTI, and leukocyturia were ascertained and analyzed.Results: 163 patients with UTI had the including criteria of this study. We found cortical defect in 41 kidneys (12/6%). Presence of vesicouretral reflux, increased ESR, positive history of UTI, increase in white blood cell count and age older than 2, were the risk factors for cortical defect after UTI.Conclusion: We found that the emergence of cortical defect after UTI had correlation with above mentioned variables. However, DMSA scan is recommended to follow up pyelonephritis, especially in cases having these risk factors.

Background: A healthy normal skin is essential for a person's physical and mental well being. Disability originated from skin diseases is important in daily life. The present study is assessed health related quality of life in dermatologic patient on autumn 2006.Materials and Methods: This study was performed on 532 outpatient dermatologic clients by Persian version of SF-36 questionnaire. Data were analyzed by SPSS-13 software. The statistical significance of the observed differences was tested with parametric (t-test, ANOVA and Pearson's correlation) and non-parametric tests (Mann-Whitney, Kruskall-Wallis and Spearman's correlation).Results: Mean age of participants was 33.8±15 and gender of them was 32.5% male and 67.5% female. The mean scores on all SF-36 subscales reported by the participants on this study were considerably lower than the Iranian national norms. Moreover, scores of married participants was lower than singles.Conclusion: Data of the present study reveal one major issue. There is no correlation between the scores in subscales of SF- 36 questionnaire & severity, width and history of hospital admission from dermatologic disease but there is significant correlation with location of lesion.

Background: Ideally, the period of patients admission in Emergency Department (ED) should not exceed 6 hours. Prolonged in-hospital course has deleterious effects on ED overcrowding, quality of patient care and patient satisfaction. To evaluate the causes of this problem the current study was conducted in a typical overcrowded ED of a general teaching hospital in Tehran City.Materials and Methods: In this cross-sectional prospective study, charts from patients held longer than 24 hours, in Imam Hossein Hospital affiliated to Shaheed Beheshti Medical University, were reviewed from October 23rd through November 23rd, 2005.Results: Of 3630 patients, 222 had been held in the ED for more than 24 hours. Reasons for this long-term stay were lack of available bed (68 patients), delayed admission because of involvement of more than one specialty (21 patients), uncertain diagnosis (33 patients) and completion of their treatment course in the ED (52 patients). In addition, Thirty-one left the ED against the medical advice and seventeen were refused to be admitted because they were moribund and medically hopeless.Conclusion: Long-term stay of patients in ED of teaching hospitals is a major problem. The most frequent causes are limitation of inpatient beds, lack of a clear guideline to admit multispecialty and moribund patient and those with uncertain diagnosis. The following solutions are proposed (1) Creation of a holding unit (2) Delivery of more authority to Emergency Physicians (3) Pre-established rules for admitting controversial patients (4) Active inter-facility transfer.

Background: Preterm delivery is complicated with considerable high morbidity & mortality of newborns. Incompetent cervix is one of the important causes of preterm labor wherein such cases cerclage (Mc. Donald & Shirodkar) has been used for prophylaxy. Cerclage decreases the incidence of preterm labor with unknown Mechanism. In some recent studies it was suggested that increasing in cervical length after cerclage is the main cause for decreasing preterm labor.This study was carried out to see if cerclage has any therpeutic effect on cervical length. Materials and Methods: This clinical trial was performed on 18 pregnant women needing cerclage for the histoy of previous second trimester pregnancy loss or patients whose cervical length in transvaginal sonography was < 30mm. Cervical length was measured twice by transvaginal sonography; 48 hours before and 72 hour after cerclage. Afterwards, these two measurements were compared. Paired t-test was applied for statistical evaluation.Results: Mean cervical length before and after the cerclage was 25.8±2.8 mm and 26.7±2.4 mm, respectively. There was no statistically significant difference between before and aftercerclage cervical length.Conclusion: It was concluded that increase in cervical length after cerclage is not statistically significant (P > 0.05). The mechanism of cerclage in preterm labor in case of incompetency of cervix was not increasing the cervical length.