DANESHVAR MEDICINE
Year:2003 | Volume:10 | Issue:45|Papers Count:12

Tracheostomy offers advantages for long term respiratory support. This study was performed to assess the changes in pulmonary mechanics before and after tracheostomy in 20 patients with prolonged mechanical ventilation. We can not detect any significant differences in pulmonary mechanics after tracheostomy except the change in peak inspiratory pressure. Peak inspiratory pressure was significantly reduced (pre tracheostomy 31.59+5. 7 mmHg vs post tracheostomy 27.5+5.3mmHg). We concluded that tracheostomy very little changes pulmonary mechanics except in a fall in peak inspiratory pressure.    

Although prenatal mortality rates have improved for pregnant diabetic women because of insulin therapy and tight control, infants of diabetics still remain significantly higher rates of congenital malformations and spontaneous miscarriage compared with those of non-diabetic conditions. It seems that elevated blood glucose in uncontrolled diabetes is casually correlated with diabetic embryotoxicity. The incidence of these complication decreases somewhat with improved maternal glycemic control during the period of fetal organogenesis. This reduced incidence, however, still remains three to four times higher than control. Because of this persistent elevation, it is possible that the metabolic insult leading to these complications may be occurring earlier in development, before organogenesis, specifically during the pre -implantation period. This study was designed to obtain more information about the effects of high glucosis on pre –implantation embryos. In this research, the effects of high glucose on the in vitro development of the mouse pre-implantation embryos were studied by incubating the embryos recovered in 2-cell stage and cultured in HTF medium with different concentrations of glucose (2.87, 17, 30, 40, and 50) during two experiments. In first experiment, the embryos were cultured for 48 hours and in the end of culture, to study apoptosis and necrosis, the embryos were assessed by use of double staining (with Hochest33324 and propidium Iodide) and TUNEL techniques. In second experiment, the embryos were cultured for 96 hours. And the effects of high glucose on the rate of embryonic development were assessed by use of an inverted microscope and finally the total cell number, apoptotic index and necrotic index were assessed by double staining and TUNEL techniques. Results: In first experiment, there were no significant difference in apoptotic index and necrotic index among the groups cultured for 48 hours in 2.87, 17, 30 and 40mM glucose. In second experiment, there were significant differences in rates of morula, blastocysts, and hatching, total cell number and apoptotic index among different groups until 40mm glucose and this differences were dose dependent. All of embryos cultured in 50mM glucose in 8-cell stage. In this study, we demonstrated that high concentrations of glucose inhibit embryos development in vitro, and induce apoptosis (by 17, 30, 40 mM) or necrosis (by 50mM). These findings suggest that, maternal hyperglycmia may impaired preimplantation embryo development and induces apoptosis in blastomers and leads to decrease key progenitor cells in blastocysts, and by this way, in next embryonic stages causes embryonic malformations.    

The aim of among study was to demonstrate the variety of sleep disorders occurring among the students and to estimate the prevalence of main sleep disorders in this pilot study, of Iranian general population. We carried out a cross - section study. This study involved a random population of 300 subjects of students in various colleges of shahed university, who were interviewed during the April and May in 2002, in Tehran. It was included 152 Males (%50.7) and 148 females (%49.3) and mean age was 21. 7 years. We used a clinical questionnaire including sociodemographic data, habits, sleep disorders and information regarding the somatic and psychiatric pathology. A detailed analysis of the influence of sex; age, course of study, marriage, occupational status, habitation, day time activities (Exercise), social life satisfaction. Insomnia symptoms were reported less than one - fourth of students. The overall prevalence of positivity in a scroening test of psychiatric disorder was %24.1 and insomnia %23.5. Different type of insomnia including: difficulty intaining sleep (DIS) was (%48.9), difficulty maintaining sleep (DMS) was (%17), walking up earlier in the morning ht and early morning and waking up during the night by pathologic disorders (%7.7). Other results indicate prevalence %64.5 for excessive daytime and naps %44.6 for night time terror and nightmare %20 for sleep Apnea and %8.1 for snoring and obstructive Apnea and %29.3 for sleep paralysis. %55.9 Respondents have a main sleep duration between (6.5 to 8.5) hour and %28.4 of them having a total sleep time less than 7 hour and %8.8 having (T.S.T) more than 9 hour. Furthermore, various types of insomnia were associated with unmarried (p=0.009); occupying (p=0.05); living in student dormitory (p=0.001)and dissatisfaction from social life (p=0.001)and dissatisfied from course of study in college (p=0.02). The consumption of sleep - enhancing medication and medication to reduce anxiety and depreciation is important: in shape from %12.5 student who consumption medication and %75 of them using one of this Drugs: Anti - anxiety (%39.3), Anti - depressant (%28.6) and sedative and hypnotic drag (%7.1). A high prevalence of sleep disorders is estimated in young Adult students of shahed university in Tehran. Our data in general is similar to those found in other countries, and different found are discussed.  

Jaundice is one of the presenting signs of neonatal urinary tract infection (UTI). The physicians who are caring for jaundiced but otherwise healthy neonates always wonder whether they should perform urine culture in these babies or not? This study was performed to evaluate the indication of suprapubic urine culture in otherwise healthy jaundiced newborns admitted in Hazrat Zeinab & Shahid Mostafa Khomeini hospitals from March, 1997 through March, 2001. Urine culture was obtained from 1000 jaundiced but otherwise healthy neonates admitted in Hazrat Zeinab and Sahid Mostafa Khomeini Hospitals during a 4-years period. Urine culture, samples obtained by suprapbic aspiration. Among 1000 studied neonates, only six (0.6%) had positive urine culture, which is the same incidence as in the general population. Performing suprapubic urine culture is not necessary and should not be considered as routine procedure in evaluation of jaundiced but otherwise healthy newborn infants.    

The effects of inhaled toluene on rabbit's hearing system using ABR evoked by Tone-Burst and Click stimuli were studied. The wave forms of ABR were recorded either prior to or following exposure (2 weeks) to toluene vapors (1000 PPm). The absolute latency of the wave forms were measured. The results showed that the wave forms were altered by exposure of animals to toluene. The mean size of the absolute latency in post-exposed animals significantly was higher than that of pre-exposed ones. It is concluded that toluene vapors cause hearing loss in rabbit.      

Mercuric chloride (HgCl2) is a white, cristalin and poison powder which is absorbed from GI and skin, and excreted from kidney and urine. This material is used in compound of laxative drugs, beauty creams and contrast material. Chronic poisoning with mercuric chloride causes sensorial, mobile, behavioral and mental disorders. Therefore 36 rates of sprague dawley were injected by mercuric chloride (Experimental groups) and normal saline solution (control groups) in eighth, ninth and tenth days of gestation intraperitonealy. Embryos were removed from uterus in 15th day of gestation and then tissue passage procedures micron slides were prepared and stained by H &E method and were studied by light microscope. Microscopic studies in experimental groups cells disarrangement were seen different orientation of nuclei. Cell death and extracellular space were increased and concentration of cells was decreased. Mitosis division and diameter of cortex were increased. Therefore it results show that mercuric chloride has theratogenic effects on embryo cortex and causes cell death and nervous disorders.

The paper presents an overview of the concept and application of different compartmental models to describe the decay of an injected glucose tracer in the blood plasma of a group of female subjects. The data acquired as part of a study at St. Thomas' Hospital, London. The subjects are in their post-partum period and some of whom had suffered from gestational diabetes during their pregnancy. A known mass of glucose and glucose tracer were injected intravenously into each subject and blood samples were taken at various times. To obtain a stochastic model of the decay of plasma glucose tracer concentration, a two-compartmental, system war considered, blood plasma and intravascular tissues respectively, and two differential equations were used to build the model. In stochastic model building, Soong's approach was applied. In this approach it is assumed that the stochasticity incorporated into the four compartmental parameters (two fluxes between compartments, a loss from the second compartment and the initial concentration of glucose tracer in the first compartment). Therefore, the compartmental parameters describing the flow of glucose tracer vary randomly from the blood plasma into the muscle tissue. The four parameters of the model were estimated by using blood sample data for each subject. The variability in the set of glucose tracer curves was assumed to be due to the variability of the parameters and each parameter was assumed to have a multivariate lognormal frequency distribution. The mean and S. E. of the plasma glucose concentration Way calculated by using a 4 dimensional integration at times between 0 and 180 minutes to build the stochastic model. A comparison was made between the stochastic and deterministic models for the mean and S. E. of the concentration of glucose tracer. A small difference between the means and a large difference between the S. E. were found. Also the stochastic model for the mean fits the data better than the deterministic-model. Furthermore, the differences between the stochastic and deterministic models for S. E.s were large.  

In this study, an indirect ELISA method was developed by using the Horse Radish peroxidase enzyme (HRP) and GST-π which purified from human placenta first using the purified GST- π polycolonal antibody was produced and the stages of designing method were carried out by contribution of secondary antibody conjugated with peroxidase. This method was standardized by using the standard GST- π in buffer medium and in a serum sample which immunostripped from endogenous GST- π. using this method, some concentrations between 0.4 to 20 ng/ml from serum GST- π are measurable without cross reaction with other isoenzymes of GST (µ and α). The specificity of this method is to investigate, using of other isoenzyes such as GST- µ and GST- α which purified from rat liver, that their interference was maximum 5.8% in limited working concentration range. The accuracy of the system was studied by addition of three different concentration of exogenouse GST- π to immunostripped serum, the recovery rate in different concentrations was between 89-106%. Inter and intra assay variations showed a CV less than 12%. Then, using the developed ELISA and GST- π were measured in the serum of 42 healthy controls and quantities over 16 ng/ml were observed in 90% of patients who suffering from stomach cancer and 86% patients suffering from esophagous cancer.    

The birth weight is one of the indicators of mother's health during pregnancy and it is the preliminary guarantee for health and growth of neonatal period. In various studies the factors which have influence on birth weight are weight gain during pregnancy, body mass index (BMI) of prepregnancy, mother's age and neonatal sex. Attending to importance of birth weight, noticing to some controllable effective factors are valuable, like mother's weight gain during pregnancy. Because investigations about effective factors on birth weight in Iranian mothers were not available, this cohreet study has been done on 206 healthy pregnant which started prenatal care during first trimester. In accordance with statistical analysis and making use of multiple regression test, there was a significant relation between birth weight and prepregnancy BMI (Pv=0. 00) weight of the previous neonate (Pv=0.02) and mother's weight gain during pregnancy (Pv =0.03). Meanwhile the birth weight was reduced by passive cigarette smoking and female gender of neonate. It seems appropriate suggestions in preconceptional care and performance of suitable measurements in prenatal care that could guarantee suitable birth weight.      

Spasticity is one of the most common features of the motor deficits associated with the upper motor neuron syndrom. It is also one of the most common problems confronting rehabilitation professionals. Quantitative measures of spasticity are needed to describe, objectively and precisely, the severity of spasticity and the extent of associated 'motor deficits, but there is no standard, universal and objective method for quantifying spasticity. In this study, a method is developed for objective measurement of spasticity based on velocity reduction due to resistance to passive movement (RTPM). The aim of this research was to develop a biomechanical, noninvasive measure of spasticity which could be used in routine clinical practice. In this study, 32 normal subjects (31 men and 1 woman) and 10 hemiplegic subjects (7 men and 3 women) that had no e(how limitation or contracture. Hemiplegic subjects were examined by a physiotherapist using Modified Ashworth Scale. A device to measure RTPM due to spasticity at the elbow was developed. Using this custom-built measuring device, the elbow was extended passively from maximal possible flexion and angular velocity and its changes due to RTPM was measured. Pearson correlation for velocity as dependent variable was 0.949 (P=.00). test -retest reliability was 0.918 (P=,00). Correlations were significant at the 0.01 level Associated Reaction and Asymmetrical Tonic Neck Reflex interaction way statistically significant (f=33.797, df=2,1390, P=.00) and head in midline associated with less velocity reduction or less spasticity. A seven points scale bayed on velocity reduction presented. Percentage agreement between this scale and Modified Ashworth Scale scores provided by physiotherapist way 61%. The method was reliable and valid.  

Panoramic radiography is one of the important diagnostic methods in dental radiology. Since this method has been used commonly in recent years, the assessment of absorbed doses received by critical organs in this radiographic technique is necessary. In this research, the absorbed doses of the eyes, parotids and thyroid glands were measured for 40 adult patients undergoing panoramic examination using Planmeca Panoramic Systems. To assess the dose, LiF thermoluminescent dosimeters were calibrated and placed on the above organs and the mean absorbed doses of the eyes, parotids and thyroid gland at two radiology centers of Isfahan (center 1 and 2). The values estimated for the eyes, parotids and thyroid at center 1 and 2 were: 91.5±10.0, 84.3±7.3, 2723±54.3 and 2657±72.4, 1514±28.4, 1461 ±40.0 micro- Gray respectively. Statistical tests revealed no significant difference (P>0.05) between the absorbed doses of the right and left eyes, the right and left sides of parotid glands and the right, middle and left parts of thyroid. These findings were expected considering the way the panoramic systems operate. On the other hand, the results acquired from the both centers were compared with each other. Analysis of the data revealed significant differences (P<0.05) between the two centers for all the organs. The reason for the differences observed may be the more workload of the center 1 and the lack of periodical calibration of the panoramic systems studied. It was also noted that the absorbed doses of the eyes estimated in this study were significantly lower than the dose limit recommended by the ICRP for the eyes. It is worth mentioning that although the estimated absorbed doses received by the organs/tissues of interest were quite low for the panoramic radiography techniques investigated in this study, according to the ALARA (As Low As Resonable Achievable) principles and because this imaging technique may be used frequently and in short intervals of time, some precautions -such as periodical calibration of equipments- must be taken into consideration.