Iranian Journal of Medical Sciences
Year:2005 | Volume:30 | Issue:1|Papers Count:11

Background: Non-steroidal anti-inflammatory drug (NSAID) use and H pylori infection are two major causes of peptic ulcers. This study investigates the effect of H pylori infection and NSAIDs on gastroduodenal damages and bleeding (GIB). Methods: 104 patients with acute gastrointestinal bleeding (GIB) and 102 patients with dyspepsia without bleeding were studied. Duodenal (DU) and gastric ulcers (GU) were identified by endoscopy and H pylori infection by histologic examination of biopsy samples. Association of NSAID and H pylori with DU, GU and/or GIB was determined by calculation of odds ratio. Results: The percentages of NSAID-users in patients with and without GIB were 50% and 34% respectively. DU and GU were more frequent in patients with GIB than those without bleeding (P<0.001). In NSAID-users, the percentages of DU as well as GIB were significantly higher as compared with non-users (P<0.02). Concerning H pylori-infected as compared to non-infected patients, the prevalence of DU was significantly higher (P<0.000). The percentage of GU was significantly lower (P<0.02). DU was significantly higher in NSAID-users who were infected with H pylori than those of non-infected (P<0.001), but such a relationship was reversed with respect to GU (P<0.015). However, the rate of GIB in this group was not decreased significantly. Conclusion: H pylori infection increased the risk of DU in NSAID users, whereas, it decreased the risks of GU and GIB in NSAID and GU in non users.

Background: Graves’ disease is an autoimmune disease, characterized by the presence of antibodies directed to TSH receptor or nearby regions as well as antibodies to double strands DNA (dsDNA) anticardiolipin and nuclear antibodies. This study evaluated anticardiolipin and rheumatoid factor, such as IgA and IgM antibodies in patients with Graves’ disease. Patients and methods: Anticardiolipin and rheumatoid factor were measured in sera of 84 patients (29 male, 55 female) with evidence of Graves’ disease and 41 healthy individuals (15 male, 26 female) with negative history of hyperthyroidism and other autoimmune diseases. Results: Mean level of anti cardiolipin antibody (ACLA) in patients and control groups were 0.192±0.11 and 0.087±0.200 optical density (OD) respectively. The level of IgMRhematoid factor (IgM-RF) of patients and healthy control groups was the same, whereas the mean IgA-RF levels in patients was significantly lower than control group. Conclusion: Anticardiolipin level in different studies showed various results which may be due to genetic backgrounds. Lower level of IgA-RF may also be due to environmental factors, which stimulate specific lymphocytes that producing this type of antibodies.

Background: Lipopolysaccharides (LPSs) and several antigenic proteins of Brucella have been considered for preparation of diagnostic reagents and subunit vaccines. The objective of this study was to identify and compare immunogens of B. abortus S19 which induce humoral immune responses in human, goat and rabbit. Material and Methods: The bacterial whole cell extract was prepared in extraction buffer and resolved using twodimensional gel electrophoresis (2-DE). The resolved antigens were reacted against human, goat and rabbit sera using western blotting. Results: At least 19, 14 and 16 immunogenic proteins were recognized in western blotting with human, goat and rabbit sera, respectively. The most abundant proteins of the bacterium with immunogenic properties in goat and rabbit but not in human, were a group of 5-6 proteins with molecular masses of 32-34 KDa and isoelectric point (pI) ranging from 4.5 to 5.7. In contrast, a group of 5 proteins with molecular weight of 45 KDa and pI in the range of 4.5 to 5.4 as well as several low molecular weight proteins were immunogenic in human. Furthermore several proteins of Brucella had similar reactions against all sera. Conclusion: These results showed that some of the antigenic proteins of Brucella could be candidates for more accurate diagnosis of Brucellosis in humans and domestic animals.

Background: Neurotransmitter release is an essential link in cell communication of the nervous system. Many investigations have focused on gamma amino butyric acid (GABA)- ergic neurotransmission, because it has been implicated in the pathophysiology of several central nervous system disorders. To bypass complications related to homo- and heterosynaptic modulation and to avoid indirect interpretations of data, we herein describe a simple approach for direct measurement of GABA release. Material and Methods: Giant synaptosomes originated from nerve terminals of rat cerebellum mossy fibers were prepared for the study. Electron micrographs as well as lactate dehydrogenase assay are used for morphological and biochemical verifications. Giant synaptosomes were preloaded with labeled [3H]GABA. Spontaneous and stimulated release of [3H]GABA was measured using a superfusion apparatus. Stimulation was evoked by increasing exteracellular concentration of K+ ions. Results: Spontaneous [3H]GABA release had a constant and nearly linear kinetics. [3H]GABA outflow evoked by depolarizing solution containing 15 mM of K+ showed 2-3 fold increases over the basal release. The same effect was also reproducible after several minutes. Conclusion: The present findings indicate that this preparation could be used as a suitable and versatile in vitro model to study GABA release from axon terminals under basal and evoked conditions.

Background: Fasting during the holy month of Ramadan (fasting) for Muslims is a religious duty. The impact of fasting on some diseases has been reported in medical literature. This study evaluated the effects of fasting on appendicitis. In this population-based descriptive study, we investigated whether the incidence of acute appendicitis differs during fasting compared to other non fasting lunar months. Patients and Methods: A retrospective study was carried out on patients with pathologically documented diagnosis of acute appendicitis attending our surgery department during three consecutive Hijri years, from November 5, 2000 to December 4, 2002. The annual incidence of acute appendicitis was compared between three months, before, during and after Ramadan.Results: The total number of documented appendicitis were 414, 423 and 407 for three consecutive years of 2000 to 2002 (1421 to 1423, Islamic lunar years) respectively. The overall incidence of acute appendicitis in people aged from 15 to 70 years was 171.53/100,000 per year. Compared with the mean monthly occurrence of appendicitis, a statistically significant reduction in the incidence of appendicitis was found during Ramadan, whereas, the frequency of acute appendicitis increased significantly in the month following Ramadan (p<0.001). Conclusion: The incidences rate of acute appendicitis was significantly lower in the holy month of Ramadan, which was most likely due to the fasting. Bowel resting could reduce the risk of appendicitis but more investigation is recommended.

Background: Most research on autonomic dysfunction of diabetes mellitus is conducted on ganglions innervating gastrointestinal (GI) tract and there are limited works focusing on cervical sympathetic ganglia. The effects of diabetes mellitus (DM) on the neurons of superior cervical sympathetic ganglion (SCSG) are investigated by stereological methods. Material and Methods: Female rats (n=72) randomly divided into DM (blood glucose =400-600 mg/dl) and control (n=36) groups. Rats were sacrificed at 4-, 8- and 12-weeks of induction of DM (65 mg/kg streptozotocin, ip). The same procedure followed chronologically in control group. SCSG of both groups were removed, fixed, and embedded in cylindrical blocks. Isotropic uniform random sections obtained and stained. The mean particle volume (according to the method of volumeweighted mean particle estimation) of the perikarya and nuclei of ganglion cells (neurons) were estimated using the pointsample intercepts method.Results: There was no significant difference between the mean perikaryal and nuclear volumes of DM and control rats after 4-, 8- and 12-weeks. There was, however, a significant increase in the mean volume of perikarya and nuclei of the neuronal cells of DM rats at 8- and 12-weeks diabetes as compared with those of 4-weeks.Conclusion: The mean volume of SCSG and their nuclei were not significantly reduced after 4-, 8-and 12-weeks in DM rats and these cells continued their normal growth.

Background: In spite of available, and sensitive screening assay for detection of hepatitis B virus surface antigen (HBsAg), occasional cases of post-transfusion hepatitis B virus infection are still observed. The aim of the present study was to assess the prevalence of positive anti hepatitis B core (anti-HBc) and presence of HBV-DNA in serum sample of healthy blood donors negative for both HBsAg and anti-HCV antibody. We evaluated whether anti-HBc could be adopted as a screening assay for blood donation. Material and Methods: Two thousands sera negative for both HBsAg and anti-HCV collected from healthy blood donors tested for presence of anti-HBc antibody. All sera positive for anti-HBc antibody were then investigated for determination of anti-HBc and anti-HBs titers, HbeAg and anti-HBe antibody by enzyme immunoassay (EIA). Every sample that tested negative for HBsAg but positive for anti-HBc alone or in combination with other serological markers was also examined for the presence of HBV-DNA by polymerase chain reaction (PCR). Results: Out of 2000 HBsAg negative blood samples, 131 samples (6.55%) were positive for anti-HBc. HBV-DNA was detected in 16 of 131(12.2%) anti-HBc positive specimens. The liver function test results were all in normal range except in 4 (25%) of 16 HBV-DNA positive subjects. Conclusion: Anti-HBc antibody should be tested routinely on blood donor volunteers, and if the sera become positive regardless of anti-HBs titer, the blood should be discarded. Further testing for HBV-DNA is appropriate to follow up the blood donor patient for HBV infection.

The objective of this study was to validate the use of bone mineral measurements of the calcaneus bone by dual X-ray and laser (DXL) in a cross-sectional study carried out in an osteoporosis clinic. Measurements of bone mineral density (BMD) at proximal femur and spine were obtained by dualenergy photon X-ray absorptiometry (DEXA). Osteoporosis was defined by a DEXA T-score <-2.5 at the femoral neck or lumbar spine. Sensitivity, specificity and kappa statistics for DXL were calculated, assuming the DEXA measurement as the gold-standard. The study included 475 women with a mean age of 54±11.9 years. 15% had osteoporosis while 39% were osteopenic (-2.5<T-score between<-1) at the femoral neck or spine. A significant correlation (p<0.001) was found between BMD values as measured by DXL at femoral neck and DEXA at the lumbar spine. Assuming the same T-score cut-off value for the diagnosis osteoporosis and a modified cut-off value for the diagnosis of osteopenia (-2.5<T-score<- 1.5), yields a sensitivity of 83% and a specificity of 74% to 86% for the DXL device. In conclusion, BMD measured at the calcaneal bone by DXL, has a good correlation with that measured by axial DEXA.

A 3-year-old girl was presented with periorbital edema, hypertension, proteinuria, and hematuria. She recovered clinically after 9 days with normal urinalysis. During the follow-up, she developed recurrent episodes of nephrotic syndrome. The kidney biopsy revealed mild mesangial proliferation and a low dose of prednisolone could effectively control the disease.

Herein, we report a patient with arterio-venous fistula secondary to mycotic aneurysm, causing high output heart failure. The patient had one-year history of refractory heart failure and recurrent pulmonary edema. This presentation is a good example of curative surgically treatable cause of high-output congestive heart failure.

Inflammatory endobronchial polyp is a rare disease mostly encountered in asthmatic patients. Chronic airway and foreign material irritation or thermal injury may result in the formation of granulated tissues and become polypoid mass. Herein, we describe a 52-year-old man with severe respiratory distress and infection with 35 years history of smoking. He had an obstructive pattern in his pulmonary function tests and severe bronchiectasis of right lower lobe that responded well to lobectomy with polypectomy. Pathologic examination revealed large endobronchial polyp 9x2 cm obstructing right and left bronchi and right lower lobe bronchiectasis. Such large inflammatory endobronchial polyp has rarely been presented in literature.