Medical Journal of The Islamic Republic of Iran
Year:2002 | Volume:15 | Issue:4|Papers Count:11

In order to determine the effect of Valsalva maneuver and head rotation on the internal jugular vein (IJV) diameter and cross-sectional area and overlap with the carotid artery (CA) and find the best technique for safe cannulation of the IJV and decrease the risk of CA puncture, the diameter of both the IJV and the CA and percentage of overlap between the two vessels and cross-sectional area of the IJV were measured by ultrasonography on the right side of the neck in the supine, head down position, at three different degrees of head rotation with and without the Valsalva maneuver in 30 subjects. The results were analyzed by two-way repeated- measures analysis of variance followed by least significant difference (LSD). Head rotation increased the overlap between the two vessels (p<0.001). Valsalva's maneuver also increased overlap between the twp vessels (p<0.02) and increased IJV diameter and cross-sectional area (p<0.001).Head rotation did not change IJV diameter and cross-sectionalarea significantly (p>0.05). Valsalva's maneuver and head rotation did not change CA diameter significantly (p>0.05). Wetherefore advocate the neutral head position with Valsalva's maneuver as a safe and reliable method for IJV cannulation.      

Radiation-related wounds challenge surgeons in all disciplines of surgery. Wound-healing complications are commonplace, and solutions for reconstruction are limited. Muscle and musculocutaneous flaps have improved this situation. But the question is, does previous radiation of the muscle to be transposed affect the outcome? 143 consecutive previously irradiated patients treated with muscle or musculocutaneous flaps composed the group under consideration: these 143 patients had 206 muscles transposed. The overall complication rate for muscle transposition to close a radiated wound was 20 percent. Of the 143 patients who received radiation, 62 patients had the muscle transposed for wound closure from the primary field of radiation. 81 patients were closed with non-irradiated muscle. When the transposed muscle had been radiated, the complication rate was 29.6 percent; in 14.3 percent, the entire muscle underwent necrosis, requiring total removal and a second tissue transposition from a non-irradiated source to achieve closure. The subgroup using non-irradiated muscle had a complication rate of 12.2percent; 1 patient in this group had complete flap necrosis requiring a second tissue transposition. No postoperative deaths were encountered. The experience in our department reveals that non-irradiated muscle is the best choice for closure of a radiated wound, if possible.      

Kawasaki disease is one of the major causes of acquired heart disease of children in developed countries. This study was performed to determine the frequency of cardiac sequelae of kawasaki disease and related risk factors based on a descriptive cross-sectional study between 1994-1999 in the pediatric ward of AI-Zahra Hospital of Isfahan. Out of 45 patients, 29 were male (64.4%) and 16were female (35:-6%) with a sex ratio of 1.8 (p<0.05). Five patients suffered from pericardial effusion (11.1%), 6 patients had mitral valve insufficiency (13.3%) and 10 patients (22.6%) had coronary artery aneurysms (CAA). Seven and 3 cases of these 10CAAcases were male and female, respectively, with a sex ratio of 2.3 (p<0.05). CAAs were less in patients who received intravenous immunoglobulin (IVIG) in the first 10 days than untreated cases or cases who were treated later (p<0.05). CAAs persisted only in 2 patients after the convalescent period of disease and a new case of CAA which did not exist in the acute phase was detected. In conclusion, CAA's in this study were higher than worldwide reports. Early diagnosis and treatment with IVIG are necessary for prevention of cardiac involvement in kawasaki disease.      

Many patients with thyrotoxicosis develop hypercalciuria and nypercalcemia. Urine calcium excretion depends on diet, latitude and sunshine exposure. With regard to variation of these indices in different geographical regions, we conducted a one-year study on 202 patients, 65 males and 137 females, with thyrotoxicosis of varying severity. The mean age of patients was 35.24± 1.95 and 35.87± 12.21 years for men and women respectively. Free T4 index, serum calcium and phosphorus, PTH and alkaline phosphatase were measured in all patients. The mean for FTI was 7.48±2:1.98. Serum Ca and P mean was 9.31±0.46 Mg/dL and 4.11±0.61mg/dL respectively. 3 patients (1.5%) had hypercalcemia and hyperphosphatemia was detected in 38(18.6%) patients. The mean of urine Ca and P were 190± 106.7mg/24h and 626±246.73mg/ 24 h respectively. Increased urine Ca and P was detected in 20(9.8%) and 4(4.4%) patients respectively. PTH was suppressed in 34(16%) and alkaline phosphatase was increased in 50(24.5%) patients. There was no significant relation between FTI with serum and urine Ca and P and serum PTH and alkaline phosphatase in thyrotoxic patients. There was also no appreciable difference in serum Ca and P and urine Ca between the two sexes with respect to the lower exposure of muslim women to sunlight. These results contrast with the high frequency of hypercalcemia (27%) and hypercalciuria in patients with thyrotoxicosis in previous studies and might be due to habitual low calcium diet and sunshine exposure in this area.      

When pooled immunoglobulin G (IgG) from patients with multiple sclerosis (MS) was used to probe a human fetal spinal cord λgt11 cDNA library, the IgG was found to bind to a predicted epitope of human mitochondrialND4 sequence. To investigate the involvement of the ND4 as an autoantigen in MS, we determined the presence of specific antibody in the serum of MS patients and serum samples of some other autoimmune disease as controls. A peptide, which is part of the ND4 protein in human mitochondrial complex I, CysLeuAlaAsnSerAsnTyrGluArgThrHisSerArg, was conjugated with a maleimido-thiol bond to diphtheria toxoid and used as an autoantigen. Toremove any IgG which bound to diphtheria toxoid and the bovine serum albumin (BSA) blocking agent in the ELISA, the sera were preadsorbed before being incubated with the conjugate. About 20% of patients with multiple sclerosis (MS) had antibody to the peptide and when present, the level was found to fluctuate. In preliminary experiments autoantibody to ND4 was found to be not specifically associated with MS. The prevalence and involvement of the autoantibody in multiple sclerosis remains to be determined.      

The effects of cAMP-analoguedibutyryl- AMP and anticalmodulin W-7 were studied on de novo synthesis and secretion of lipids in cultures of hepatoma Mc- Ardle RH7777 cells and normal rat hepatocytes. Dibutyryl-cAMP and W-7 separately caused a significant decrease in the secretion of de novo synthesizedtriacyl [3H] glycerolin both cultures of Mc Ardle cells and rat hepatocytes. The inhibitory effects of dibutyryl-cAMP and W-7 were concentration-dependent and appeared at the lowest concentration examined, 5µM and 20µM respectively. Dibutyrylc AMP at a concentration of 50 µM andW-7 (20 µM) suppressed the secretion of triacylglycerol by approx. 38% (p<0.05) and 37% (p<0.05) respectively. Dibutyryl.- cAMP but not W-7 also suppressed the secretion of phosphatidylcholine significantly. Dibutyryl-cAMP and W-7 had no significant effect upon [3H] glycerollabeled de novo formed triacylglycerol and phosphatidylcholine, except at the highest concentration tested, 500µM and 50µM respectively, where both triacylglycerol and phosphatidylcholine synthesis were suppressed significantly. Similar findings were obtained on cultured hepatocytes. The molar ratios of newly made triacylglycerol/phosphatidylcholine in the media and cells of hepatocytes were about four times compared to that of McArdle cells, indicating more lipidation and core expansion of nascent lipoprotein particles in hepatocytes. The molar ratio of triacylglycerol/phosphatidylcholinein the medium and cells of cultured McArdle cells was unchanged significantly in the presence of either dibutyryl-cAMP or W-7, However, the molar ratio was decreased 25% (p<0.01) in the presence of dibutyryl-cAMPin the media but not in the cells of cultured hepatocytes.These results suggestthat hepatoma McArdle cell's response to both cAMP-analogue and calmodulin antagonist are comparable to that of normal rat hepatocytes. In addition, the inhibitory effects of dibutyryl-cAMP andW-7 at low concentration are unlikely to be due to the suppression of triacylglycerol and phosphatidylcholine synthesis.        

Transforming growth factor betas are multifunctional polypeptides in the cytokine superfamily. They have a growth inhibitory role on hemopoietic progenitor cells in semisolid colony assay as well as in long-term bone-marrow culture. TGF-ß2 represses stromal cells, stem cell factor gene transcription, and decreases the stability of c-kit transcripts in hemopoietic cells. TGF- ß also modulates GM-CSF production from human lymphocytes. The present study reveals the TGF- ß2 role in production of GM-CSF in HTB 5637, human bladder carcinoma cell line. HTB 5637 cells were treated with 5 ng/mL of human TGF- ß2 viable cells were counted and GM-CSF concentrationwas determined. No antiproliferate activity of TGF- ß2 on HTB 5637 cell line was observed. Biological assay showed increased levels of GM-CSF in the supernatant of cultured cells. However this increase was lower than that expected from ELISA. Since TGF- ß may be an active suppressor factor regulating hemopoiesis, it seems that some inhibitory factor(s) may be produced (increased) in response to TGF- ß2 treatment.  It has been shown that GM-CSF mRNA content from HTB 5637 cell line is very stable and this stabilization is translational dependent. Using Slot blot and Northern blot analysis, we determined that TGF- ß2 upregulated GM-CSF gene expression in HTB 5637 cell line. The results suggest that TGF- ß2 upregulates the production of GM-CSF gene at the transcriptional level.      

Borrelia microtti and Borrelia persica are two Iranian strains of spirochetes whose vectors are Ornithodorous tholozani and Ornithodorous erraticus which are responsible for relapsing fever. BSK medium has been used for in vitro culture of other strains of borrelia, although the two mentioned strains could not be successfully cultured in it. We have modified BSK medium by using guinea pig and fetal calf serum instead of rabbit serum. It was observed that for in vitro culture of Borrelia persica, guinea pig serum and for Borrelia microtti, fetal calf serum show the best growth.      

The effects of formalin as a peripheral noxious stimulus on the activity of lateral paragigantocellularis nucleus (LPGi) neurons were examined. Spontaneous activity of LPGi neurons was recorded after confirmation of their responsiveness to acute pain, and thereafter formalin (50 µL, 2.5%) was injected in the contralateral hindpaw. The response of the LPGi neurons was monitored for 60 min. A biphasic response with a peak lasting 3 to 5 min post-injection, and a second more prolonged tonic excitatory response were obtained which corresponds to the nature and time course of behavioral studies. It is concluded that LPGi neurons may be involved in the processing of nociceptive information related to formalin as a noxious stimulus.      

Alpha-fetoprotein (AFP), a serum glycoprotein belonging to the onco-developmental proteins group, serves as a marker both in cancer research and in studies concerning fetal development and fetal pathophysiology. Monoclonal anti-AFP antibodies are essential reagents in developing appropriate techniques for measurement of this protein. In this study, in order to produce anti-AFP monoclonal antibody(mAb), AFP was partially purified from cord sera using two-step ion-exchange chromatography on DEAE-cellulose with a final recovery of about 570 µg. MAbs against this preparation was raised by hybridoma technology using Ag8.653 mouse myeloma cells as the fusion partner. Hybridomas appeared in 10% (30/300) of culture wells and of these 2 clones were found to be positive for anti-AFP production. In western blot analysis a 70 kD band from dead fetus serum-but not adult serum-was stained by both mAbs. A sandwich ELISA technique using polyclonal antisera on one side and mAbs on the other side was employed to plot dose response curves. The positive dose dependent reactivity of the mAbs with standard AFP and other AFP containing samples and the negative reaction with normal adult sera lacking AFP showed the specificity of the mAbs for AFP.    

In this study, we used Random Amplified Polymorphic DNA (RAPD) for identification of 17 isolates of Leishmania from the skin and reticuloendothelial system of humans, animal reservoirs (rodent and dog) and sand flies in various parts of Iran in the last decade. Fifteen species have been confirmed by isoenzyme characterization by the London School of Hygiene and Tropical Medicine and Shiraz University of Medical Sciences. In this study, strong confirmation has been observed between random amplified polymorphic DNA with isoenzyme characterization.