Tehran University Medical Journal
Year:2004 | Volume:62 | Issue:1|Papers Count:17

Background: Hematopoietic stem cell (HSC) transplantation has brought the possibility of the use of high dose chemotherapy in the treatment of malignant hematopoietic diseases. Short-term HSC preservation at 4˚C is the most common method for autologous peripheral blood stem cell transplantation (PBSCT). Materials and Methods: Thirty-seven mobilized PBSC samples from thirteen hematological patients (4 AML, 4 MM and 5 Lymphoma cases) who were selected for autologous PBSCT and 24 normal candidates for allogenic PBSCT were preserved in five separate sterile 2 ml tubes in 4˚C. Each sample was evaluated for total nucleated cell (TNC) count, dye exclusion cell viability and Granulocyte-Macrophage colony forming unit (GM-CFU; in semisolid medium after 16 days) in days 0, 2, 4, 6 and 8. The results were converted to percentages of day 0 measures. The data were analyzed by SPSS 10.0 using Paired Samples T test, Independent Samples T test and Regression.Results: The mean percentages (and standard deviations) of TNC count, cell viability and GM-CFU for days 0, 2, 4, 6 and 8 are shown below: No significant correlation was found between age, sex, weight and the kind of donor with TNC, viability and GM-CFU.Conclusion: In this study, we have found that during storage of mobilized PBSC in 4˚C, TNC count and cell viability still remains higher than 70% after eight days, while GM-CFU decreases more rapidly and falls to less than 50% after day 4.Therefore, TNC count and cell viability do not decrease as fast as GM-CFU.

Background: The damaging effect of exposure to loud noise on the structures of internal ear has been studied from many years ago. The effect of drill-generated noise on the non-operated ear is one of the problems that are less discussed. This study aims to evaluate the hearing loss that occurs in the non-operated ear in patients who undergo mastoidectomy by use of PTA (pure tone audiometery) and DPOAE (distortion product otoacoustic emission).Materials and Methods: In this descriptive- analytic study, 49 patients who underwent mastoidectomy in Amir-Alam and Iman Khomeini hospitals, were evaluated for noise trauma generated by drilling on the non-operated ear. Patients were between 9-55 years old (mean age= 29) and they consisted of 25 males and 24 females. The patient's preoperative state were measured by PTA and DPOAE on the opposite ear also the postoperative state were re-evaluated by PTA and DPOAE.Results: As a result, in 4 cases a significant change in PTA thresholds were observed, while two of them showed recovery after one month. Seven cases showed significant change in DPOAE amplitudes, of whom five cases recovered later.Conclusion: In conclusion, the drill-induced hearing loss on the non-operated ear occurs in a few patients and it is often reversible.

Background: There has been a little attention to pediatrics esophagus problems until recent years. The term esoghagitis can be used to described chemical, infectious, inflammatory, ischemic, immunologic and degenerative abnormalities. Prevalence of reflux esophagitis varies between 2 to 5 percent of general population but little data about its incidence in pediatric age groups. The aim of this study was to evaluate the epidemiology and prevalence of esophagitis and study of symptom, diagnostic measures, therapeutic intervention and prevention of its complication. Materials and Methods: In this prospective and cross sectional study 500 patient under16 years with upper digestive complaints or alteration of their state of health under went upper endoscopy, with special attention paid to esophagus.Results: Among 500 children (205 male, 207 female), pathology reported esophagi is in 325 cases. Majority of the patient were 8 to12 years. Most common complaints was abdominal pain (45/7%) and the second complaints was vomiting (13%), but most common complaints in severe esophagitis was melena (66%) and hematemes(18/8%). Most of patient (63% ) had a mild grade of esophagitis. When difference between endoscopy and pathology compared: Mild esophagitis in endoscopy (67%) ,but in pathology was (63%), moderate esophagitis (14/7%) in endoscopy was (17%) in pathology and severe form 2/8% in endoscopy but (4/9%)in pathology.Conclusion: According to results of our study in children age group with chronic abdominal pain ,vomiting ,excessive regurgitation, failure to thrive, we noticed that esophagitis is common etiologic factor. Histological esophagitis frequently occur in the absence of gross endoscopic findings and we need biopsy and histological examination to confirm diagnosis.

Background: The results of studies about relationship between depression and positive signs in schizophrenia are controversial and clarifying the nature of this association may be difficult. The aim of present study is to investigate relationship between depressive symptoms and positive signs, in acute phase of patients with chronic schizophrenia, who have been admitted in Roozbeh Hospital. Materials and Methods: Assessments were performed using the Beck depression Inventory for depression (subjectively) and positive and negative syndrome scale (PANSS) for psychotic symptoms. Results: The results demonstrated a significant correlation between depressive symptoms and positive signs in these patients. Also, a significant correlation existed between depression and these items: delusions, hallucinatory behavior, excitement, hostility. Conclusion: depressive symptoms and positive signs in schizophrenia may have a common underlying pathophysiological origin.

Background: The purpose of this study was to evaluate the effect of treatment with radioactive iodine on the function of gonads in males and females with follicular and papillary thyroid carcinoma. Materials and Methods: Consenting patients in the reproductive age were grouped according to the cumulative dose of received radioiodine and followed for at least 12 months. For all men, serum levels of FSH, LH, and testosterone were measured; some (53 cases) were also studied by semen analysis. For women, tests for serum levels of LH, FSH, estrogen, and progesterone were performed. Results: Overall, 246 patients (159 females, 87 males) were studied. In 87.4% of men, there was an increase in serum FSH level after radioiodine therapy, in 20.7% of whom the level remained high during follow-up period. The average serum level of FSH after each course of treatment was significantly higher than the level before treatment (p<0.01), and there was a meaningful correlation with the cumulative dose of received iodine (p<0.001). Reduced number of sperms was shown in 35.8% of male patients, among whom 73.7% also showed reduced motility. In 36.8% of the patients with reduced sperm number (13.2% of the total), this finding was persistent during the follow-up period. Increased level of FSH was correlated with reduced sperm counts in all doses (p<0.005).There was no significant correlation between serum levels of LH and testosterone with iodine treatment in males (p=0.47).In women , no significant correlation between gonadal-hypophyseal hormones and treatment with radioactive iodine was found, and there were no signs and symptoms of sexual dysfunction. Infertility was not noticed in any patient and no case of abortion was found.Conclusion: It seems that cells in spermatogonia lineage (in contrast to Leydig cells) are radiosensitive, with the sensitivity related to the cumulative dose of received radioactive iodine. But in the oogonia cell line, the radiosensitivity is insignificant.

Background: Migraine is a chronic hereditary and relapsing headache. With regard to the prevalence of this ancient disease and its economic complications in country, in this study , nocturnal serum melatonin of migraine patients and control subjects have been evaluated and compared by ELISA kit.Materials and Methods: Fifty migraine patients (mostly women) were compared to a control group (mostly men) matched according to age. Results: Statistical analysis revealed a decrease in nocturnal serum melatonin levels for migraine patients (32.9±28.4) compared to the control one (75.6±56.8). With using of t-test by ELISA kit showed significant difference (p=0.0064). Conclusion: With regard to this, the pineal gland has the main role in the synchronization of the organism with the environmental conditions and migrainous headaches.

Background: Tympanic membrane perforation as a sign of different otologic disorders have multiple causes, for example trauma .Traumatic perforations heal spontaneously in most cases but in large and stable perforation otolarngologist intervention is necessary . In the stable perforation of tympanic membrane , if there isn’t infection in the tympanic cavity , the paper patch or myringoplasty may be used. These procedures need remedy charge and time and may be with morbidity and other complications. Recently materials like hyaluronic acid and epidermal growth factors has been used to speed healing of tympanic membrane perforation, and their effect has been proved. Pentoxifylline an anti-thrombotic drug has positive effect on increasing perfusion and wound healing in pathological conditions. Alike we have used pentoxifylline to show it’s effect on the healing of guinea pig perforated tympanic membrane.Materials and Methods: This study has been done prospectively, on 32 guinea pig ears. Results & Conclusion: Final otomicroscopic study after three weeks showing no significant difference in the healing rate of tympanic membrane in pentoxifylline group versus control group.

Background: All the patients with Angina pectoris have not stenotic coronary artery. Syndrome x consists of patients with Angina pectoris and positive Exercise test along with normal coronary angiography. Syndrome x includes 25-30 percent of those who undergo diagnostic coronary arteriography at the different centers. In our study it was attempted to know the prevalence and characteristics of this special group in Afshar cath-lab.Materials and Methods: In a prospective cross sectional descriptive study 200 patients who were admitted for coronary angiography evaluated in terms of Risk factors: HTN, Family history Hyperlipidemia, DM, Cigarette smoking , clinical symptoms , response to TNG, different symptoms, ECG and Exercise test. data in two subgroups with normal and abnormal Coronary angioghraphy were compared. Six patients were excluded because of ambiguous Coronary angiography.Results: Among 194 patients 51 patients (26.3% )had normal coronary artery. 38.9% of female and 21.4% of males showed normal coronary angioghraphy (P = 0.013). The prevalence of risk factors among those with syndrome x and abnormal coronary Artery were as follow. HTN 37% vs 42% , Hyperlipidemia 50% vs 51% , smoking 25% vs 37% , DM 12% vs 28% , obesity 45% vs 47% Positive family history for CAD = 21.5% vs 47% respectively. Angina relieved suitably with TNG in 24% of those with syndrome x compared to 76% suitable response in those with abnormal coronary arteries.(P Value = 0.49 ). Regarding to functional class , 87% of patients with normal coronary artery belonged to class I and II. also 26% had atypical pain 50% had normal rest ECG and 51% achieved stage III or IV of Bruce protocol during Exercise test.Conclusion: Syndrome x was more prevalent among women ,also angina was less typical and less responsive to TNG. Most patients had not positive familial history for CAD. normal ECG was more prevalent among those with syndrome x .

Background: Vitamin C is a major antioxidant in lung airways and also functions against external insulting oxidant sources such as smoke and environmental contaminants. The aim of study was to assess the vitamin C in asthmatic patients, by it’s measurement in plasma and white blood cells (WBC).Materials and Methods: In a case–control study 50 asthmatic patients and 50 healthy person were randomly selected. The data were obtained by utilizing socioeconomic questionnaire and 24 hour dietary recall. l0 c.c blood samples were drawn. Plasma and WBC vitamin C concentration were measured colorimetrically. The data were analyzed by FPI and SPSS software. Results: The results indicate that 38 percent and 92 percent of patients had deficient plasma and WBC vitamin C concentrations respectively. There was a significant difference in plasma and WBC vitamin C concentrations among patients and control group (P<0.0001) Analysis of regression showed that a significant dependence was observed between the duration of asthma and plasma vitamin C status (P=0.03), though a positive significant correlation was obtained between plasma vitamin C status and dietary vitamin C intake (P=0.0001, r =0.56), The interaction of socioeconomic parameters and vitamin C concentration in asthmatic patients in this study was not significant . Conclusion: Present study indicates that while there is an association between vitamin C status and asthma but WBC vitamin C status is more sensitive in this regard and deserves further study and consideration.

Background: Stenotic coronary arteryIt is essential to identify the best simple anthropometric index in any population to predict chronic disease risk. This study was designed to compare the ability of waist circumference (WC), body mass index (BMI) and waist-to-hip ratio (WHR) to predict cardiovascular risk factors in an urban adult population of Tehranian men. Materials and Methods: This population-based cross-sectional study was conducted on 4449 men aged 18-74 years, participants of Tehran Lipid and Glucose Study (TLGS). Demographic data was collected. Anthropometric indices were measured according to standard protocol. Blood pressure was measured and hypertension was defined based on JNC VI. Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as FBS≥126 mg/dl and dyslipidemia based on ATP II. The presence of "at least one" and "at least two" risk factors from the four major cardiovascular risk factors (hypertension, dyslipidemia, diabetes and smoking) was also evaluated.Results: Mean age of men was 41.8±15.4. Mean BMI, WHR and waist circumference was 25.6±4.2 kg/m2, 0.91±0.07 and 87.7±11.7 cm, respectively. Of the three individual indicators, WHR had the highest sensitivity for all risk factors. No combination of indicators had higher average sensitivity + specificity than WHR alone. WHR had a higher percentage of correct prediction than BMI and waist circumference for all risk factors. No combination of measures was significantly more accurate than WHR alone, except for combinations where another indicator has been combined with WHR by "or".Conclusion: It is concluded that WHR is the best predictor of cardiovascular risk factors compared to BMI and WC in Tehranian adult men residing in district-13.

Background: ‏Today, coronary artery disease is a leading cause of death and morbidity in the world and recognition of all aspects of this problem appears to be necessary and important. In recent years in addition to traditional coronary risk factors, other new risk factors are presented that can affect coronary arteries and accelerate atherosclerosis process. One of the most important of these, are infections, specially with Chlamydia pneumonia. We aimed to study this possibility that is whether correlation between infection with Chlamydia pneumonia and Acute Myocardial Infarction. (AMI).Materials and Methods: This research is a descriptive case-control study which evaluates frequency of infection with Chlamydia pneumonia in the 100 patients with AMI and 105 patients without any history or evidence of CAD admitted in sections of CCU and surgery, in Dr. SHARIATI and SINA hospitals in 2001. For this purpose we took 5ml blood sample from all of the patients, and tested for specific anti Chlamydia pneumonia antibodies (IgG & IgM) by ELISA method. Results: Our study showed that 38 percent of control group patients and 54 percent of patients with AMI had positive titer of anti Chlamydia pneumonia antibody and so they were infected with Chlamydia pneumonia {OR= 1.9 (95% CI: 1.34 to 2.46)} (P<0/001). Conclusion: This study demonstrates that, there is significant correlation between infection with Chlamydia pneumonia and occurrence of AMI so treatment of this infection could be of profit.

Background: The idea of integration of medical education into health care system with the goal of comprehensive self sufficiency and complete response to public health needs were initiated in 1985. There were many prose and cones in this procedure which raised many controversies. The dilemma about strengths and weaknesses increased in 2002 during which Iran parliament tried to change the situation. In this study we tried to conclude and exit the dilemma.Materials and Methods: We studied the attitude of key academic person regarding the integration. In a cross-sectional study using a pretested questionnaire, we assessed the attitude of 556 academic staffs and managers from eight randomly selected medical universities. Results: Most of respondents agreed the positive out come of integration like establishment of disease surveillance and improving in health indicators, but they believed that the quality of medical education has decreased. Most of respondents suppose that dissociation of medical education may cause a lot of problems. Conclusion: There are a lot of controversies regarding the strengths and weaknesses of integration. External factors were causes of decreasing the quality of education so it is important to decide about the future by considering external factors.