Tehran University Medical Journal
Year:2004 | Volume:62 | Issue:2|Papers Count:13

Background: Role of cytokines in regulation of immune system has been the subject of studies and clinical investigations. One of these cytokines, IL-2 has been well initially introduced as T cell Growth factor (TCGF), but subsequently it appeared that IL-2 is one of the important mediators affecting growth, development and activity of T, B, NK and LAK cells. Nowadays this cytokines has extensive use in clinical and research fields of immunotherapy of cancer and infectious disease. Materials and Methods: In this study, we used Jurcat cell line for production and partial purification of IL-2 10 6 cell/ml were stimulated by PHA (1μg/ml) and PMA (10 μg/ml)at the third day of the culture and then supernatant were collected after 22 hrs.Results & Conclusion: In order to obtain sufficient amount of IL-2 and eliminate interfacing materials, supernatants were concentrated using Amicon 10 and 30 PM filters. After concentrating, bioassay and Elisa were performed to detect the biological activity and amount of produced IL-2. Reversed phase-HPLC was used to confirm the IL-2 identity and purification.

Background: Alopecia areata is a common, inflamatory and chronic disease of hair and nails, which in some cases result in growth inhibition and lose of hairs. Several factors such as genetic factors, autoimmunity, atopy, stress, fear etc, are known as effective factors in induction and severity of the disease, but the ethiology of this disease is not known exactly so far. Some evidences such as presence of an autoantibodies against hair follicules and infiltration of immunocompetent cells in affected areas of the disease lead that most investigators classify alopecia as autoimmune disease. In one investigation in immunology department of Tarbiat Modarres university concerning the humoral immunity in alopecia pathogenesis some evidences were found for the presences of a neoantigen in affected hair follicles. Since various studies indicates that cellular arm of the immune system is more important in alopecia areata pathogenesis, in this investigation we studied the existence of neoantigens in affected hair follicles using lymphocyte transformation test (LTT).Materials and Methods: The proliferation responses of peripheral blood mononuclear cells (MNC) from alopecia patients and normal individuals were investigated against the follicular extracts of affected and normal hairs separately.Results: Our results indicate a non significant difference between proliferation responses of MNCs from alopecia patients and normal controls against follicular extract of normal hairs. These responses were not significantly different against folliclar extracts of affected hairs as well. Regarding our results.Conclusion: We could not show the existence of a neoantigen in alopecia hair follicles, but the obtained results can not completely reject the role of a neoantigen in alopecia p athogenesis as well, because in LTT the responding c ells are 0 f memory type and these cells may be very low in peripheral blood. The immune response in this disease may be restricted to affected areas such as hair follicles, so non-different proliferation response of peripheral blood lymphocytes can not exactly reflect the quality of immune response in affected areas. More investigations are needed to clear this matter.

Background: Wilms tumor is the most frequent primary renal neoplasma in pediatric age group. Classically it is composed of three histologic parts: Blastemal, Epithelial and stromal. Different factors are implicated as prognostic determinants. Nowadays special attention is paid to proliferation markers for determining the biologic behavior of tumors. In this study we tried .toascertain the proliferative il1dex of 22 cases of Wilm s tumor in our center who have had rather good follow up (at least two years).Materials and Methods: After reviewing the H and E slides, we stained sections with PCNA and ki67 and scanned them by image cytomertry. Then the proliferative indices for each histological part was determined.Results: We resuted that proliferative indices of blastemal and epithelial parts have significant (p< 0.0002) difference (increment) from that of stromal part. Also the patients were divided into those with recurrence (within two ys of primary surgery) and recurrence. The profileration indices of PCNA for those recurring tumors was significantly higher (PCNA= 22.3%) (P= 0.0015). Conclusion: Finally we concluded that using proliferative markers in Wilms turnor is useful as an effective prognostic factor.

Background: Total Intravenous Anesthesia (TIVA) compared to general anesthesia has some pits and falls. Many drugs have been employed for this anesthesia. Propofol is accounted as the last advent anesthetic drug. It belongs to alkyl phenol families and has been accounted one of the best choices for the continuous infusion. Invention of midazolam as the first water soluble benzodiazepine was also an important event in anesthesia and it can be used as continuous infusion for the anesthesia.Materials and Methods: I n this randomized controlled clinical trial, alfentanyl plus propofol or midazolam were used for TIVA anesthesia in 60 female patients undergoing Dilatation and Curettage (D&C) in Dr.Shariati hospital in March 2002 till March 2003. They were allocated reandomly in two group of alfentanyl plus propofol (propofol group) or alfentanyl plus midazolam (midazolam group) Results: There was no significant difference in mean of age between propofol group and midazolam group (P>0.05), also There was no significant difference in preanesthesia condition such as blood pressure and heart rate between propofol group and midazolam group (p>0.05). After induction of anesthesia there was a gross blood pressure decrease in both group that it was greater in midazolam group (85 mmHg versus 73 mmHg, P<0.05 ); following this, there was an increase in heart rate in both groups that it was modest in propofol group (98 Beat/Sec versus 118 Beat/Sec, P<0.05). There was no significant difference in mean infused alfentanyl (P>0.05) also there was just one naloxane injection in midazolam group that have no significant difference between groups (P>0.05). Recovery room stay was significantly lower in propofol group (25 minutes versus 39 minutes, P<0.05). Conclusion: The results of this study was similar to Vuyk et.a1.Intheir study there was a significant lower recovery time estimated by psychomotor reflexes and there was significant lower drowsiness, place and time orientation time compared to midazolam group. Finally according to the results of this study it can be resulted that TIVA with propofol is more suitable than midazolam and it can lower hospitalization time and cost. In future studies using 0ther narcotics and other narcotics-anesthetic compounds with various dose can be mentioned.

Background: Pulmonary involvement is a common and serious complication of rheumatoid arthritis. This cross sectional study sought to determine the prevalence of pulmonary disease in patients with rheumatoid arthritis on the basis of history, physical examination, chest X-ray and PFT.Materials and Methods: 103 patients (81 Women, 22 Men) fulfilling the ACR (American College of Rheumatology) criteria for RA (Rheumatoid arthritis) were consecutively included in a cross sectional study. Detailed medical (including respiratory symptoms and the disease activity symptoms) and drug and occupational histories and smoking were obtained. All patients underwent a complete pulmonary and rheumatologic examination and conventional chest radiography. All patients underwent PFT that comprised spirometry and body plethysmography. Results for PFTs were expressed as percentage of predicted values for each individual adjusted for age, sex, and height.Results: On the basis of history: Their mean age was 43.3 ±2.6 years (range: - 17-74) and the mean duration of the disease was 69.3± 15.6 months. Rheumatoid factor was positive in% 61.2. No patients were 05 Pack/Year smoker in whole life. Prevalence of pulmonary involvement based on radiographic and pulmonary function test detected in 41 patients (39/7%). The most frequent respiratory clinical finding was dyspnea (33%), (NYHA grade I in 17.5% and NYHA grade 11in 15.5%), Cough (with or without sputum) in 13.6%, Crackle was the most sign in pulmonary examination (5.8%). Chest X-ray was abnormal in 13.3 % that the most common finding in this study was reticulonodular pattern in 20 patients (19.4 %), and pleural effusion detected in 7 patients (6.7%). PFT was abnormal in 30 patients (29.1 %). A significant decrease of FEF 25%-75% below 1.64 SD. Small airway involvements was the most abnormal finding of PFT. No relation between rheumatoid arthritis disease activity (ESR>30, Morning stiffness>30¢, Anemia, thrombocytosis) with pulmonary disease was seen. Conclusion: This study suggests a high prevalence of lung involvement in patients with rheumatoid arthritis. Therefore; we recommend a complete investigation in patients with RA with any respiratory symptom.

Background: Mucositis [bucal Mucous inflamation] is the most common complication resulting from the radiotherapy in tumors of head and neck. These malignancies are often curable through radiotherapy. This complication, however, may impair the treatment process and cause malnutrition. So far no medicine has been Known to prevent this complication. Vitamin E is a stabilizer of cell membrane and is also used in mucositis treatment. The survey 0 f 0ral vitamin Eeffect on mucositis prophylaxis in radiotherapy of head and neck malignancies. Materials and Methods: Seventy patients afflicted with head and neck malignancies referring to Imam Khomeini Hospital were randomly divided into 2groups, two of whom died during treatment process. The first group (The case group consisting of 34 patients) Consumed oral vitamin E 200 mg daily for seven days. The second group (The control group) did not use any medicine at all. The two group underwent radiotherapy. They were compared and contrasted as to mucositis severity and dysphagia during treatment.Results: In the first group, since the fourth week up to the end of the treatment, there was a lower frequency and grade of mucositis in contrast with the control group. In the fourth week, the grade two mucositis in the first group (Case group) was 20.6% and 47.5% in the control group the difference was statistically significant (P=0.024). There was also a lower frequency and grade of dysphagia in the case group since the fourth week versus the control group. In the fourth week, moderate dysphagia was 29.4% in the case group and 55.9% in the control group. The difference was statistically significant (P=0.023).Conclusion: Oral vitamin E has Proved to be effective in the Prophylaxis of Moderate and severe mucositis and dysphagia resulting from radiotherapy. It is advisable to conduct more research with more cases, lengthier duration and heavier doses.

Sphenochoanal poyp is rare nasal mass that originates from sphenoid sinus. In anterior rhinoscopy it may be mistaken with antrochoanal polyp. CT of paranasal sinuses and nasal endoscopy has increased diagnostic accuracy. Simple polypectomy without removal of intra sinus mass is associated with increased risk of recurrence. Treatment of sphenochoanal polyp must include removal 0 f intrasphenoid part via enlargement of the sphenoid sinus ostium. At present time the choice of the surgical approach for sphenochoanal polyp is endoscopic sinus surgery. We introduce a case of sphenochoanal polyp and review its clinical, radiologic and pathologic findings and insist on endoscopic sinus surgery as a safe, effective treatment for it.

Background: Cerebrovasular diseases (CVD) are one of the most common anomalies which may affect on auditory cortex. In this research we have tried to evaluate the function of CANS in a group of 50-70 years old cerebrovascular accident (CVA) patients without hearing problem by using Persian version of C.S.T.Materials and Methods: This cross-sectional analytic study was established at Loghman-e-Hakim Hospital on a group of30 normal subject (15 male, 14 female) and a group of 40 patients with CVA including 30 patients (16 male, 14 female) with abnormal CT scan and 10 patients with normal CT scan.Results: Routine audiologic test including: Pure tone audiometry, Immitance audiometry and speech audiometry were nearly normal in all cases. There were significant differences between mean scores of CST in the patients with CVA and control group (P<0.05). There were no significant differences between mean scores of C ST in male and females (p>0.05). In spite of nearly normal hearing and high scores in the simple speech tests such as SDS, there were significant differences in mean scores of CST in both ears of CVA patients (p< 0.05). Another important point is that in some of patients with CVA.Conclusion: Although common radiologic evaluations such as CT scan showed no anatomic or structural anomaly but central auditory assessments such as CST can show dysfunctions of CANS. Therefore, CST might be a valuable test in CANS batteries for the cerebrovascular diseases.

Background: Cephalometry is one of the important branches of anthropometry that has wide uses in identification, forensic medicine, plastic surgery, orthodontics, archeology and determining the origins of races. This research was investigated to determining the head and face phenotypes among one-day newborn boys in two aborigines of Sistani and Baluchi who were resident in Zahedan.Materials and Methods: The investigation is based on cross-sectional analytical descriptions of 420 newborn aborigine boys (216 Sistani & 204 Baluchi), who were clinically healthy, in Quds hospital in summer 1381, in Zahedan. In this study cephalic and prosopic indices were determining by classical cephalometric.Results: The mean and the standard deviations of cephalic index were 83.67x4.80 and 83.64x4.77 and prosopic index 86.79x5.87 and 86.53x6.76 for Sistani and Baluchi subjects respectively. Based on the cephalic index, the dominant head types in sistani group were hyperbrachycephalic (37%) and brachycephalic (37%). In Blachui group, the hyperbrachycephalic (37.3%) and brachycephalic (35.3%) type were the dominant one. Furthermore, according to the prosopic index. The dominant face type among sistanis was euryprosopic type (42.6%). In Baluchi group, the dominant face type was also euryprosopic (39.2%).Conclusion: This research showed no statistically significant differences in terms of head and face type indices between two aborigines of Zahedan. Based on this cross-sectional study, it seems that there is similarities between the aforementioned groups.

Background: The purpose of this study was to compare electronic fetal heart rate monitoring (EFM) characteristics between Appropriate for Gestational Age (AGA ) and Small for Gestational Age (SGA) fetuses and to determine whether SGA fetuses have specific abnormalities.Materials and Methods: Among children born from Apr 2002 to Mar 2003 in Arash hospital, we identified 300 singleton infants born after 36 weeks gestation of uncomplicated pregnancies in whom second-trimester (24-27 weeks gestation) EFM records were obtained. Individual components of fetal heart rate (FHR) pattern; baseline rate, baseline FHR variability, presence of acceleration and periodic and episodic deceleration, and birth characteristics were compared between AGA and SGA infants or between pregnancies with or without second-trimester decelerations. Statistical analysis was performed using Student t, Chi square and Fisher exact test.Results: Among 300 infants, 261 (87%) were AGA and 39 (13%) were SGA; 65 had and 235 did not have second-trimester decelerations. Baseline FHR variability, second- trimester decelerations and intrapartum FHR decelerations were significantly higher in SGA fetuses than in AGA fetuses (P<0.05). Birth weight and gestational age were significantly lower in SGA fetuses than in AGA fetuses (P<0.05). There were no significant differences in baseline rate and acceleration ,maternal age and parity, Apgar score in 1 minute, meconium staining, mode of delivery, NICD admission, between SGA and AGA infants. Small for Gestational Age infants were more frequent in pregnancies with second-trimester decelerations compared with those without second-trimester deceleration (P<0.05). Baseline FHR variability in pregnancies with second-trimester decelerations was significantly higher than in pregnancies without second-trimester deceleration (P<0.05).Conclusion: Periodic or episodic decelerations and increased FHR variability during late second-trimester EFM were associated with an increased risk of SGA infant.

Background: The diagnosis of acute bacterial meningitis rests on CSF examination by lumbar puncture. Before lumbar puncture, intracranial mass lesions that increase intracranial pressure, must be ruled out, so brain CT-scan may be considered. In this study we evaluated the accuracy of physical examination for intracranial mass in patients with meningismus. Materials and Methods: 100 patients who had symptoms and signs of acute meningitis were evaluated and then brain scan was performed. After this, clinical manifestations were compared with CT results and sensitivity, specificity, positive and negative predictive values and accuracy were analyzed.Results: 73% of patients were men and 27% women. Most of patients were between 22 to 31 years old. 34% of patients had meningitis, 22% had SOL, 69% had one neurological symptom or sign at least. As a whole, sensitivity, specificity, pos. and neg. predictive values and accuracy in diagnosis of contradictions of L.P. are 90.9%,37.1%,28.9%,93.5%,59% . Conclusion: This study shows that with help of symptoms and signs fundoscopy in patients suspected to have meningitis, we can perform LP without brain CT preliminary.