Journal of Isfahan Medical School
Year:2002 | Volume:19 | Issue:63-64|Papers Count:25

Meningiomas are tumors derived From menigothelial cells and their prognosis depend on tumor histologic grade. Meningiomas often contain steroid hormone receptors and this could be used as a prognostic indicator, when differentiating benign from malignant meningiomas according to histology and clinical findings are difficult.Intracranial meningiomas from 105 patiens (29 males and 76 females, range 15-84 years) were evaluated immunohistochemically for female sex hormone receptor using specific monoclonal antibodies.Eigthy nine tumors were benign, eleven were malignant and five were atypical.Of the 89 beningn meningiomas, 76 cases were transitional, 22 were meningo the liomatous 6 were fibroblastic and one was secretory. Nuclear progestrone receptor was found in fifty four (60%) of benign meningiomas (45 cases were female) and none of the atypical and malignant ones. PR status was scored 0 (0% nuclei positive), 1 (<1%), 2 (1-9%), 3 (10-49%) or 4(>50%). Nuclear estrogen receptor was negative in all of the cases.Fischer's exact test showed an inverse correlation between tumor grade and PR staining score (P<0.00l) and Female had more progestrone receptor than male (P<0.00l).These data indicate the presence of PR even in small number of tumor cells is a favorable prognostic factor. But there was no correlation between age, histologic subtype and PR score.

Preeclampsia is one of the most common & least known disorders of pregnancy. This is a trophoblastic disorder & pregnancy termination & placental removal is the most successful and definit treatment of it.The aim of this study is to determine serum βHCG titer in preeclampsia (mild & severe) & normotensives, in patients. This is a case control study in singletone pregnant women, hospitalized at two Isfohan public hospitals (IUMS) Alzahra & Shahid Beheshti, 26 Patients witth severe preeclampsia, 26 patients with mild preeclampsia (tire case groups) & control croup, 28 Normotensives women. Three groups were matched abOIlt age, gestational age, Parity, serum bHCG titer which was detennined by EUSA test. Analysis of variance & chi square tests were used for statistical analysis. Mean serum βHCG±SD in severe preeclampcia: 3137 ± 3669. In mild preeclampsia 9700±10977 & in normotensive group 17702±15018 IU/L βHCG in severe preeclampcia were significantly lower than mild preeclmnpsia & normotensives (P<0.001).

Percutaneous transluninal coronary angioplasty (P.T.CA) is one of the efective treatment of coronary artery disease.This method was described in 1979 and since then has improved rapidly. In this study the results, and the complications of 162 cases of PTCA is described. The procedure was done between the years of 1373 to 1375 in Chamran Hospital in Isfahan. The patients were followed up untill the end of 1380. Primary successful was 80%. The most but rare complications were acute closure disection and also hematoma at inquinal area.

P53 gene is a tumour-suppressor gene and produce an m-RNA that is expressed in almost all cell or tissue types of body. Mutations of the P53 tumour suppressor gene observed in 50 to 70% of colorectal carcinomas and several reports have suggested the P53 mutation is a late event.90% of mutations reported in the P53 mutation database have limited their analysis to exons 5 to 8 . The methods used in the current study for the detection of P53 mutation is polymerase chain reaction (PCR) followed by single strand conformation polymorphism (SSCP). In I case of the 20 cases(5%) a shift was detected in exon 5. In 2 cases (10%) altered bands were identified in exon 8. By using "Fisher exact" statical method there is probability of correlation in analysis of several life factor. In according to the results which we got in our studies, rate mutation in exon 5 is equal to 5% and the rate mutation in exon 8 is equal to 10% which these results have perfectly comformity with the results in our studies as before. Our results indicate a difference in mutational spectrum of the P53 gene in distal and proximal colorectal caners. The results of this and another-studies indicate the importance of this gene as a prognostic marker, but there are also many opposite results.

The aim of this study is to evaluate insulin secretion and resistance with oral glucose tolerance test in normal individuals In this study, 30 normal individuals were selected and oral glucose tolerance test was performed. Glucose and insulin were checked in 0,30,60 and 120 minute .For insulin secretion and resistance calculation, hemostasis assessment model was used. T.test and regretion methods were used for stutistical analysis. P value less than 0.05 was considered significant. In this study, 30 persons were evaluated ( 15 men, 15 women) . The mean age of patients were 42±11 years. There was no significant differences between insulin and glucose concentration between men and women. Glucose 60 had significant direct correlation with insulin secretion (P=0.02) and indirect correlation with insulin resistance (P=0.001). Glucose 60 in oral glucose tolerance test is a simple method for predicting insulin resistance and secretion.

Angular and rotational deformities of the knee are common sequela of many osteopenic disorders, especially neuromuscular ones. Correction of these deformities is essential and when severe, they must be corrected with a bony procedure, sepecially by a supracondylar femoral osteotomy.Considering problems of internal and external fixation and complication of hard wares used for fixation, a new technique of osteotomy is presented that avoids these problems if correctly done and used only in osteopenic patients. 17le goal has been the investigation of results in regard to change in deformity, ROM of knee, complication, improvement in gait and function, patient satisfaction and the cost of operation and devices.In this procedure 4/5 of cortical bone in supracondylar area of femur with rongeur is removed and 1/5 of remained cortex with spongeal bone is intact. After correction of deformity in this area enough stability is present and usage of other device is not necessary. 50 patient had been operated on in Isfahan hospitals. The minimum follow - up was (4) 1/2 months and maximum was 6 years. Knee RO.M was unchanged (P=0.605), but the correction of deformity and improvement of gait were obvious (P<0.001). The complication rate was low (4 of 50 patients) and all of them were recovered with minor morbidity. Therefore the operation is very effective in correcting knee deformity, relatively safe and cost effective and recommended for. correcting any deformity of the knee (especially flexion contracture) in any osteopenic patient.

Benign paroxysmal positional vertigo (BPPV) is a common, self-limiting condition. The purpose of this study was to comare the efficacy of canalith repositioning procedure (CRP) and dimenhydrinate in the treatment of BPPV.In this prospective randomised unblinded controlled clinical trial 173 patients (45 men and 128 women) with a clinical diagnosis of BPPV (based on a positive history and Dix- Hallpike maneuver ) were entered into this clinical trial The mean duration of the symptoms was 6 month (range 1-120 months) and the mean age of the patients was 44. 27 years. The patients were randomly allocated to undrgo treatment with either dimenhydrinate, 50mg/tds (n=60), or CRP via Epley's maneuver (n=53), or placebo (n=60). Weekly follow up was done for 3 months to evaluate symptomatic improvement. Accrding to the resulte of this study 92-5% of the patients in the CPR group were symptom free while all of the patients receving dimenhydrinate or placebo had symptoms on followup (P<0.0001). At 3 months 98% of the patients in the CRP group and 17% of the patients in the dimenhydrinate group were satisfied with their respective treatments (P<0.0001). We conclude from our study CRP is significantly superior to dimenhydrinate in the treatment of BPPV.

With regard to importance of pulmonant artery pressure (PAP) in mangement, prognosis and dicision planning for correction of congenital heart disease, and either the role of echo - Doppler as reliable method for estimation of PAP, this study was performed for comparison of sensitivity and specificity between tricuspid regurgition (TR) versus pulmonary artery echo - Deppler method. The study papulation consisted of 40 patients that required right heart catreterization.Before catheterization, echocardiography was performed, then in cases with detectible TR, pulmonary artery acceleration time (ACT) was measured and PAP was evaluated. In TR method, estimation of mild to modrate pulmonary hypertension (PH) had: 885% sensitivity & 86% specificity, and for severe PH were 100% & 90% and for overall PH were 91% & 893% respectively. on the other hand, with ACT method sensitivity and specificity for determining mild to modrate PH were 81% & 85%, in severe PH 100% & 93% and in overall PH 79% & 71% respectively. In statistical analysis, there was no significant difference between above methods in PH determination. Therefor, as noted to results of this study, when measurment TR is not possible, we could use. ACT method as an alternative method.

Glioblastoma multiforme is the most common and highly malignant tumors of the brain that constitute at least 30% of all primary brain tumors and approximatcy 50% of glioma in most series. These tumors usually occur in the sixth to seventh decade. Headache, mental status changes and focal weakness are the most common symptoms at the time of diagnosis, seizure are much rare. The tendency of glioblastoma to metastasize to the CSF is well documented reaching approximatly 25% in one autopsy series but these tumor very rarely metastasize to remote extraneural sites. A case of right parietal glioblastoma multiforme (G.B.M) that metastasized to pleura 2.5 years after craniotomy and despite combined radio-chemotherapy is reported and a review of the literature is presented.

Helicobacter pylori is a microaerophilic gram negative fastidious bacterium. It has been associated with chronic gastrits, peptic ulcer and gastric carcinoma. In the present study by urec PCR directly without culture 79 biopsies were studied and compared with bacteriological methods including gram stain, rapid urease test and mlture. 64 cases were positive on PCR at sensitivity 91.4% and specifity 100% 73 cases were positive on rapid urease test at sensitivity 100% and specifity 66.7% and 71 cases were positive on gram stain at sensitivity 88.9% and specfity 100% 40 cases were positive on culture at sensitivity 57.1% and specifity 100%.Based on the results obtained by urec PCR we can indifity H.pylori directly without culture on biposy speciemens. In comparison with bacteriologieal tests urec PCR enjoyes a higher dgree of sensitivity and specifity. In addition to identifying the bacterium, we can use methods such as RFLP with restriction endonuclease on products of PCR to determine genotyping, reinfection infection with new strain, recrudesencece or drug resitance. Also using by this methods we can study in malignant cases embed tissues including MALT and find the role of H.pylori in the disease as retrorespective study.

Hemangioma is a vascular tumor with increased endothelial turnover during proliferative phase of development that may involute progressive cellular death or fibrosis. Hemangioma is the most common tumor of infancy potential problems in the proliferative phase include ulceration; bleeding, infection, distortion of the cornea, obstraction of the visual axis, nasal passage larynx or auditory canal, CHF, skeletal distortion and the effect of this tumor on the face of the children sometimes need's for treatment with exision the tumore.We did this study because of high incidence hemangioma in infancy and the complication and effects of this on beauty. The main aim for this study was the comparision of surgical insison and CO2 laser insison in treatment of hemangioma.This study is a kind of clinical traial and the population studied who reffered to Alzahra and Emam Mousa kazem hospitals in Isfahan on 1373 to 1379. These information were calculated through studing of 60 cases with cutaneous vascular tumors. The volume sample was n =30 in each group. with attention that the minimum and maximum of the operating time in exision of hemangioma is 15 and 180 minute and with supposing that the distribution of operating time is normal so variances are equal the volume sample in each group was n=30 estimate SD in each group is 27.5 as the result of n=30 from each of groups with error possibility x=0/05 and power is 1-b=0/80. minimum difference between the operation thime mean equal 20 minute in two metodes in statistical is significant in this study patient informations accumulated in check list that contain: hospitalization time, age, sex. pay expanditure, the mean bleeding during the operation, the lenth of operation time, surgical complication. The follow up the patient was six month. the method of smapling was occasional the information was given to spss soft ware and with use of the statistical metods T-test and chi-squar was analysed.The mean bleeding during the operation in two groups compared with using t-test and the mean and SD in the group of surgical insision was 123.8+108.8 and in the group of CO2 laser was 30.8+29.2 as the result of the difference between in this two gropus was significant (P<0.00l). The mean of hospitalization time and the pay expenditure in the year of 1379 and operating tine in two groups compared with using the t-test. The (p) in each group was 0/13 and 0/38. As the result, the difference between two groups was not significant, relative plenty edema, percantge pain in the insision, infection incidence, percentge escar after exision of mass was compared the (P) in each group was 0.3, 0.57, 0.31, 0.60 as the result, the difference between two groups was not significant. In the group that used laser of CO2 wasn't seen any infection. female/male ratio was 1/6 and the most common site of involvment was head and neck. The mean age and size of mass and dissection area was compared with attention that (P) was 0.68, 0.30, 0.2, as the result of difference between two groups was not significant.The information resulted during study shows: that use of CO2 laser insision for hemangioma cause the less bleeding during the operation than the use of surgical insision so the compilication as like injection is less than in the use of CO2 laser.

Myofascial trigger point syndrome is a common cause Of muscle pain which causes significant disabilty and pain for patients. This study has done in 501 army hospital from November 1999 to November 2000. The study population comprised of 50 patients who had randomly assigned in one of two groups: (Group 1: ultrasound treatment plus stretching exercises) and (group 2: Injection of methyl Prednisolon plus stretching exercises). Treatment effectiveness was assessed using Visual Analoge scale, duration of pain, neck range of motion and sleep disturbance. Comparison of therapeutic results in two groups showed that ultrasound treatment and trigger point injecton are equally effective in reducing pain intensity, duration of pain and improving sleep distubance. Group 1 showed sigificant improvement in nech range of motion, where as group 2 did not.

Enteritis due to campylobacter is the most common cause of acute bacterial diarrhea worldwide. Eighteen species and subspecies of campylobacter have been described, two of these (C.jejuni and C.coli) account for the majority of human infections.Campylobacters are asaccharolytic, fastidious bacteria, and this limits the available biochemical tests by which isolates may by differentiated. These limitations might in principle be overcome by use of PCR technique. To compare the culture techniqne with PCR assay, a total of 196 fecal specimens from patients with symptoms of enteritis were tested for the presence of campylobacters using culture and PCR All the specimens were cultured on campylobacter selective agar and incubated in microaerophilic conditons at 42˚c for 48 - 72 h. Identification of isolated campylobacters to species level was done by following procedures: Gram stain, oxidase and catalase activities, hippurate hydrolysis, and susceptibility to nalidixic acid and cephalothin.DNA extraction from fecal samples was done by use of High Pure PCR Template Preparation Kit. The ploymerase chain reaction (PCR) was used to direct detection of thermophilic Campylobacter jejuni and Campylobacter coli in DNA extractions from fecaI samples. Two species - specific PCR primer sets (JEJ1, JEJ2, COL1, COL2) was used to differentiation between C.jejuni and C.coli in fecal samples. Compylobacter strains were isolated from 15 (7.6%) of 196 patients with diarrhea (12 C.jejuni and 3 C.coli). By contrast, PCR assay detected campylobacters in 18 of 196 samples, including 15 previous culture positive samples, and further identified them as C.jejuni (14) and C.coli (4). The sensitivity and specificity of PCR was 100 and 98% respectively. According to the results of present study, it is proposed that PCR is a reliable and sensitive method which may be used as a routine diagnostic technique for detection of compylobacters in clinical specimens.

This study was conducted to detrermine the variety of kinds space occupying lesions (SOL) by CT scan and MRI findings in neurological clinic outpatients. In observational study, outpatient neurological clinic in the city of Isfahan, from 57750 patients who were attended and evaluted in this clinic in a six year period. This study have revealed that the most common types of brain SOL were glioma (32.3%) followed by the meningioma (17. 7%), subdural hematona (15.75%), metastases (1. %) and macroadenoma (5.5%).In comparison with other similar study, in this study glioma had less frquency and meningioma had more frequency in SOL. In this study 57750 neurological clinic outpatients were evaluated during 6 yean and were revealed that 253 patients srffer from SOL. The brain SOL is one of the causes of etiogic factors in outpatient who attended underwent neurological clinics, as a result, in each 228 patients in neurological clinic outpatients, one suffer from SOL.

The objective of the study is to determine the distribution of the frequency of fertilization and pregnancy in wives of azospermic infertile males in whom FNA of tcstcs wcrc positive, and in nonazospermic infertile males. Both groups were treated by ICSI.The records of 400 azospermic infertile males with positive FNA of testes were studied Age, ovum & embryo quantity, transference modality, fertilization occurance and pregnancy out come in the two groups were compared with 400 control cases. Most of the cases were in the age range of 30 - 39 years (56.2%), the majority of their wives in the range of 20 - 29 years old (54.7%). Postinduction, the wives had between 6-10 ovum mostly (44.4%) Among the azospermic patients, 300 (75%) had positive fertilization and 54 (13.5%) had their wives pregnant. Fertilization does not occure with significant difference in the two groups although the pregnancy in their wives does.Weather azospennic or not, fertilization does not occure with significant difference in the two groups, although the pregnancy in their wives does.

Diarrheal diseases is one a leading cm/se of morbidity and mortality in young children in developing countries. Various microorganisms cause diarrhea by several pathogenic mechanisms. It is essential to study the relative of the possible etiologic orgamisms to better underestand the epidemiology of dial7.hea in a community target interventions.There are a number of different diarrhoegenic bacteria of which Enteropathogenic Eshershia Coli (EPEC), Salmonella, Shigella and Kelebsiella are the most widely studied both in developed and developing countiries. Rotavirus is now known to be the most common cause of severe diarrhea in infants and young children, each year causes of illness are reported that leads to hospitalisation. In this study common cause of diarrhea have been studied subclinically for Rotavirus, Salmonella, Shigella, Kelebsiella and Eshershia Coli. 224 children who where under 6 year old have been studied in 1sfahan University hospitals from. Tir to Esfand 1378. Culture methods were used for bacterial identification and specific antiserum was used for serotype determination. ELISA method was used for Rotavirus isolation in stool samples. Electerom Microscope (E.M) the most sensitive methods to Rotavirus identification it was used to evaluation of ELlSA test. Enteropathogens were detected from 224 patients: Rotavirus in 43 patients (19.2%) EPEC in 16 patients (7.1%). Shigella in 1 patient salmonella in 1 patient, non Eshershia Coli EPEC in 23 patient and Klebsiella pneumonia in 8 patient. Mix pathogens were found simultaneously in a number of patients. For example 37 Case of Rotavirus, 12 Case of EPEC, 2 Case of Shigella and 8 Case of Klobsiella were mixed with other cause of diarrhea in this study.

Exercise test is a powerful tool for diagnosis of coronary artery disease (CAD) but value of exercise test for extensiveness and severity of CAD is still explained. The aim of present research is to determine the relationship between severity of ST segment displacement in exercise test and left ventricular performance, the number of coronary artery involvement and severity of coronary artery disease. The present study is a prospective, cross sectional, case control study that was performed in 1997 in Chamran heart center. In this study 103 patients with regarding exact inclusion and exclusion criteria were entered to this study. The inclusion criteria were patients with chronic stable angina pectoris and abnormal exercise test that candidate to coronary angiography or the patients with abnormal coronary angiography that candidate to perform exercise test. The exclusion criteria is unstable angina pectoris and prior history of myocardial infarction and other heart disease.ST segment depression in V4 to V6 in exercise test is correlated with three vessels disease, but no significant correlation between appearance and severity of ST segment depression in exercise test and three vessels disease is seen. ST segment depression in inferior leads in exercise test is relatively correlated with single vessel disease (without considering specific vessel). ST segment depression in exercise test isn't correlated with single or two vessel disease. There is no any corellation between ST depression in exercise test and left ventricular performance was seen. With regarding to low prevalence of ST segment elevation in exercise test, there was no any statistically significant finding were obtained.

A 35 years old woman after transfemoral renal angiography developed sudden pain in right lower quadrant. On examination there was a palpable mass in right lower quadrant. Abdominal CT. Scan showed rectus sheath hematoma at same area. By conservative managment she improved within two weeks.