eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2007-11
21
3
167
172
article
Primary liposarcoma of the liver: a case report and review of the literature
B. Nakhai
1
AR. Motabar
amotabar@yahoo.com.
2
Department of Surgery,Hazrat Rasool Hospital, Iran University of Medical Sciences,Tehran, Iran
Department of Surgery, Rasool Hospital, Niayesh St., Tehran, Iran
Abstract Liver neoplasm is not an uncommon disease in Asian countries. Liposarcoma is a rare mesenchymal malignant tumor which usually originates in the retroperitoneum and extremities. From 1973 till now about 10 cases of primary liver liposarcoma have been reported. We present the eleventh case in a young adult female with uncommon presentation. She suffered from a huge mass in the right portion of the liver with clinical manifestations of sepsis and respiratory distress. Despite aggressive surgery, tumor recurrence after six months led to death after a year. Hepatectomy is the best strategy to achieve long term survival for patients.Trials of preoperative radiation therapy with or without intraoperative irradiation are underway.
http://mjiri.iums.ac.ir/article-1-332-en.pdf
liver
liposarcoma hepatectomy
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2007-11
21
3
162
166
article
Rhabdomyolysis and thinner intoxication
E. Ghanei
dr_e_ghanei@yahoo.com
1
M. Homayooni
2
A. Nasrollahi
3
Department of Internal Medicine, Shohada-e-Tajrish Hospital, Ghods,Square, Tehran, Iran
Department of Internal Medicine, Shahid Beheshti University of Medical Sciences
Department of Internal Medicine, Shahid Beheshti University of Medical Sciences
Abstract We report a case of paint thinner intoxication by inhalation, with rhabdomyolysis, renal failure, skin lesions and severe sciatic nerve lesion at gluteal region.
http://mjiri.iums.ac.ir/article-1-331-en.pdf
thinner intoxication
rhabdomyolysis
acute renal failure
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2007-11
21
3
158
161
article
Variables that predict reintubation after open-heart surgery
F. Sabzi
1
H. Teimouri
hassan_teimouri@yahoo.com
2
Department of Cardiovascular Surgery, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
Department of Anesthesiology, Shahid Madani Hospital, Lorestan,University of Medical Sciences, Khoramabad, Iran
Abstract Background: This study sought to determine patient characteristics, process of care, and outcome as predictors of reintubation after open-heart surgery. Methods: We performed a retrospective case control study that included all patients undergoing cardiac surgery who required reintubation and an equal number of control patients not requiring reintubation. Putative risk factors were analyzed univariately by Moses, Kroskal Willis and χ2 tests. Results: Of the 300 consecutive patients reviewed, 39 required reintubation for cardio- respiratory reasons. Univariate predictors of reintubation (P= 0.05) were preoperative CO2, ejection fraction, weight, diabetes, and intra-operative fluid balances. Multivariate predictors of reintubation for each group (with cardio-respiratory reasons) and for all patients were determined and included preoperative PaCO2, type of operation, ejection fraction (EF), pre- operative PaO2, number of grafts, age, intra-aortic balloon pump, pump time, clamp time, pH at extubation time, and PaO2 at extubation time. Conclusion: Patients who required reintubation had the worst respiratory function. Patients identified as having high risk factors for reintubation should be followed closely and treated for problems that will lead to reintubation.
http://mjiri.iums.ac.ir/article-1-330-en.pdf
reintubation
open-heart surgery
risk factor
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2007-11
21
3
154
157
article
Long-term outcome of transfemoral thrombectomy in patients with acute iliofemoral vein thrombosis
M. Mozafar
mohamad_mozafar@yahoo.com
1
M. Talebianfar
2
Shahid Beheshti University of Medical Sciences, Shohada-e-TajrishMedical Center, Ghods Square, Tehran, Iran
Shahid Beheshti University of Medical Sciences and Health Services, Shohada-e-Tajrish Hospital,Tehran, Iran
Abstract Background: The optimal therapy of acute iliofemoral venous thrombosis is still a matter of debate. The purpose of our study was to evaluate the late results of iliofemoral thrombectomy with regard to the prevention of the development of a Post Thrombotic Syndrome (PTS). Methods: During 2000-2003, 18 patients underwent transfemoral venous thrombectomy for acute iliofemoral venous thrombosis. 16 patients were reexamined after a 5-year follow-up. At follow-up, the patency of venous segments as well as the development of reflux was investigated by duplex-ultrasound. Furthermore, clinical signs and symptoms of PTS in patients were recorded. Results: Clinical pulmonary emboli did not occur in the perioperative period. Two patients died because of disseminated metastatic cancer and another after massive retroperitoneal bleeding due to anticoagulation therapy. In a 5-year follow up, 31% had valvular reflux. Venous patency rate was 75%. The rate of PTS was 37.5% without the severe form of PTS. Patients did not have healed, healing, and/or active venous ulcer. Conclusion: It is thought that vein patency and valvular function were relatively restored, and PTS was prevented after surgical thrombectomy. Vascular surgeons should include venous thrombectomy as a part of their routine operative armamentarium, offering this procedure to patients with iliofemoral DVT, especially if other options are not available or have failed.
http://mjiri.iums.ac.ir/article-1-329-en.pdf
DVT
iliofemoral thrombosis
venous thrombectomy
PTS
valvular reflux
vein patency
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2007-11
21
3
151
153
article
End-to-end esophagojejunostomy versus standard end-to-side esophagojejunostomy: which one is preferable?
M.R. Kalantar Motamedi
1
A. Saberi
saberikourosh@yahoo.com
2
H. Khajooei Kermani
3
M. Aminseresht
4
A. Kavyani
5
M. Talebian
6
M. Akbari
7
Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Shohada-e-Tajrish Medical Center, Ghods Square, Tehran, Iran
Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences
Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences
Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences
Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences
Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences
Abstract Background: End-to-side esophagojejunostomy has almost always been associated with some degree of dysphagia. To overcome this complication we decided to perform an end-to-end anastomosis and compare it with end-to-side Roux-en-Y esophagojejunostomy. Methods: In this prospective study, between 1998 and 2005, 71 patients with a diagnosis of gastric adenocarcinoma underwent total gastrectomy. Standard esophagojejunostomy with an end-to-side fashion was performed in 41 patients and compared with our recommended technique of end-to-end esophagojejunostomy in 30 patients. Results: This study showed that esophagojejunostomy with an end-to-end fashion has a low incidence of postoperative dysphagia (33.3%), whereas in those with an endto- side anastomosis the rate of ysphagia is very high (83%). Conclusion: A Roux-en-Y esophagojejunostomy with an end-to-end anastomosis has a low incidence of postoperative dysphagia and we strongly recommend using this technique.
http://mjiri.iums.ac.ir/article-1-328-en.pdf
total gastrectomy
alimentary tract reconstruction
esophagojejunostomy
dysphagia
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2007-11
21
3
145
150
article
Can mustard gas induce late onset polyneuropathy?
MR. Azarpazhooh
r_azarpazhooh@yahoo.com
1
A. Shoeibi
2
MR. Soroush
3
S. Khateri
4
SJ. Mousavi
5
E. Modirian
6
Mashhad University of Medical Sciences, No.380, Sajad blvd, Mashhad, Iran
Mashhad University of Medical Sciences
Janbazan Medical Engineering Research Center, Mashhad, Iran
Janbazan Medical Engineering Research Center, Mashhad, Iran
Janbazan Medical Engineering Research Center, Mashhad, Iran
Janbazan Medical Engineering Research Center, Mashhad, Iran
Abstract Background: Mustard gas, lethal in high doses, affects multiple organs such as skin, eye and respiratory system. We studied the development of late onset mustardinduced polyneuropathy among chemically wounded Iranian veterans. Methods: In this descriptive study, 100 chemically wounded Iranian veterans with severe eye involvement were examined for any signs and symptoms of polyneuropathy by an internist. 20 patients were suspected to have neurological symptoms or signs. These patients were examined by a neurologist again. 13 showed abnormal neurological symptoms. Electrodiagnostic exams were performed for this group by another physician. Results: 13 veterans had abnormal neurological exam results with prominent sensory signs and symptoms in almost all of them. Brisk deep tendon reflexes were found in 3 cases. Electrodiagnostic studies were compatible with axonal type distal sensory polyneuropathy in 6 subjects. Conclusion: To the best of our knowledge, this is the first report of late onset polyneuropathy among chemically-wounded victims who were exposed to mustard gas. The pathophysiology of this form of neuropathy is still unknown. Unlike most toxic neuropathies, obvious clinical signs and symptoms appeared several years after exposure. No specific treatment for polyneuropathy due to chemical weapons exposure has been described to date.
http://mjiri.iums.ac.ir/article-1-327-en.pdf
mustard gas
polyneuropathy
chemical weapon
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2007-11
21
3
139
144
article
Esophageal replacement in children: presentation of 18 cases and results of their surgical procedure
S. Delshad
Drdelshad@gmail.com
1
P. Farhood
2
SJ. Nasiri
3
Pediatric Surgery Department, Ali Asghar Children Hospital, Zafar Ave.,Tehran, Iran
Department of Pediatric Surgery, Iran University of Medical Sciences, Tehran, Iran
Department of Pediatric Surgery, Iran University of Medical Sciences, Tehran, Iran
Abstract Background: Esophageal replacement is indicated in certain circumstances including long gap esophageal atresia, severe strictures due to gastro-esophageal reflux (GER) and caustic burns. We analyzed our results of 18 patients who underwent esophageal replacement in our university hospital. Methods: We reviewed esophageal replacements carried out in our department between June 1996 and August 2004. We report 18 patients (4 girls and 14 boys) with ages ranging from 3.5 until 30 months. Fifteen patients had long gap atresia, two had strictures due to GER, and one case had caustic burn. Esophageal replacement was performed through an abdominal midline incision by one of three methods, namely: colon transposition in 15, gastric replacement in 2, and gastric tube in 1 case. Results: Leakage and stricture were the most common complications of esophageal replacement. Most deaths were due to aspiration pneumonia and congenital cardiac disease. Conclusion: Esophageal replacement has limited indications. It allows a good functional result, with adequate oral feeding and normal growth.
http://mjiri.iums.ac.ir/article-1-326-en.pdf
esophageal replacement
esophageal atresia
colon interposition
gastric replacement
gastric tube
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2007-11
21
3
135
138
article
Comparison between the effects of Harrington Rod and multisegmented instrumentations in sagittal plane correction of idiopathic scoliosis
MT. Peivandi
Drpeivandy@yahoo.com
1
E. Ameri
2
B. Mobini
3
A. Mohtashemi
4
Department of Orthopedics, Emdadi Hospital, Mashhad University ofMedical Sciences, Fadaian-e-Eslam Ave, Mashhad, Iran
Department of Orthopedics, Shafa Yahyaiian Hospital, Iran University of Medical Sciences, Tehran, Iran
Department of Orthopedics, Shafa Yahyaiian Hospital, Iran University of Medical Sciences, Tehran, Iran
Department of Orthopedics, Shafa Yahyaiian Hospital, Iran University of Medical Sciences
Abstract Objective: To present the changes in projected thoracic hypokyphosis and the behavior of lumbar lordosis within and below the fusion and to compare these changes between the Harrington rod (HR) and posterior multisegmented hook instrumentation. Methods: 178 patients with idiopathic scoliosis, who had undergone posterior spinal fusion with Harrington technique (106 patients) or multisegmented hook system (72 patients), were analyzed. Results: The average coronal plane correction was 37% with the Harrington technique and 54% with the multihook system. In sagittal plane correction and in thoracic kyphosis in patients treated with HR technique, the preoperative thoracic hypokyphosis became normal in 20% of cases, remained unchanged in 60% and deteriorated in 20% of cases. Normal preoperative thoracic kyphosis did not increase in any of the cases. The thoracic kyphosis in patients treated with multihook technique became normal in 66%, remained unchanged in 17% and deteriorated in 17% of cases. Normal preoperative thoracic kyphosis remained the same post-operatively in 92% and changed to kyphosis in 8% of cases. Of 38 cases with decrease in total lumbar lordosis, 33 cases showed decrease, and 5 cases remained unchanged postoperatively concerning lumbar lordosis at the fusion level. Conclusion: The effect of the multihook system to correct coronal plane deformities was markedly better than the HR system (53.8% vs. 37.9%).
http://mjiri.iums.ac.ir/article-1-325-en.pdf
hypokyphosis
sagittal contour
lumbar lordosis
Harrington
idiopathic
multihook
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2007-11
21
3
131
134
article
Thyroglossal cyst carcinoma: overview of 15 years experience
S. Nikakhlagh
1
N. Saki
nsaki_Ir@yahoo.com
2
N. Ranjbari
3
Head and Neck Surgery, Imam Khomeini Hospital, Jondishapour University of Medicine SciencesAhwaz, Iran ,
Head and Neck Surgery, Department of Otolaryngology, Head and Neck Surgery, Jondishapour University of Medical Sciences, Ahwaz, Iran
Department of Pathology, Jondishapour University of Medical Sciences, Ahwaz, Iran
Abstract Background: Thyroglossal duct cysts (TDC) are the most common congenital neck masses arising from the expansion of the epithelial tract remnants occurring during embryogenic thyroid migration. About 7% of the population have thyroglossal duct remnants. Clinical presentation is frequent in children, but adults can also present with thyroglossal duct cysts. Thyroglossal duct cysts may rarely develop carcinomas (1-1.6 %) but tend to occur more in adults than children. Methods: We retrospectively reviewed all cases of TDC carcinoma surgically treated during a 15-years period at Ahwaz Emam Hospital center. Results: Three patients (two female and one male patient), who were 23 to 46 years old (mean 38 yr.) were identified. The frequency of TDC carcinoma among surgically removed TDC cysts was 0.7%. Amidline upper neck mass was the initial symptom in all patients. The diagnosis of cancer was made after the Sistrunk’s procedure in all three cases. All patients had papillary carcinoma. Thyroid involvement was noted in one case. One patient had near-total thyroidectomy, and two received postoperative radioactive iodine. After a mean follow-up of 11 years (range: 1 to 15 yr.), no patient had a documented local recurrence or distant metastatic involvement, and no tumor-associated mortality was observed. Conclusion: Although development of a papillary thyroid carcinoma from thyroglossal cyst is very rare, it should be born in the mind of the surgeon and the pathologist that this possibility exists and the ductal wall should be examined elaborately.
http://mjiri.iums.ac.ir/article-1-324-en.pdf
thyroglossal duct
cyst
papillary carcinoma
neck surgery
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2007-11
21
3
125
130
article
Extended RetroauricularTemporal Flap with Conchal Cartilage for Alar or Columellar Reconstruction
S Motamed
info@DrSmotamed.com
1
A Fadaee Naeeni
2
Department of Plastic Surgery, 15th Khordad Hospital, Karimkhan Ave.,South Aban Street, Tehran, Iran
Department of Plastic Surgery, 15th Khordad Hospital, Shahid Beheshti University of Medical Sciences
Abstract Background: The retroauricular-temporal or Washio flap has been introduced for reconstruction of partial nose and cheek defects, and has many advantages. We decided to evaluate the extended use of this technique in order to repair full thickness nasal defects. Methods: Superficial temporal and retroauricular arteries are identified with Doppler flowmetry. Selection points A, B, C and D are delineated. Point Ais the point around which the entire flap rotates, and is a fixed point in front of the anterior end of the helix and behind the superficial temporal artery. The next step is the selection of point C for the flap to reach the defect.We operated 8 cases utilizing this method to reconstruct alar and columellar defects with chondrum. Results: We found this technique very useful. The advantages of this technique include suitable flap color, good texture, no need for microsurgery experience, donor and recipient sites for surgery are in one field, and the donor site scar is inconspicuous. Conclusion: We find this technique very effective in repairing total subunit (nasal tip) defects. To fully appreciate it, we have to expand the distal part of the flap by including conchal cartilage with it.
http://mjiri.iums.ac.ir/article-1-323-en.pdf
retroauricular-temporal flap
conchal cartilage
full-thickness alarcolumellar defect