eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
91
93
article
HYPEREKPLEXIAAND EXCESSIVE STARTLE RESPONSE IN AN INFANT: A CASE REPORT
J AKHOONDIAN
1
M JAFARZADEH
2
MJ PARIZADEH
3
From the Department of Pediatrics. Imam Reza Hospital, Mashhad University of Medical Sciences Mashhad, l.R. Iran
We present an infant girl with hyperekplexia, hypertonia, hyperreflexia and a characteristic
exaggerated response to nose tap. This disorder is important to recognize
because of the increased risk of apnea and sudden infant death, This infant responded
to clonazepam.
http://mjiri.iums.ac.ir/article-1-662-en.pdf
Hyperekplexia. Hypertonia. Startle
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
87
89
article
PRESENTATION OF A PEDIGREE OF AN IRANIAN FAMILY WITH TWO MEMBERS WITH CUTIS LAXA AUTOSOMA LRECESSIVE TYPE I
H POUR-JAFARI
h_pourjafari@yahoo.com
1
A SARIHI
2
From the Departments o.f*Genetics Sciences. Hamadan. I.R. Iran.
Congenital cutis laxa is an exceptional condition. No large scale pedigree has
been reported from Iran. We report a family with 106 members with two members
affected with cutis laxa.
Our cases were two patients (male and female) with pre- and postnatal growth
retardation, cutis laxa, characteristic facies and other manifestations which proved that
they were affected with cutis laxa. Their family history was studied and a large pedigree
was drawn up.
Based on the findings in their pedigree pattern, in addition to clinical and pathological
studies, one can say that cutis laxa in this family is autosomal recessive. We also
showed obligate carrier members in the family.
Recent studies have shown that cutis laxa is a heterogeneous group of conditions
both clinically and genetically. Autosomal dominant, autosomal recessive, X -linked and
also acquired forms have been reported. Our study indicates that our case is an autosomal
recessive type I. We discussed the pedigree that covers five generations.
http://mjiri.iums.ac.ir/article-1-661-en.pdf
Abnormalities
Cutis laxa
Hereditary diseases.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
85
86
article
HUGE PRIMARY INTRASCROTAL SCHWANNOMA: A CASE REPORT AND REVIEW OF THE LITERATURE
ALI SHAMSA
shamsa@mums.ac.ir
1
ABBAS A OMIDI
2
From the Departments of Urology and Pathology, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran.
From the Departments of Urology and Pathology, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Testicular schwannoma is a very rare benign scrotal tumor. It is a painless mass,
but sometimes referred because of pain or sensory losses. Tumor markers are normal
and radical orchidectomy is its best treatment. Here we present an unusual case of
intrascrotal schwannoma in a 57 year old man, with a review of the literature.
http://mjiri.iums.ac.ir/article-1-660-en.pdf
Schwannoma
in trascrotal mass
neurinoma.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
79
84
article
AVICENN A\'S VIEWPOINTS ON FEVER AND IT \'S COMPARISON TO MODERN MEDICINE
SZ TABEI
1
MB MASODMPOUR
2
R ASADOLLAHI
3
N SOBHANI
4
S SAJJADI
5
From Shiraz University of 'Medical Sciences. Shiraz. Iran.
In his book "Canon in Medicine (AI-Ghanoon)", Avicenna has specified a chapter
containing two sections pertaining to fever. After defining fever and explaining it's
different stages, he divides it into three types: hectic fever, infection-induced fever and
daily fever. After accurate attention to the patient's history and key-points in examination,
he focuses on fever signs and its treatment regarding each type of the three. In this
article, we intend to discuss Avicenna's views on fever in comparison to those of modem
medicine.
http://mjiri.iums.ac.ir/article-1-659-en.pdf
Fever
Avicenna. hectic fever
infection-induced fever
daily fever.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
73
77
article
FOOD INTAKE, BODY COMPOSITION AND ENDURANCE CAPACIT Y OF NATIONAL BASKETBALL TEAM PLAYERS IN I.R. OF IRAN
NAHID SALARKIA
n_salarkia@hotmail.com
1
MASOUD KIMIAGAR
2
AZADEH AMINPOUR
3
From the National Nutrition and Food Technology Research Institute. Shaheed Beheshti University and Medical Services. Tehran. !.R. Iran.
In this descriptive cross-sectional study 14 national basketball team players attending
the preparatory camp for the Asian games with mean age of 25. 6 ± 3.1 yrs,
height of 191 ± 6 em,w eight of87.3 ±8 .1 kg and BMI of 23.9 ±1.7 were surveyed.
The subjects underwent anthropometlic, aerobic power, body fat content and V02max
measurements in three stages of the training period (before training, during training and
before the actual competition). In two stages (before and during training) nutritional
assessment and food intake using weighing method in 7 intermittent days was made.
Anthropometlic measurements showed body weight and BMI changes during the
period of study to be negligible and non-significant.
Subcutaneous fat was reduced significantly (p< 0.02). Also V02max increased
appreciably (p<0.001) from 42. 3± 3.3 in the first stage to 44.3 ± 4.4 and 44.5 ± 2.2
mL/ Kg body weight per minute in the second and third stage respectively which demonstrates
the positive role of exercise on maximum oxygen uptake or V02max. The
results of quantitative food intake assessment showed the energy intake to be at 3900
kcal per day.
At this stage carbohydrate,f at and protein provided 50,35 and 15% of energy
respectively. In the second stage energy intake was 3600 kcal with 55, 30 and 15% of
energy coming from carbohydrate,f at and protein respectively which were in the normal
range in both stages .
Regarding vitamins and minerals, intake of iron, calcium and ascorbic acid was
above the range, while thiamin, riboflavin and niacin were within the range and vitamin
A as well as B6 were below the recommended levels.
Further research regarding nutrient intake monitoring, nutrition education of athletes
and coaches as well as international nutrition research offering a defined menu in
preparatory camps is necessary.
http://mjiri.iums.ac.ir/article-1-657-en.pdf
Food intake
skin fold thickness
basketball
V02I11ax
athlete\'s nutrition.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
67
71
article
USE OF LEUCOCYTE-ESTE R ASE AS A ME A NS OF TESTING SUITABILITY OF SPUTUM SPE CIMENS FOR LABORATORY EXAMIN ATION
NCD UKWANDU
1
JO CHIKWEM
2
AE MOSES
3
M JAJUA
4
CO ELEMUWA
5
J OKPE
6
S lWUANYANWU
7
From the I Department a/Medical Microbiology, College of Medical Sciences, University of Maiduguri, PM.B. 1069, Maiduguri. Nigeria
From the I Department a/Medical Microbiology, College of Medical Sciences, University of Maiduguri, PM.B. 1069, Maiduguri. Nigeria
From the I Department a/Medical Microbiology, College of Medical Sciences, University of Maiduguri, PM.B. 1069, Maiduguri. Nigeria
From the I Department a/Medical Microbiology, College of Medical Sciences, University of Maiduguri, PM.B. 1069, Maiduguri. Nigeria
the Central Public Health Laboratories. Yaba, Lagos, Nigeria
the Department of'Medical Microbiology, University of'Lagos Teaching Hospital, Jdi-A raba, Lagos. Nigeria.
the Department of'Medical Microbiology, University of'Lagos Teaching Hospital, Jdi-A raba, Lagos. Nigeria.
The study has strived to compare the leucocyte-esterase stripe activity on sputum
samples with gram-stained direct smear microscopy. This is for the demonstration of
white blood cells (WBCs) and so to develop a simple method for selecting suitable
sputum samples for cultural examination and laboratory diagnosis.
. A total of 17(34.0%) out of 50 samples studied were shown to be unsuitable for
microbiological examination and for identification of mycobacterial infection. Sputa of
patients between the ages of20-29 years old were found to be more positive by demonstrating
more WBCs and squamous epithelial cells (SECs). We believe this technique
should offer an alternative to the conventional direct smear microscopy used for
examining patient's sputa in our hospital laboratories.
http://mjiri.iums.ac.ir/article-1-656-en.pdf
Sputum
Leucocyte-esterase
laboratory.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
61
66
article
COLLAGENASE ACTIVITY IN PREVOTELLA BIVIUS ISOLATED FROM PATIENTS WITH PREMATURE RUPTURE OF MEMBRANES
REZA HOSSEINI DOUST
rcmb@bmsu.ac.ir
1
ASHRAF MOHABBATI MOBAREZ
2
From the Research Center o/Molecular Biology, Baqiatallah University of Medical Sciences, Tehran, l.R. lran
the Department of Microbiology, Tarbiat Modarres University, Tehran, I.R. lran.
Bacterial vaginosis (BV) has been considered to be the most prevalent infection
found in sexually active women. BV is thought to play an important role in the premature
rupture of membranes (PROM) and preterm birth. Preterm delivery accounts for
a substantial percentage of low birth weight infants and perinatal mortality and morbidity.
Bacteroides and Prevotella species have been isolated from the amniochorion of
women with preterm birth and PROM. Women with> 104/mL Prevotella bivius (formerly
Bacteroides bivius) have a 60-100% higher rate of preterm delivery. The purpose
of this study was to determine wether some strains of Prevotella species isolated
from PROM and BV patients produce proteases especially collagenase enzymes which
faciliate the rupture of membranes leading to preterm birth.
Vaginal specimens have been obtained from 120 women with BV and premature
rupture of membrane in 30-44 weeks gestational age. Twenty anaerobic coccobacilli
consisting of Bacteroides fragilis, black pigmented Bacteroides and Prevotella bivius
were isolated and identified. The isolates were examined for protease activity, using
porcine skine gelatin and casein as substrates by Martleys method.
Elastase and collagenase activity were detected using elastin, guinea pig skin collagen,
bovine achilles tendon col1agen, FALGPAand GP,VPKas substrates by Levenson
method.
Collagenase and elastase activity was detected in 90 and 100% of isolates.
Gelatinase and caseinase activity was detected in 40 and 50 % of isolates. Collagenase
produced by Prevotella bivia isolates was purified by ammonium sulphate precipitation,
gel filtration and ion exchange chromatography. The collagenase was cleaved from
the synthetic collagen substrate F ALGPA, and GP, VPK substrates. The activity of the
enzyme was inhibited by EDTA, Antipain and PMSF.
This study suggests that proteases produced by Prevotella bivia may be involved
in the pathogenesis of premature rupture of membrane. PROM before 37
weeks has been reported to be significantly higher among patients with Bacteroides
and Prevotella colonisation of the genital tract. The amniochorion consists of collagen
and elastin which convey physical integrity to the placenta. Collagenase and elastase
released into the genital tract may promote connective tissue destruction in the cervix
and chorioamnion membranes.
http://mjiri.iums.ac.ir/article-1-655-en.pdf
Prevotella bivius-collagenase activity- BV- PROM
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
55
60
article
THE CYTOTOXICITY PATHWAY OF NATURAL KILLER CELLS IN CORD BLOOD COMPARED TO P ERIPHERAL BLOOD
M KHEIRANDISH
kheira_m2001@yahoo.co.uk
1
M EBTEKAR
2
AA POURFATHOLLAH
3
ZM HASSAN
4
A KAZEM NEJAD
5
From the *Department of Immunology School of Medical Sciences, Tarbiat Modalres University, Tehran, and the **Iranian Blood Transfusion Research Center, Tehran, Iran.
The cytotoxic activity of natural killer cells is usually tested by radioactive assay
CSI Cr release assay), which detects the release of cytoplasmic contents after plasma
membrane disintegration of dying cells. In contrast to this indirect evaluation of cytotoxicity,
the assessment of cell damage by flow cytometry aims to provide a more exact
characterization of the death pathway via detection of the percentage of apoptosis and
necrotic cells. Annexin V-FITC (Axv -FITC) can be used to label cells in the early
apoptotic state, while propidiurn iodide (PI) indicates late apoptosis or necrosis.
The NK cytotoxicity of cord blood (CB) and peripheral blood (PB) was determined
after 4 hours of incubation in the absence of cytokines. After 4 hours in vitro
incubation, co-staining with Annexin V-FITC (Axv-FITC) and propidiurn iodide (PI)
pelmitted discrimination between viable, early apoptotic and necrotic cells. As we would
expect, the cytotoxicity pathway in PB mononuclear cells (MNCs) consists of both
apoptosis and necrosis pathways but in CB MNCs it almost consists of early apoptosis
and necrosis is negligible. With escalating E: T (effector: target) ratio changes in the
percentage of apoptotic cells in PB samples were significantly higher than CB samples.
The mechanism( s) of the low cytotoxicity of resting cord NK cells is not welllmderstood.
Complementary research in this field is recognized to elucidate the phenotypical
and functional properties of CB cells and how they relate to maturational stages. CB
studies are important for transplantation research and may provide insight to the suppressive
mechanism by which the host -recipient could evade GVHD and rejection.
http://mjiri.iums.ac.ir/article-1-653-en.pdf
Peripheral Blood
Cord Blood
Natural Killer Cells
Apoptosis
Necrosis
Flow Cytometry.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
45
53
article
ANTICALMODULIN DRUGS DUE TO THE NET EFFECTS CANNOT ANTAGONIZE DIBUTYRYL-CAMP-MEDIATED SUPPRESSION OF DE NOVO SYNTHESIZED LIPID SECRETION IN BOTH CULTURED MCARDLE CELLS AND RAT HEPATOCYTES
MEHDI RASOULI
mehdi2rasouli@yahoo.com.
1
RICHARD LEHNER
richard.lehner@ualberta.ca
2
University of Sari
From the Department of Pediatrics alld Cell Biologv, CIHR Group on MoleclIlar and Cell Biology, of Lipids, University of Alberta, Edmonton, Canada, T6G 2S2
The effects and interaction between cAMP-analogue dibutyryl-cAMP and
calmodulin antagonists were investigated on de novo synthesis and secretion of lipids in
cultures of hepatoma McArdle-RH7777 cells and normal rat hepatocytes. Dibutyryl cAMP caused a significant decrease in the secretion of de novo synthesized
triacyl [3H] glycerol in both cultures of McArdle cells and rat hepatocytes. The inhibitory
effect of dibutyryl-cAMP was concentration-dependent and appeared at the lowest
concentration examined, 5 µM. Dibutyryl-cAMP at a concentration of 50 11M suppressed
secretion of triacylglycerol by approximately 38% (p<0.05) and secretion of
phosphatidylcholine by 30% (p<0.05). Dibutyryl-cAMP did not affect the synthesis of
triacylglycerol and phosphatidylcholine, except at the highest concentration tested,
500 µM, where both triacylgJycerol and phosphatidylcholine synthesis were suppressed significantly.
Anticalmodulin W-7 also inhibited secretion of newly made triacylglycerol in a
concentration-dependent manner in both cultures of McArdle cells and rat hepatocytes.
W-7 at a concentration of 20 µM suppressed triacylglycerol secretion by about
37% (p<0.05), while the secretion of phosphatidylcholine and synthesis o f
triacylglycerol and phosphatidylcholine were not affected, unless at more than 20
µM concentration, at which both triacylglycerol and phosphatidylcholine synthesis were
decreased significantly.
The inhibitory effect elicited by dibutylyl-cAMP (100 µM) was not abolished in
the presence of calmodulin antagonists, W-7 (20 µM), trifluo perazine (20 µM) and
chlorpromazine (20 µM). The simultaneous effects of dibutyryl-cAMP and e ither
calmodulin antagonists were not additive or synergistic. None of the calmodulin antagonists
affected the cellular content of de novo synthesized triacylglycerol and p hosphatidy1choline
significantly. Neither dibutyryl-cAMP nor any calmodulin antagonist or
their combination did affect the overall rate of de novo synthesis of triacylglycerol and
phosphatidylcholine. All calmodulin antagonists examined alone also had a net significant
inhibitory effect on the secretion of newly made triacylglycerol. The results presented
here suggest that calmodulin antagonists have net direct effects and hence could
not overcome dibutyryl-cAMP-induced suppressive effects on the secretion of newly
made triacylglycerol. The cell types, normal hepatocytes relative to hepatomas, did not
influence the results.
http://mjiri.iums.ac.ir/article-1-654-en.pdf
Calmodulin
Cyclic AMP
Hepatocyte
PhosphatidyJcholine
McArdle cells
TriacygyceroJ and VLDL.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
45
53
article
ANTICALMODULIN DRUGS DUE TO THE NET EFFECTS CANNOT ANTAGONIZE DIBUTYRYL-CAMP-MEDIATED SUPPRESSION OF DE NOVO SYNTHESIZED LIPID SECRETION IN BOTH CULTURED MCARDLE CELLS AND RAT HEPATOCYTES
MEHDI RASOULI
mehdi2rasouli@yahoo.com.
1
RICHARD LEHNER
richard.lehner@ualberta.ca
2
University of Sari
From the Department of Pediatrics alld Cell Biologv, CIHR Group on MoleclIlar and Cell Biology, of Lipids, University of Alberta, Edmonton, Canada, T6G 2S2
The effects and interaction between cAMP-analogue dibutyryl-cAMP and
calmodulin antagonists were investigated on de novo synthesis and secretion of lipids in
cultures of hepatoma McArdle-RH7777 cells and normal rat hepatocytes. Dibutyryl cAMP caused a significant decrease in the secretion of de novo synthesized
triacyl [3H] glycerol in both cultures of McArdle cells and rat hepatocytes. The inhibitory
effect of dibutyryl-cAMP was concentration-dependent and appeared at the lowest
concentration examined, 5 µM. Dibutyryl-cAMP at a concentration of 50 11M suppressed
secretion of triacylglycerol by approximately 38% (p<0.05) and secretion of
phosphatidylcholine by 30% (p<0.05). Dibutyryl-cAMP did not affect the synthesis of
triacylglycerol and phosphatidylcholine, except at the highest concentration tested,
500 µM, where both triacylgJycerol and phosphatidylcholine synthesis were suppressed significantly.
Anticalmodulin W-7 also inhibited secretion of newly made triacylglycerol in a
concentration-dependent manner in both cultures of McArdle cells and rat hepatocytes.
W-7 at a concentration of 20 µM suppressed triacylglycerol secretion by about
37% (p<0.05), while the secretion of phosphatidylcholine and synthesis o f
triacylglycerol and phosphatidylcholine were not affected, unless at more than 20
µM concentration, at which both triacylglycerol and phosphatidylcholine synthesis were
decreased significantly.
The inhibitory effect elicited by dibutylyl-cAMP (100 µM) was not abolished in
the presence of calmodulin antagonists, W-7 (20 µM), trifluo perazine (20 µM) and
chlorpromazine (20 µM). The simultaneous effects of dibutyryl-cAMP and e ither
calmodulin antagonists were not additive or synergistic. None of the calmodulin antagonists
affected the cellular content of de novo synthesized triacylglycerol and p hosphatidy1choline
significantly. Neither dibutyryl-cAMP nor any calmodulin antagonist or
their combination did affect the overall rate of de novo synthesis of triacylglycerol and
phosphatidylcholine. All calmodulin antagonists examined alone also had a net significant
inhibitory effect on the secretion of newly made triacylglycerol. The results presented
here suggest that calmodulin antagonists have net direct effects and hence could
not overcome dibutyryl-cAMP-induced suppressive effects on the secretion of newly
made triacylglycerol. The cell types, normal hepatocytes relative to hepatomas, did not
influence the results.
http://mjiri.iums.ac.ir/article-1-652-en.pdf
Calmodulin
Cyclic AMP
Hepatocyte
PhosphatidyJcholine
McArdle cells
TriacygyceroJ and VLDL.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
45
53
article
ANTICALMODULIN DRUGS DUE TO THE NET EFFECTS CANNOT ANTAGONIZE DIBUTYRYL-CAMP-MEDIATED SUPPRESSION OF DE NOVO SYNTHESIZED LIPID SECRETION IN BOTH CULTURED MCARDLE CELLS AND RAT HEPATOCYTES
MEHDI RASOULI
mehdi2rasouli@yahoo.com.
1
RICHARD LEHNER
richard.lehner@ualberta.ca
2
University of Sari
From the Department of Pediatrics alld Cell Biologv, CIHR Group on MoleclIlar and Cell Biology, of Lipids, University of Alberta, Edmonton, Canada, T6G 2S2
The effects and interaction between cAMP-analogue dibutyryl-cAMP and
calmodulin antagonists were investigated on de novo synthesis and secretion of lipids in
cultures of hepatoma McArdle-RH7777 cells and normal rat hepatocytes. Dibutyryl cAMP caused a significant decrease in the secretion of de novo synthesized
triacyl [3H] glycerol in both cultures of McArdle cells and rat hepatocytes. The inhibitory
effect of dibutyryl-cAMP was concentration-dependent and appeared at the lowest
concentration examined, 5 µM. Dibutyryl-cAMP at a concentration of 50 11M suppressed
secretion of triacylglycerol by approximately 38% (p<0.05) and secretion of
phosphatidylcholine by 30% (p<0.05). Dibutyryl-cAMP did not affect the synthesis of
triacylglycerol and phosphatidylcholine, except at the highest concentration tested,
500 µM, where both triacylgJycerol and phosphatidylcholine synthesis were suppressed significantly.
Anticalmodulin W-7 also inhibited secretion of newly made triacylglycerol in a
concentration-dependent manner in both cultures of McArdle cells and rat hepatocytes.
W-7 at a concentration of 20 µM suppressed triacylglycerol secretion by about
37% (p<0.05), while the secretion of phosphatidylcholine and synthesis o f
triacylglycerol and phosphatidylcholine were not affected, unless at more than 20
µM concentration, at which both triacylglycerol and phosphatidylcholine synthesis were
decreased significantly.
The inhibitory effect elicited by dibutylyl-cAMP (100 µM) was not abolished in
the presence of calmodulin antagonists, W-7 (20 µM), trifluo perazine (20 µM) and
chlorpromazine (20 µM). The simultaneous effects of dibutyryl-cAMP and e ither
calmodulin antagonists were not additive or synergistic. None of the calmodulin antagonists
affected the cellular content of de novo synthesized triacylglycerol and p hosphatidy1choline
significantly. Neither dibutyryl-cAMP nor any calmodulin antagonist or
their combination did affect the overall rate of de novo synthesis of triacylglycerol and
phosphatidylcholine. All calmodulin antagonists examined alone also had a net significant
inhibitory effect on the secretion of newly made triacylglycerol. The results presented
here suggest that calmodulin antagonists have net direct effects and hence could
not overcome dibutyryl-cAMP-induced suppressive effects on the secretion of newly
made triacylglycerol. The cell types, normal hepatocytes relative to hepatomas, did not
influence the results.
http://mjiri.iums.ac.ir/article-1-651-en.pdf
Calmodulin
Cyclic AMP
Hepatocyte
PhosphatidyJcholine
McArdle cells
TriacygyceroJ and VLDL.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
39
43
article
PREVALENCE OF CELIAC DISEASE IN CHILDREN AND ADOLESCENTS WITH TYPE I DIABETES MELLITUS
H MOAYERI
H. Moayeri @ radsa net.
1
SH BAHREMAND
2
From the Pediatrics Department. Imam Khomeini Hospital. Faculty of Medicine. Tehran University of Medical Sciences. Tehran. Iran.
The association of celiac disease and type I diabetes mellitus has been known for
some time. This study was undertaken to investigate the prevalence of celiac disease
(CD) in diabetic children and adolescents. Eighty-seven patients (44 females, 43 males)
aged 2- 18 years, with type I diabetes participated in this study. A group of 87 healthy
unrelated girls and boys matched for age and gender served as controls. They were
screened for the presence of celiac disease related marker [IgA - endomysial antibody
(EMA)] and patients who were EMA positive further investigated with intestinal biopsy.
Among diabetic patients a 3.4% prevalence of celiac disease was observed, a
value significantly higher than that found among healthy controls. Girls were more frequently
EMA positive than boys. Intestinal biopsies of all 3 patients with positive EMA
showed a histologic picture confirming the diagnosis of CD. Diabetics with CD were
significantly younger, had an earlier onset of diabetes, had a lower height and weight
standard deviation score and poorer glycemic control compared with diabetics without
CD (p<O.05). We failed to show any significant correlation between EMA- positivity
and duration of diabetes. The results suggest EMA - positivity to be a good immunological
marker for use in screening for celiac disease and such screening to be justified
in our patients with type I diabetes mellitus, regardless of diabetes duration.
http://mjiri.iums.ac.ir/article-1-650-en.pdf
Adolescents
Children
Celiac disease (CD)
19A - endomysial antibody (EM A)
Type 1 diabetes mellitus.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
35
38
article
ROLE OF MAGNESIUM LOADING TEST IN DETECTING HYPOMAGNESEMIA IN CRITICALLY ILL PATIENTS
SM SOHREVARDI
smsohrcvardi@yahoo.com.
1
M MOJTAHEDZADEH
2
S SADRAY
3
A NAJAFI
4
JD SPENCE
5
C MUNOZ
6
H TAVAKOLI
7
the Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, I.R. Iran
Intensive Care Unit, Sina Medical Center; Tehran University of Medical Sciences
the Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, I.R. Iran
Intensive Care Unit, Sina Medical Center; Tehran University of Medical Sciences
the Stroke Prevention and Atherosclerosis Research Centre, LHSC, Canada.
the Stroke Prevention and Atherosclerosis Research Centre, LHSC, Canada.
Intensive Care Unit, Sina Medical Center; Tehran University of Medical Sciences
Magnesium (Mg) deficiency has not usually been considered in clinical practice
due to lack of relevant blood tests and because the symptoms are often vague and nonspecific.
Serum concentrations may not adequately reflect Mg status. Mg Loading Test
(MLT) can provide infonnation on total body Mg stores. We prospectively studied 21
critically ill patients (10 male, 11 female) admitted to the ICU, to investigate the prevalence
of Mg deficiency. Their mean age was 50±21 years. To determine serum Mg,
venous blood specimens were obtained just before the MLT. Mg sulfate (30 mmol)
was infused during an 8-hr period and 24-hr urine samples were collected from the
starting of Mg infusion. Although low serum Mg « 1.8 mmol/L) was present only in 2
patients, MLT showed Mg deficiency in 18 patients. MLT detected Mg deficiency in
13 out of 14 patients with normal serum Mg, in 2 out of 2 subjects with hypomagnesemia,
and in 3 out of 5 cases with hypennagnesemia. 0f7 fetal cases, 6 occurred in individuals
with hypomagnesemia (6118) and 1 death occurred in the nonnomagnesemic group
(1/3). There was no relationship between Mg retention, age (r= 0.33,p= 0.63) and
serum Mg concentrations (r= 0.15,p= 0.925). There was a significant correlation
between Mg uptake and APACHE II score (r= 0.46,p= 0.035).
In conclusion, Mg depletion is highly prevalent in ICU patients according to MLT.
MLT is superior to serum Mg in determining actual Mg status in this group. Therefore,
we suggest that MLT, and not serum Mg, should be carried out in patients when Mg
deficiency is suspected.
http://mjiri.iums.ac.ir/article-1-649-en.pdf
Magnesium Loading Test
Serum magnesium
Intensive Care Unit
APACHE II Score.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
29
33
article
VALUE OF FINE NEEDLE ASPIRATION IN DIAGNOSING ABDOMINAL AND RETROPERITONEAL MASSES OF CHILDREN
B GERAMIZADEH
geramib@sums.ac.ir
1
A AZIZI
2
PV KUMAR
3
HR FOROOTAN
4
A RASEKHI
5
From the Transplant Research Center, Nemazee Hospital. Shiraz University a/Medical Sciences. Shiraz. Iran.
The aim of this study was to evaluate the role of fine needle aspiration cytology in
the diagnosis of abdominal and retroperitoneal masses in children on this study. In 53
cases of childhood abdominal and retroperitoneal masses within a 4 year period (1998-
2001) preoperative fine needle aspiration was done under the guide of CT scan. 2
pathologists reviewed fine needle aspiration smears. In all of the cases the gold standard
for diagnosis was the tissue specimen, which showed 37 malignant, 2 benign
neoplastic and 12 nonneoplastic diseases. This study showed that the sensitivity and
specificity of fme needle aspiration cytology for the diagnosis of malignancy and benignity
(positive or negative for malignancy) is 97.2% and 81.2% respectively. It was
100% accurate for the diagnosis of cell type in neuroblastoma-ganglioneuroblastoma,
hepatoblastoma and Wilm's tumor, 77% accurate for lymphoma and 57% for germ cell
tumors. There was no complication in any of the cases after fine needle aspiration. So
fine needle aspiration is a reliable and sensitive method for the preoperative diagnosis
of malignant pediatric abdominal and retroperitoneal masses and we recommend doing
FNA cytology as a routine method for the diagnosis of such cases.
http://mjiri.iums.ac.ir/article-1-648-en.pdf
FNA
cytology
Abdominal
Retroperitoneal
masses
children.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
21
27
article
USEFULNESS OF SLEEP-DEPRIVED EEG IN THE DIAGNOSIS OF SEIZURE DISORDERS IN CHILDREN
SEYYED MOHAMMAD RAFIEI
1
From the Department of Pediatric Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
The provocative effects of sleep deprivation (SD) on patients with seizure disorder
and on the electroencephalogram (EEG ) are well known. The purpose of the study
was to test its routine use and usefulness in the pediatric and adolescent age group with,
or suspect of having, seizure disorder, especially those presenting with first unprovoked
seizure.
Between September 2000 and November 2002, among patients referring to the
author's clinic and the Pediatric Emergency Department of Nemazi Hospital, Shiraz,
598 children and adolescents were randomly assigned to a 10-minute surface EEG,
either routinely, or after a period of partial or total SD. Those who refused or could not
tolerate the SD procedure entered the routine group. The EEG's were analyzed for the
presence of epileptic abnormality.
Of598 patients ,5 44( 91 %) had clinical seizures the rest (54,9%) were seizure
suspects or had seizure "mimickers" ( syncope, night terrors, pseudo-seizures, etc). Of
seizure patients, 210 ( 38.6 % ) suffered from a first unprovoked seizure, and the rest
(334,61.4%) had more than one seizure episode at the time of EEG performance.
Abnormal epileptiform EEG's were more frequently seen in the group of seizure
patients who were sleep-deprived before performing the EEG, as compared to the
routine group. Conversely, more normal EEG's were seen upon routine performance
of EEG (p value <00001, X2 = 76.5).
Similarly, more abnormal sleep-deprived EEG's were seen in patients with first
unprovoked seizure than when EEG was done routinely in this subgroup of patients.
Patients with complex partial seizure had significantly more abnormal EEG's when subjected
to SD (p<0000 1).
Older patients could tolerate SD better than the younger age group so more
routine EEG's had to be performed in the younger age group. Younger children could
only tolerate partial SD. There was no difference in the yield of EEG in patients with
absence epilepsy between the two groups. In 5 patients with juvenile myoclonic epilepsy,
S D precipitated a generalized tonic-clonic seizure which necessitated acute antiepileptic
drug administration to the seizure activity.
All patients with non-seizure episodes showed normal EEG's.
In conclusion SD can be safely applied in the work-up of selected pediatric
patients with seizure disorder, especially in those with their ftrst unprovoked seizure, in
whom an abnormal EEG might dictate anti-epileptic drug therapy.
Not all children with seizure disorder need to undergo SD for EEG, as it may not
be necessary i n some, and intolerable in others. In non-seizure episodes, i f used in
appropriate pediatric age groups, it can be very helpful to ensure that a seizure disorder
is not present.
http://mjiri.iums.ac.ir/article-1-647-en.pdf
Seizure Disorder
Epilepsy
Electroencephalography(EEG)
Sleep Deprivation (SD).
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
13
19
article
COMPARISON OF MORBIDITIES BETWEEN INFANTS OF PREGESTATIONAL & GESTATIONAL DIABETIC MOTHERS
FIROUZEH NILI
1
A MAHDAVIANI
2
From the Department a/Pediatrics. Tehran University a/Medical Sciences. Tehran. l.R . Iran
To describe and compare the clinical outcome of infants born to mothers with
gestational and pregestational diabetes mellitus, this study was conducted between January
2000 to January 2002 in Tehran vali-E-- -Asr Hospital. Among 4472 deliveries, we
found 107 infants born to diabetic mothers out of whom 6 were twins.
The prevalence of diabetes in total deliveries was 2.39%. Mean age of gestational
and pregestational diabetic mothers was 30.9 ±5.86 and 31 ± 5.37 respectively.
74 infants (69%) belonged to gestational diabetic mothers. 50% of infants were
male. Mean birth weight of infants was 3067± 784.917 (700 -5600g). Gestational age
in 57% of infants was less than 38 weeks.APGAR score at 1 & 5 minutes was <6 in 10
and 5 cases respectively.
Hypoglycemia was detected in 31 %, hypocalcemia in 13%, hypomagnesemia in
4.5%, polycythemia in 6.8%, macrosomia in 28.6%, small for gestational age in 2%,
respiratory distress syndrome in 8.2%, early sepsis in 9.2%, NICU admission in 23.7%,
and hyperbilirubinemia in 34%.
The incidences of most of these morbidities were higher in infants of pregestational
diabetic mothers. The differences between the incidence of hypoglycemia, hypocalcemia
; 5 minute APGAR score in infants of pre gestational and gestational diabetic
mothers were significant (p<0.05).
There was a significant correlation between the incidence of hypoglycemia and
birth weight of infants (p< 0.05). The existence of congenital anomalies in infants of
gestational diabetic mothers could be due to unrecognized cases of noninsulin dependent
diabetes mellitus, and with respect to mean age of mothers it is advisable to detect
diabetes before pregnancy in high risk groups and correct the level of hemoglobin Alc
before pregnancy. Cleft palate and undescended testes among the anomalies support
this hypothesis that prostaglandin deficiency may have a role in the pathophysiology of
congenital malformations in these infants
http://mjiri.iums.ac.ir/article-1-646-en.pdf
Gestational diabetes mellitus
Pregestational diabetes
Infants of diabetic mothers
Neonatal complications.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
7
11
article
THE EFFICACY OF DECOMPRESSIVE CRANIECTOMY IN TREATMENT OF PATIENTS WITH MASSIVE HEMISPHERIC CEREBRAL INFARCTION
ALI EBRAHIMI NEJAD
1
BEHNAZ SEDIGHI
2
FATEMEH HOSSEIN NAKHAEE
3
From the Departments of*Neurosurgery, **Neurology, and ***Bio-Statistics & Epidemiology. Kerman University of Medical Sciences, Kerman, fran
Massive cerebral infarction is often accompanied by early death, secondary to
brain edema and trans-tentorial herniation. Several reports indicate beneficial effects of
decompressive craniectomy in this situation, but the efficacy of this procedure is still a
matter of debate.
A n experimental study in a period of3 years was done on2 3 patients with brain
edema due to massive cerebral infarction 11 patients were subjects and were operated,
and1 2 were in the non-operated group who only underwent conservative treatment.
A ll patients in this study had GCS below 8.
The m ean age of the operated patients was 54.5 yea r s and f o r the
unoperated patients 64.4 yea r s. Mean GCS in the operated cases was 7.00
and in the unoperated cases was 7.66. In the operated g r o up 4 of 11 patient s
lived (36.4%) and in the u l10perated group1 o f1 2 cases lived ( 8.3%). I n the
living operated cases, 1 had GOS 4 and 3 cases had GOS 3. In unoperated
cases 1 patient lived that had a GOS of2.
These results show that decompressive craniectomy can be an effective lifesaving
procedure for malignant brain edema after cerebral infarction and can also give acceptable
functional recovery.
http://mjiri.iums.ac.ir/article-1-645-en.pdf
Decompressive craniectomy
Cerebral infarction
Brain edema.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2004-05
18
1
1
5
article
THE SURGICAL MANAGEMENT OF COMPLICATED PULMONARY HYDATID CYSTS
NOURADIN PIRMOAZEN
1
FARROKH SAIDI
2
ZARGHAM H. AHMADI
3
FARZAD FIROUZI
4
From the Department oj'Thoracic Surgel)l, Modarres University Hospital, Shaheed Beheshti University oj'Medica/ Sciences, Tehran, Iran.
Iran is recognized as an endemic area for lung hydatidosis. Surgical removal of
some hydatid cysts may have setious morbid consequences. To determine the characteristics
of these special cysts, a retrospective survey was carried out on patients admitted
to Modarres Hospital in Tehran between 1989 and 1998. We have found that
ruptured, bilateral, lung located, and giant cysts (> ] 0 cm) cause more surgical and
anesthetic complications, thus we named them "complicated cysts".
Of 110 patients, 62(56.4%) had complicated hydatid cysts. Of these, 2 individuals
died during anesthesia induction because of hypoxemia. Since sudden severe hypoxemia
did not respond to all essential measures, the patients were returned to the
supine position (from lateral decubitus position), then rigid bronchoscopy was performed
for drainage of cyst secretions and fragments of laminated membrane.
At the time of induction of anesthesia, the contents of a ruptured cyst may spill into
the airway and cause hypoxemia and even death. In order to prevent this complication,
two different approaches were used: (l)A chest tube was introduced into the cyst
through the chest wall and its contents were drained (2) Patients were placed in the
sitting position during intubation.
Double lumen endotracheal tube (DLT) may allow salvage of unaffected lung from
inadvertent leakage of cyst contents or laminated membrane emboli formation, but it
does not guarantee a safe operation. Thus, rigid bronchoscopy should always be available.
Cystostomy was the most common surgical technique performed in our center
(80%). Massive air leakage, bronchial fistula, and permanent lobar collapse were the
main indications for lung resection in our series. Surgical complication rates of our study
were higher than reports from the west.
Coordination and cooperation of experienced surgeons and anesthetists can result
in better outcomes following complicated cyst removal.
http://mjiri.iums.ac.ir/article-1-644-en.pdf
Hydatid cyst of lung
sitting intubation
double-lumen endotracheal tube (DLT)
residual cavity of hydatid cyst.