Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
USING THE INFERIOR MESENTERIC ARTERY FOR THE THIRD RENAL RE-TRANSPLANTATION: A CASE REPORT
97
99
EN
HOSSEIN
NOORBALA
From the Department of Urology, Baqiyatallah Hospital, Bagiyatallah Medical Sciences University, Tehran, I.R.lran.
A 32 year old man underwent renal transplantation for the third time. This
procedure was performed in December 1994, using the kidney of a living unrelated
donor. The first transplanted kidney remained in the body after rejection but the
second one was removed due to trauma.
End-to-end anastomosis of the renal artery to the inferior mesenteric artery was
performed and the ureter was reimplanted to the bladder by Lich's technique. The
post-op period went on quite normally and no surgical complication or renal rejection
was observed. The transplanted kidney continues to function normally after more
than 18 months. In reviewing the medical literature and papers, we did not find any
report on using the inferior mesenteric artery for renal transplantation.
.
We recommend using the inferior mesenteric artery for renal re-transplantation
in cases in which no other suitable artery exists. Since there would be.no need for
aortic dissection and because of rough similarity between the diameters of the renal
artery and inferior mesenteric artery, the potential risk of vascular complications
would be less.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
DISSEMINATED INFECTION DUE TO FUSARIUM SP. IN A PATIENT WI TH CHRONIC GRANULOMATOUS DISEASE
93
96
EN
SHAHINDOKHT
BASIRI DJAHROMI
From the Department of Medical Mycology, Pasteur Institute of Iran
ALI ASGHAR
KHAKSAR
From the Department of Medical Mycology, Pasteur Institute of Iran
MOJGAN
VAZIRI KASHANI
the Section of Pathology, Pasteur Institute of Iran
SAHBA
ARSID
the Department of Pediatrics, Hazrat Rasool Acram Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
The present report discusses disseminated fusariosis in a 15 year old boy with
chronic granulomatous disease (CGD). He was admitted to the Hazrat Rasool
Acram Hospital in November 1995, with a chronic wound in the right ankle and
buttock area. Antibacterial therapy was started, but there was no response. The
patient was still febrile. Chest x-ray revealed parahilar lesions in both lungs. Tissue
biopsy and broncho-alveolar lavage were performed and the specimens were sent
to Pasteur Institute. In both specimens, Fusarium sp. was recognized as the
pathologic agent by direct smear and culture techniques. The patient underwent
antifungal therapy receiving amphotericin B and oral ketoconazole. The result of
this treatment suggests that aggressive management of fusariosis offers the best
chance of survival. This paper reports the first case of disseminated fusariosis in
Iran.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
UNUSUAL AND RARE TERATOMAS OF THE HEAD AND NECK: A REPORT OF THREE CASES
89
92
EN
M
NAGHIBZADEH
From the Department of Otolaryngology, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, I R. Iran.
Teratomas are bulky lesions that rarely occur in the head and neck regions.They
are composed of tissues from all germ layers with varying degrees of differentiation.
They arise from pluripotential stem cells and ectopic embryonic non-germ cells. The
most common sites of occurrence in the head and neck are the cervical region and the
nasopharynx. Three cases of these tumors are reported here that were found in the
nasopharynx, cervical region and the base of the tongue.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
ATTEMPTED SUICIDE BY INSULIN INJECTI ON TREATED WITH HYPERTONIC GLUCOSE SOLUTION
85
87
EN
MOHAMMAD
ABDOLLAHI
From the Department of Toxicology, Faculty of Pharmacy, Tehran University of Medical Sciences,
NASER
JALALI
the Faculty of Medicine, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, I R.lran.
MOHAMMAD
SHARIFZADEH
GHOLAMREZA
KARIMI
A young woman with no history of diabetes tried to commit suicide by
injecting 2800 units of subcutaneous NPH insulin. She was transferred to Loghman
Hospital within 12 hours. The main clinical symptom was continuous seizure
activity which was resistant to all forms of routine drug therapy. The patient was
treated with intravenous hypertonic glucose (50%) followed by continuous
glucose (10%) infusion. The patient was discharged from the hospital after 8 days
without any sequelae.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
PRIMARY HYPER OXALURIA: REPORT OF FOUR CASES AND REVIEW OF THE LITERATURE
79
84
EN
TJ
AJUDANI
From the Isfahan University of Medical Sciences. Isfahan. Iran
M
GHARAVI
From the Isfahan University of Medical Sciences. Isfahan. Iran
B
BASTANI
the St. Louis University Health Sciences Center. St. Louis. Missouri. USA.
In this paper we will present four cases of primary hyperoxaluria. All patients
had a significant past medical history of polyuria (with or without microscopic
hematuria) and polydypsia. All patients had a family history of their parents being
cousins. Initial evaluation of all patients by ultrasound and plain abdominal films
revealed nephrocalcinosis. Their clinical courses showed gradual loss of renal
function over the follow-up years. We will also review primary hyperoxalurias and
their management in this report.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
BENIGN EXTREME HYPERBILIRUBINEMIA IN A 9 YEAR-OLD GIRL WITH SICKLE-THALASSEMIA AND THE PROBABLE ROLE OF HBF IN PREDICTING THE OUTCOME
75
78
EN
MOHAMMAD REZA
SABRI
Assistant Professor
AHMAD
ALAVIAN-GHAVANINI
Senior Medical Student
Hepatic dysfunction is a frequent manifestation in patients with sickle cell
anemia. It is usually a multifactorial process. A rare benign form of extreme
hyperbilirubinemia, presumably due to intrahepatic sickling, may be the cause.
We report a 9 year old girl with sickle-thalassemia hemoglo binopathy, presenting
with profound jaundice. Sickle cell disease is often mild in the Iranian population
due to relatively higher levels of HbF, suggesting that the βs gene is associated
with a gene capable of producing high levels of HbF. Moreover, sickle
thalassemia disease is generally milder than sickle cell disease. In this patient,
the previous electrophoresis had shown a relatively high HbF level (34.3%).
This may account for the benign course of hyperbilirubinemia and no need for
blood transfusion in this case, despite the majority of previous reports
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
THE EFFECTS OF ANTERIOR DISCECTOMY AND INTERPOSITION AL IMPLANT UPON LUMBAR MOTION SEGMENT STABILITY
71
74
EN
KEIKHOSROW
FIROOZBAKHSH
From the Department of Orthopaedics and Rehabilitation, University of New Mexico School of Medicine, Albuquerque, New Mexico, U.SA.
FRED V.
ORCUIT
The cadaver spine motion segment behavior under torsional load was evaluated
with the disc intact, with partial anterior discectomy and with spacer insertion. The
results of this study explain how anterior lumbar discectomy and interbody fusion
(ALIF) affects the torsional stability of the motion segment.
The pseudarthrosis rate of the anterior lumbar discectomy and interbody
fusion (ALIF) is known to vary with leveL Therefore fifteen fresh human
cadaveric degenerated discs at L3-4, L4-5, and L5-S1 levels were loaded in
torsion: intact after anterior discectomy and, after spacer interposition and
removaL
Torsional rigidity of intactL5-S 1 was greater than L3-4 (41 %) orL4-5 (53%).
Anterior discectomy significantly decreased the torsional rigidity compared to
intact: L3-4 (73%) L4-5 (48%) and L5-S1 (55%). Interpositioning of spacer
partially restored the torsional stability compared to discectomy: L3-4 (22%) L4-
5 (18%) and L5-S1 (38%).
In conclusion, L5-S 1 degenerated discs are rotationally more stable than L3-
4 or L4-5. Anterior discectomy significantly increases torsional flexibility. Spacer
interposition partially restores the disc's torsional stability which is most prominent
at the L5-S 1 leveL Increased rotational flexibility seems related to pseudarthrosis
rate.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
MORPHOLOGICA L STUDY OF MOUSE (BALB/c) THYMUS A FTER HIGH A ND LOW DOSE DEXA METHA SONE TREATMENT
65
69
EN
B
NIKNAFS
From the Department of Anatomy, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran
TM
TAKI
From the Department of Anatomy, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran
M
REZAZADEH
From the Department of Anatomy, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran
MH
ALIMOHAMMADIAN
the Departmenl of Immunology, Pasteur Institute, Tehran, Islamic Republic of Iran.
Dexamethasone induces thymic atrophy and thymocyte apoptosis. In the
present study histological and ultrastructural changes which occur in the thymus of
the mouse (BALB/c) following treatment with high (20 mg/kg) and low (8 mg/kg)
doses of dexamethasone were investigated. In low dose treated mice, apoptotic cells
were observed focally and localized mainly in thymic nurse cells (T.N.C.). A zone
of intact thymocytes was formed in the medulla of animals receiving 20 mg/kg of
dexamethasone as well as an increase in trans-endothelial vesicles and a decrease in
the size of the vesicles in the cortical capillaries. The enveloped thymocytes within
thymic nurse cells respond to dexamethasone through apoptosis, and these changes
were seen to be more severe in mice treated with high doses of dexamethasone. The
formation of apoptotic cells in the thymus caused by low dose dexamethasone
mimics the physiological process of cell death. Differential effects of low dose and
high dose dexamethasone may have pharmacological and immunological implications.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
SPHINGOMYELIN METABOLITES A S SECOND MESSENGERS IN AIRWAY SMOOTH MUSCL E CELL P ROLIFERATION
57
63
EN
N
MALEKI DIZAJI
From the Department of Pharmacology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
A
GARJANI
From the Department of Pharmacology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
S
PYNE
the Department of Physiology and Pharmacology, University of Strathclyde, Glascow, U.K.
Sphingolipid metabolism was examined in guinea-pig airway smooth muscle
cells stimulated by platelet-derived growth factor (PDGF) and 4β-phorbol 12-
myristate 13-acetate (PMA), as mitogens and bradykinin (BK) as non-mitogen.
Stimulation of the cells by PMA and PDGF for 60 min. at 37°C induced the
following changes in sphingolipid metabolites: in cells prelabeled with PH]
palmitate, a 1.2 fold increase in radio-labeled sphingosine, a concomitant 20%
decrease in radio-labeled ceramide and no significant change in sphingomyelin
level. Stimulation of the cells by BK induced no changes in sphingolipid levels at
any time tested. This study demonstrates the existence of a "sphingomyelin cycle"
in airway smooth muscle cells. Such sphingolipid cycles may function in a signal
transduction pathway and in cellular proliferation.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
EFFECT OF β-HUMAN CHORIONIC GONADOTROPIN (β-HCG) ON NEUTROPHIL FUNCTIONS
53
55
EN
M
VODJGANI
From the Dept. of Immunology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, I.R. Iran.
F
AZADI
J
HAJATI
M
KARIMIAN
Many findings point to the presence of a close relationship between the
immune, endocrine and neurologic systems. For example the suppressive
effects of β-human chorionic gonadotropin (β-HCG) on IL-l production, the
potentiative effect of enkephalins on lymphocyte functions and the suppressive
effect of leuteinizing hormone (LH) on natural killer (NK) cell activities have
been clearly established. In this regard we have studied the effects of β-HCG on
neutrophil function in vitro. This study was performed on 28 peripheral blood
neutrophil samples (14 as test and 14 as control), by incubating neutrophil
preparations with bacteria in the presence or absence of the hormone for one
hour at 37°C. The results indicated that with 20 IU/mL of hormone, the total and
intracellular bactericidal activities of neutrophils were• significantly increased
(p<0.05), but the phagocytic activity remained unchanged.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
ISOLATION AND PURIFICATION OF MAJOR OUTER MEMBRANE PROTEINS FROM BRUCELLA ABORTUS S-99
47
51
EN
FERESHTEH
SHAHCHERAGHI
From the Department of Microbiology, Medical School, Tarbiat Modaress University, Tehran,
MOHAMMAD BAGHER
ESLAMI
From the Department of Microbiology, Medical School, Tarbiat Modaress University, Tehran,
BAHMAN
TABARAIE
the Department of Bacterial Vaccine and Antigen Production, Pasteur Institute of Iran, Tehran, Islamic Republic of Iran.
GHORBAN
BEHZADIAN-NEJAD
From the Department of Microbiology, Medical School, Tarbiat Modaress University, Tehran,
Isolation and purification of major outer membrane proteins (OMP) from the cell
wall envelope of Brucella abortus S-99 were achieved by sonication, solubilization
and membrane fractionation in the presence of non-ionic detergent (Tx-100) and
lysozyme treatments, followed by ultracentrifugation.
The crude OMP was treated with trypsin to free the preparation from any other
protein contaminants. The OMP preparation was purified by column chromatography
on Sephacryl S-200. Three major symmetrical peaks emerged from the column with
kav values of 1. 81, 2.42 and 2.56 in succession in addition to a few closely related
minor peaks. Characterization of crude OMP on SDS-PAGE showed 13 protein
bands. The three major peaks 1,2 and 3 were subjected to SDS-PAGE separately and
the molecular weights of peaks 2 and 3 were calculated to be 26 and 38 kDa,
respectively and the first peak was further resolved into two subfractions with
molecular weights of 62 and 67 kDa.
However, after treatment of OMP with trypsin the number of bands were reduced
to one prominent band with a molecular weight of 38 kDa and a thinner band of 41
kDa.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
OCCURRENCE OF VIRUSES AND P RO TOZOAN PARASI TES IN SURFACE, GROUND AND TREATED WATER IN THE CI TY OF MASHHAD, IRAN
41
45
EN
MORTEZA
ABBASZADEGAN
From the American Water Works Service Company, Belleville, IL
ALI
EMAMI
Mashhad Water Works, Mashhad
REZA
FARID
University of Mashhad, Mashhad, Iran
CHARLES
GERBA
the University of Arizona, Tucson, AZ, USA
A research plan was developed to evaluate the occurrence of enteroviruses,
giardia cysts and cryptosporidium oocysts in thirty-five different sites in the city of
Mashhad, Iran. The occurrence of these pathogenic microorganisms was evaluated
to investigate a possible health risk in the communities.
For the detection of enteroviruses in water samples, the conventional method of
cell culture, using Buffalo Green Monkey (BGM) cell line, was used. The minimum
sample volume for viruses was 500 liters, collected using a positively charged MK
cartridge filter, eluted with beef extract and concentrated by organic flocculation.
The method of detection for cysts and oocysts relied on microscopic observation of
water samples by the immunofluorescence assay (IFA). For this study, water samples
were collected using a cartridge filter, eluted by washing the filter using a detergentbased
medium, concentrated by centrifugation, clarified by a percoll-sucrose density
gradient, stained by an indirect fluorescent antibody, and examined by epifluorescence
microscopy.
A total of seventy surface, ground or treated water samples were collected from
35 different sites in the metropolitan city of Mashhad. Thirty-five samples were
assayed for the presence of enteroviruses by cell culture and 35 samples were assayed
by IFA technique for the detection of cysts and oocysts. Two surface water samples
tested positive for virus presence and three surface water samples tested positive for
giardia cysts. Based on the results of this research project, no microbial contamination
of finished water was documented, suggesting proper treatment of surface water at
the time of sampling.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
THE NORMAL CARRYING ANGLE OF THE ELBOW IN SHIRAZ
37
39
EN
MJ
EMAMI
From the Orthopedic Department, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, I.R. Iran.
F
ABDINEJAD
S
KHODABKHSHI
M
AMINI
B
NASERI
The normal carrying angle in Shiraz population was measured on the basis of
sex and age. The right elbow angle of 4266 cases was examined from birth to 30
years old. This study found the carrying angle in 2540 females to be 7.20 (range
2-19) and in 1726 males to be 6.40 (range 2-11), a 0.80 difference.
A significant difference (p= 0.05) was found in relation to age. There is a
gradual increase in the carrying angle with skeletal maturation.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
EFFECT OF PASSIVE SMOKING DURING PREGNANCY ON WEIGHT, LENG TH AND CRANIAL CIRCUMFERENCE AT BIRTH IN KERMAN, IRAN
31
36
EN
MOHSEN
JANGHORBANI
From the Department of Obstetrics and Gynecology, Medical School, Kerman University of Medical Sciences and Health Services, Kerman, Islamic Republic of Iran.
HAMID REZA
NAKHAI
Passive smoking (PS), a well-known health risk, is the major source of indoor
pollution. There is some inconsistent evidence that PS during pregnancy may
increase the risk of low birth weight. The aim of the present study was to
determine the effects of PS exposure during pregnancy on weight, length and
cranial circumference at birth of babies born to women who have described
themselves as nonsmokers, in Kerman, Iran. A random sample of 702 admitted
women aged 11 to 50 years [mean (standard deviation) 26.5 (6.1)] who delivered
a live full-term singleton baby without apparent malformation during the six
consecutive months from June to December 1994 were interviewed on the
second day post-partum and asked about smoking in all household members.
They comprised about 36.4% of total deliveries in Bahonar Kerman Medical
School Hospital during this period. All women were nonsmokers, 278 (39.6%)
were passive smokers while 424 (60.4%) were not exposed to tobacco smoke.
Potential confounders, including fetal gender, maternal age, parity, weight gain,
complications during pregnancy, maternal education, birth interval and gestation
were adjusted for by multiple linear regression analysis. Infants born to passive
smokers were on the average 22 gr. lighter than those born to nonsmokers, albeit
this difference was not statistically significant (p = 0.56) [95% confidence
interval (CI): -51, 95.7]. A mean reduction of 0.04 cm [95% CI: -0.19,0.27] in
birth length and 0.05 cm [95%CI: -0.12, 0.22) in cranial circumference was
found. In multiple linear regression model, exposure to PS during pregnancy did
not show any effect on weight, length and cranial circumference at birth after
adjusting for confounding variables.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
ANATOMIC CORRELATION BE TWEEN INTIMAL PATHOLOGY AND CEREBRAL VASOSPASM FOLLOWING SUBARACHNOID HEMORRHAGE
25
29
EN
MA
KHALILI
From the Departments of Anatomy University of Mississippi Medical Center, Mississippi, U.SA.
BR
CLOWER
K
IWASA
From the Departments of Neurosurgery, University of Mississippi Medical Center, Mississippi, U.SA.
Subarachnoid hemorrhage (SAH) resulting from a ruptured intracranial aneurysm
can induce cerebral vasospasm with subsequent reduction in cerebral blood flow
(CBF). The present study examines the pathological alterations in the wall of human
cerebral arteries at autopsy, especially with regard to intimal pathology, following
aneurysmal SAH. Arterial segments from the circle of Willis were fixed in 10%
formalin, embedded in paraffin, sectioned at 4µ and stained with hematoxylin-eosin
or toluidine blue. Similar numbers of sectioned vessels were also examined in control
material. The areas of intima, lumen and the length of internal elastic lamina were
compared witth those from control sections. Pathological changes such as myonecrosis
and fibrosis in muscular layers associated with a possible loss of compliance and
elasticity of the vessel wall were also noted. The average luminal area decreased to
56.8% ± 12.5% compared to comparable controls (p<0.005). The tunica intima was
the most abnormal component of the arterial wall with cellular proliferation which
was made up predominantly of collagen fibers and loose fibroblasts. These pathological
findings are mainly due to myonecrotic changes and intimal proliferation with the
resultant luminal constriction and CBF impairment which might explain the high
incidence of cerebral infarction in cases of SAH.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
THE PATTERN OF MALIGNANT TUMORS IN KERMAN PROVINCE
19
23
EN
H
TABRIZCHEE
From the Department of Pathology, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran.
M
MASOOMIAN
F
AHANI
MS
ZARE
This investigation was done in Kennan from March 1989 to March 1993 to study
the epidemiology of cancers in this province and to compare the results with a
previous study performed in this area and some available statistics.
A total number of 288 1 new cases of malignancy were registered and the crude
relative frequency of cancers was studied. Gastric cancer with a frequency of 9.7%,
malignant lymphoma with 8.8% and leukemia with 6.8% were the three most
common malignancies in this province, excluding skin malignancy.
Keywords: Cancer epidemiology, Gastric carcinoma, Malignant lymphoma, Breast carcinoma
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
HOW PHYSICIANS MANAGE SEIZURE DISORDERS IN INFANTS AND CHILDREN: A PILOT STUDY
15
17
EN
SEYYED MOHAMMAD
RAFIEI
From the Department of Pediatric Neurology, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran.
To see which medical specialties usually manage seizure disorders in infants and
children, a random survey was done among 105 such patients referred. These patients
were most frequently seen by a pediatrician (n= 44, 4 1.9%), general practitioner
(n=34, 32.4%), and hospital house staff of general and pediatric emergency rooms
(n= 2, 19%) in the area surveyed. A correct diagnosis of seizure disorder was
achieved in 87.6% and 87.6% of the patients were managed correctly by various
medical specialties. Several "seizure mimickers" were mistaken for seizure, i.e.,
breath holding spells, syncope and night terrors. It is concluded that various medical
specialties are involved in the care of infants and children with seizure disorder, and
further effort on the education of these specialties would avoid mis-management of
such patients.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
THE EFFECT OF C ALCIUM SUPPLEMENTATION IN THE PREVENTION OF HYPERTENSIVE DISORDERS OF PREGN ANCY IN NULLIPAROUS WOMEN
11
14
EN
ESMAT
BABADIZAVANDY
From the Department of Nursery and Midwifery, Mashhad University, Mashhad, Islamic Republic of Iran.
GHODSIH
SEYYEDI ALAVI
MASOMEH
CORDI
The purpose of this prospective study was to determine the effect of calcium
supplementation in the incidence of hypertensive disorders of pregnancy (gestational
hypertension and pre-eclampsia) in nulliparous and high risk women. 300 pregnant
women in the 24th week of gestation at the beginning of the study were entered into
a double-blind randomized trial. 143 of them who had a positive roll-over test and
hypocalciuria at the 28-32nd week of gestation were enrolled for the study.
Subjects were assigned to receive 2 g per day of elemental calcium (52
women) or placebo (61 women) from the 28-32nd week of pregnancy until
delivery. Results showed that 11.4% of calcium-treated subjects developed
gestational hypertension, compared to 31.2% of the placebo group. The rate of
hypertensive disorders of pregnancy was also higher in the placebo group (35.6%
vs 11.4%, p<0.01).
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
THE EFFECT OF GENETIC AL AND ENVIRONMENTAL FACTORS ON LIPIDS: A TWIN STUDY
5
9
EN
SHAYESTEH
JAHANFAR
From the Frank Rundle House. Royal Hospital for Women. 188 Oxford St, Paddington. 2021 New South Wales
JOHN A.
EDEN
From the Frank Rundle House. Royal Hospital for Women. 188 Oxford St, Paddington. 2021 New South Wales
XING L
WANG
the Department of Cardiovascular Medicine. Clinical Science Building. Prince Henry Hospital. Little Bay. 2036 New South Wales.
DAVID E.L
WlLCKEN
the Department of Cardiovascular Medicine. Clinical Science Building. Prince Henry Hospital. Little Bay. 2036 New South Wales.
TUAN
NGUYEN
the Garvan Institute. St Vincent's Hospital. Darlinghurst. 2010 New South Wales. Australia
To assess the relative contribution of genetic and environmental factors
(particularly androgens) on circulating levels of lipid fractions, serum androgen
and lipid fractions were measured in 34 pairs of female-female twins aged from 15-
45 years, some of whom were discordant for polycystic ovary syndrome (PCOS)
diagnosed by ultrasound. Nineteen pairs were monozygotic twins (MZ) and 15
pairs were dizygotic twins (DZ). Five pairs of MZ and 6 pairs of DZ were
discordant for scan-PC a. We measured serum concentrations of total cholesterol
(TC), high density lipoprotein cholesterol (HDL-C), triglycerides (TRIG),
lipoprotein (a) [LP(a)], and apolipoprotein B (apo B). Also, testosterone (T),
dehydroepiandrosterone sulphate (DHEAS), sex hormone binding globulin (SHBG)
and 3a-androstanediol glucuronide (3a-diol G) levels were measured.
Transabdominal ultrasound was performed. Serum levels of TC, HDL-C, TRIG,
LP(a) and apo B in the twins with PCO were not significantly different from the
levels in their matched co-twins with normal ovaries. There were no significant
correlations between androgen-hormones including T, DHEAS and 3a-diol G
with any of the lipid measurements. Body mass index (BMI) was positively
correlated with TRIG, LP(a) (both p<0.05) and negatively correlated with HDLC
(p<0.001). SHBG was negatively correlated with TRIG and LP(a) and positively
associated with HDL-C (p<0.05). Insulin was significantly correlated with TRIG
(p<0.001) and negatively with HDL-C (p<0.01). The MZ intraclass correlation
exceeded that of the DZ for all the lipid variables measured. The heritability
estimates for LP(a), apo B, TC and HDL-C were 0.95, 0.56, 0.48 and 0.54,
respectively. However, the intraclass correlation coefficient for TRIG was not
significantly different between MZ and DZ but maximum likelihood analysis
indicated that at least 10% of the variance of circulating TRIG concentration is
determined by genetic factors. We conclude that twins discordant for pcas do not
have significantly different lipid profiles. We were unable to show any significant
effect of androgens on the lipid fractions measured. The results confirm that levels
of LP(a), HDL-C, TC and apo B are under significant genetic control and that this
is particularly so for LP(a). However, only 10% of the variation in TRIG levels
could be attributed to genetic influences after controlling for age and obesity.
Increase in BMI and insulin had a significant adverse effect on the lipid profile in
these female twins, effects which may enhance coronary risk.
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
12
1
1998
5
1
STUDY OF LATE POTENTIALS IN PEDIATRIC PATIENTS AFTER OP EN HEART SURGERY
1
4
EN
ALI AKBAR
ZEINALOO
the Department of Pediatric Cardiology, Childen's Medical Center, 62 Gharib Ave., 14194-Tehran, Islamic Republic of Iran.
JG
SHAKIBI
From the Department of Pediatric Cardiology, Shahid Rajai Heart Hospital, Tehran
A
A. SHAH-MOHAMMADI
From the Department of Pediatric Cardiology, Shahid Rajai Heart Hospital, Tehran
This study was conducted to assess the incidence of abnormalities of
ventricular depolarization (late potentials) in children with sinus rhythm after open
heart surgery and their relation to spontaneous ventricular tachycardia. Open heart
surgery, particularly operations involving ventriculotomy, may predispose patients
to the development of ventricular tachycardia (VT) or ventricular fibrillation (VF).
Previous studies on children with right bundle branch block (RBBB) have shown
that late potentials may be a risk factor for developing VT or VF following open
heart surgery. After corrective surgery for congenital heart defects, scars may
create fractionation and delay of the electrical signals in the heart muscle,
providing a substrate for arrhythmias and sudden cardiac death.
To find normal values of signal averaged EKG (SA-EKG) indices in children
and their changes following open heart surgery, we studied 20 normal children and
20 children with congenital heart disease (CHD) following total correction of heart
defects without ventriculotomy. All patients were in normal sinus rhythm and did
not have RBBB. The mean age was 8.8±2.6 years for the control group and K 1±2.1
years for the operated patients. SA -EKG was performed for the operated group on
the day before and on the 2nd and 4th days after operation. Noise level was less
than 1 microvolt. The SA-EKG parameter values were as follows: control group:
filtered QRS-duration 40Hz (F. QRS-d), 84.2±9.5 ms high frequency low
amplitude signals (HFLA) , 18.9±9.5 ms rootmean square 40 (RMS 40), 181.0±89.4
µv patients: F.QRS-d, 97.2±19.3*, 116.4±21.2* and 122.2±220.4before operation,
2nd day post-op and 4th day post-op, respectively HFLA, 205±22.3, 8.9±7.0*,
and 15.4±16.4ms,respectively RMS40, 146.4±11O.9,92.1±65.9,and 112.8±60.3,
respectively. Values marked with an asterisk are statistically significant.
Except for a significant difference between the QRS duration of normal
children and pre-op values of operated patients (p<0.05), there was no remarkable
difference between the SA-EKG values pre- and postoperatively.
This study in which there was no RBBB, contrary to previous studies, shows
that SA-EKG indices are not a predictive value for VT or VF postoperatively.
Increased thickness of the ventricular myocardium may be a reason for the
increased QRS duration before operation.