2 1016-1430 Iran University of Medical Sciences 1660 Pharmacology ADENOSINE IN THE CENTRAL NERVOUS SYSTEM HOSSEINZADEH H b STONE T.W c b From the Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran. c From the Department of Pharmacology, Glasgow University, Glasgow, Scotland, U.K. 1 2 1996 9 4 361 368 17 11 2012 Besides being a metabolite of nucleotides like ATP, adenosine is a mediator of neuronal function in the central nervous system. Its actions are mediated by at least three extracellular receptors. In this review different aspects of adenosine such as biosynthesis, release, inactivation and its receptors are discussed. It also covers pre- and postsynaptic effects as well as postreceptor mechanisms of adenosine. Finally, therapeutic aspects of this neuromodulator have been discussed.
1659 Parasitology and Mycology ASSOCIATION OF ABO AND Rh(D) BLOOD GROUPS WITH TRICHURIASIS IN THE NORTH OF IRAN SADJADI M d MASSOUD J e d Dept. of Microbiology, School of Medicine, Shiraz University of Medical Sciences, P.o.Box 71345•1798, Shiraz, Islamic Republic of Iran. e From the Dept. of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences. Tehran, Islamic Republic of Iran. 1 2 1996 9 4 359 360 17 11 2012 1658 Otorhinolaryngology HYDATID DISEASE OF THE SUBMANDIBULAR GLAND KHADEMI B f PEYVANDI A.A ALAVI K f From the Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran. 1 2 1996 9 4 357 358 17 11 2012 Echinococcosis is a tissue infection of the human caused by the larval stage of Echinococcus granulosus or E. multilocularis. Hydatid cyst of the head and neck region is uncommon and involvement of the salivary glands, especially the submandibular gland, is very rare. In this article, a case of submandibular gland hydatid cyst is reported in a patient who presented with swelling of this area of 5 months' duration. Examination revealed a soft, nontender, mobile mass measuring 7x5 cm. Chest x-ray and abdominal ultrasonography were normal. Excision of the mass was performed and pathologic examination revealed a hydatid cyst of the submandibular gland. 1657 Pediatric CONGENITAL PERMANENT DIABETES MELLITUS WITH HYPOP LASIA OF THE PANCREAS: REPORT OF 2 CASES AND REVIEW OF THE LITERATURE KARAMIZADEH Z i AMIRHAKIMI G.H i From the Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran. 1 2 1996 9 4 355 356 17 11 2012 Two siblings (a girl and a boy) with intrauterine growth retardation and earlyonset insulin dependent diabetes mellitus, who had a clinical syndrome consistent with' congenital pancreatic hypoplasia will be reported. 1656 Neurosurgery NEUROGENIC HYPERTENSION: REPORT OF FIVE CASES TO HIGHLIGHT THE CONTROVERSY TABATABAI S.A.F k HUSSAIN KHAN Z SABERI H k From the Dept. of Neurosurgery and Anesthesia, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 2 1996 9 4 351 354 17 11 2012 The entity of "neurogenic hypertension" is defined as arterial hypertension caused explicitly by derangement of the intricate network of the central nervous system. Among 193 cases of cranial rhizopathies operated on between 1984 and 1995 at this center, 5 cases of established arterial hypertension with concomitant rhizopathies also underwent ventrolateral medullary decompression. The elevated blood pressure showed an incredible decline, reaching normal values after vascular decompression. The systolic blood pressure however showed a much greater fall than the diastolic component. An endeavour is made to throw light on the cases operated on with special emphasis on the central nervous system as an etiological factor to explain the cause of essential hypertension. 1655 Clinical Biochemistry COMPARISON OF THE PATTERN OF DIST RI BUTION OF AFLATOXIN B 1 METABOLITES IN ADULT AND NEWBORN RATS CHELCHELEH M ALLAMEH A o HAJIZADEH E RASSAEE M.J o From the Department of Biochemistry, Faculty of Medical Sciences, Tarbiat Modarress University, P.O.Box 141554838, Tehran, Islamic Republic of Iran. 1 2 1996 9 4 347 350 17 11 2012 Recently we have reported that newborn rats are deficient in the key enzymes involved in the biotransformation of aflatoxin Bl (AFBl), a known hepatocarcinogen. Based on these data, in vivo experiments were carried out in order to investigate the bioavailability of this carcinogen in newborn rat tissues. Administration of a single dose (i. p.) of [3HlAFB 1 to groups of adult and neonatal rats resulted in the differential distribution of AFB 1 metabolites in these animals. Uptake of aflatoxins by neonatal rats was about 50% of that in adults at all time intervals. In newborn liver, the level of aflatoxin reached its maximum 6 h after injection, and gradually decreased during the following 12 aod 24 h. In adult liver the uptake was highest 2 h after AFB 1 administration. A decrease of radioactivity in liver relative to time was associated with a surge in aflatoxin levels in the sera of both age groups. Excretion of AFB 1 metabolites was comparatively faster from newborn than from adult kidneys. Much lower radioactivity was measured in tissues such as stomach, intestine and lungs compared to liver. These observations indicate that the neonatal rat liver is less efficient in the bioactivation of AFBl, as a result of which free AFB 1 (nonmetabolized) may remain for a longer period of time in the organs of immature rats. 1654 Physiology CARDIOVASCULAR RESPONSES TO HYPERCAPNIA AND VARYING LEVELS OF ARTERIAL pH IN THE ANESTHETIZED CAT DEHGHANI G.A KHOSHBATEN A From the Dept. of Physiology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran. From the Department of Physiology, Faculty of Medical Sciences, Imam Hossein University, Tehran, Islamic Republic of Iran. 1 2 1996 9 4 341 345 17 11 2012 Effects of acute hypercapnia on the cardiovascular system (CYS) were studied in the anesthetized cat. After surgery the animal was exposed to a gas mixture of 12% CO2 and 25% O2 in nitrogen, and hypercapnia with low levels of arterial pH (pHa) was produced for 20 minutes. In the second run the same level of hypercapnia was induced by ventilating the same cat from the above gas mixture but pHa was kept normal by a slow and continuous infusion of 1HAM (0.5 mM/ kg/min). Results of this study showed that hypercapnia increased aortic flow and induced peripheral vasodilation. Hypercapnia produced tachycardia in the presence of arterial acidosis whereas in its absence this response reversed to bradycardia. Hypercapnia increased mean arterial blood pressure (Pa) by 20% during low pHa, whereas this increase was only 10% in the absence of arterial acidosis. Therefore, it is concluded that hypercapnia in conjunction with arterial acidosis has a much stronger stimulatory influence on the CYS via different arterial chemoreceptors. 1653 Microbiology and Anatomy CIGARETTE SMOKE/ETHANOL-INDUCED LIMB DEFECTS IN MOUSE EMBRYOS FAZEL A From the Department of Anatomy, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran. 1 2 1996 9 4 333 340 17 11 2012 We have produced a spectrum of limb defects in developing mouse embryos by exposing the mother to smoke from cigarettes with different nicotine concentrations, ethanol, and a combination of ethanol and cigarette smoke. The critical time of exposure was determined to be during day 10 of gestation (vaginal plug=day 0). This time is prior to the critical events which occur between the apical ectodermal ridge and the developing limb mesenchyme. When pregnant animals were exposed to smoke from two high-nicotine cigarettes (at 10:30 a.m. and II :30 a.m. on day 10), no limb defects were observed. If ethanol was given (0.015 mg/g 25% i.p. in two doses on the morning of day 10) one percent of offspring showed a limb defect. By contrast, exposure to a combination of cigarette smoke and ethanol resulted in 43% (44/102) of newborns developing both fore - and hindlimb defects. Birth weight was reduced by about 33% in animals carrying the defects. When mesenchyme cells beneath the limb apical ectodermal ridge were examined two days after teratogen exposure, striking changes in cell shape and size were evident. In as much as the incidence of mesenchymal changes in the limb buds seen on day 12 parallels the incidence of malformations seen in newborns, we postulate that anomalous limb development is secondary to the events occurring in the limb mesenchyme. We conclude that critical stages of development occur in the limb buds, and therefore certain teratogens or combinations of teratogenic agents may interfere with their normal development. 1651 Internal Medicine INFLUENCE OF GLYCOSAMINOGLYCANS ISOLATED FROM THE RAT LIVER WITH VARIOUS STAGES OF CARBON TETRACHLORIDE-INDUCED FIBROSIS UPON COLLAGEN FIBRILLOGENESIS IN VITRO KUCHARZ E.J From the Department of Internal Medicine, Silesian University School of Medicine, Tychy, Poland. 1 2 1996 9 4 327 332 17 11 2012 The influence of glycosaminoglycans (GAG) on collagen fibrillogenesis in vitro was investigated. GAG and collagen were isolated from the liver of rats treated with carbon tetrachloride at various time intervals (3-16 weeks). It was found that GAG obtained from the fibrotic liver accelerated collagen fibril formation. This effect was more evident in a solution of type I collagen than type III collagen. Studies on the liver samples showed that collagen was relatively slowly liberated in a solution of acid from the fibrotic liver as compared to normal tissue. The observed phenomena were related to the stage of fibrosis, i.e., to the duration of carbon tetrachloride treatment. Therefore, a role for GAG alteration in the development of hepatic fibrosis is suggested. 1650 Clinical Biochemistry A STUDY ON THE HEMOPOI ETIC ACTIVITY OF HUMAN PLACENTA IN VITRO, IN THE PRESENCE AND ABSENCE OF STIMULATORS AND INHIBITORS OF TRANSCRIPTION AND TRANSLATION GOLIAEI B EMADI S From the Institute of Biochemistry and Biophysics, Tehran University, Tehran, Islamic Republic of Iran. 1 2 1996 9 4 319 325 17 11 2012 The hemopoietic activity of the human placenta was studied in vitrc under various conditions in order to assess the optimal conditions of protein synthesis and colony stimulating factor (CSF) production by this tissue. The hemopoietic activity of placental tissue was assayed by the semi -solid agar medium technique. In order to obtain maximum hemopoietic activity, various stimulators were examined and it was determined that lipopolysaccharide was the most potent stimulator. Inhibitors of transcription and translation were also examined alone and in the presence of stimulators. They potently suppressed hemopoietic activity. Pulse-chase studies with the use of 3H -leucine were used to determine the kinetics of protein synthesis of placental tissue ill vitro. 1648 Parasitology and Mycology CRYPTOSPORIDIOSIS IN CHILDREN WITH DIARRHEA SUBMITTED TO HEALTH CENTERS IN THE WEST OF IRAN (HAMEDAN) FALLAH M HAGHIGHI A From the Department of Parasitology, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Islamic Republic of Iran. 1 2 1996 9 4 315 317 17 11 2012 There have been a few reports from Iran concerning infection by Cryptosporidium species, but they have referred particularly to infection in animals and their handlers. This study of infection in humans was carried out over a two year period in a large urban area in a cold region of western Iran. 554 stool specimens were examined with modified Ziehl - N eelson (MZN) staining for Cryptosporidium spp., along with appropriate methods for other parasites. The infection rate for Cryptosporidium spp. was 5.4% in children suffering from diarrhea. In addition, seven patients were found to be co-infected by other parasites. This study revealed that Cryptosporidium spp. are a relatively common parasitic cause of diarrhea in this region of Iran. 1646 Infectious Disease EVALUATION OF BCG IMMUNIZATION WITHIN THE FIRST 60 DAYS OF LIFE SHARIATZADEH M.R From the Department of Infectious Diseases, School of Medicine, Urumieh University of Medical Sciences, Urumieh, Islamic Republic of Iran. 1 2 1996 9 4 311 314 17 11 2012 The purpose of this study was to evaluate the efficacy ofthe BCG vaccine in the fIrst 60 days of life in inducing delayed-type hypersensitivity (DTH), and to evaluate the reliability of the Mantoux test in comparison with the BCG test for detecting DTH. A study was done in 885 healthy, well nourished infants 5 to 7 months old from rural areas of the Urumieh province, who received BCG immunization in the first 60 days of life. The subjects were evaluated in two random groups the fIrst group underwent the BCG test and for the second group a Mantoux test was performed (with 5TU). A total of 84.2% of infants had BCG vaccine scars. Cases who had received the BCG test had a positive reaction in more than 90% and those who had scars showed increased positivity. In the second group, 63% had a negative PPD reaction (0-4 mm induration), 23.8% were weakly positive (i.e., 5-9 mm induration), and only in 13.2% was a positive reaction (10 mm or more induration) found. So in spite of successful induction ofDTH by BCG vaccination at birth, the tuberculin test is not a reliable method for detecting hypersensitivity. 1645 Health MATERNAL HEIGHT AS A CONTRIBUTORY FACTOR TOWARDS BIRTH OF SMALL FOR DATE IN FANTS MAJD A EFTEKHAR H AZORDEGHAN F From the School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 2 1996 9 4 307 310 17 11 2012 A case control study of "small for date" and premature infants was conducted at 17 hospitals in Tehran between December 1989 and June 1990. The study population consisted of mothers of 347 small for date, 261 premature and 1164 normal infants. Mothers who were less than 18 years old and their height less than 155 cm had a statistically significant RRF. (2.18) for the birth of small for date infants, while mothers of the same age group but with a height of 155-159 or 160-165 cm had an RR.F. of 2.61 and 1.41, respectively. It was therefore concluded that an increase in height did not decrease the R.R.F. for birth of small for date infants in teen-age mothers. Mothers older than 18 years, 18-29 and 30-39 years with a height of less than 155 cm had an RR.F. of 1.63 and 1.47, respectively, both being statistically significant concerning the birth of small for date infants. Whilst in mothers taller than 155 cm and older than 18 years no-significant risk factor was noted, it was concluded that a maternal height of less than 155 cm seems to be a contributory factor to birth of small for date infants. In this study no association was established between maternal height and prematurity. Since 57% of LBW infants were small for date, any measures aiming at decreasing this figure would be beneficial to the individual as well as to the community. Short-term measures such as marriage at an older age, availability of contraception to teen-age mothers, and more years of education for girls may help decrease the proportion of small for date infants 1644 Neurosurgery CLINICAL ASPECTS OF SPINAL CORD MENINGIOMAS: ANALYSIS OF FORTY CASES MEHRAZIN M RAHMAT H ES-HAGHl G From the Department of Neurosurgery, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 2 1996 9 4 301 305 17 11 2012 A retrospective analysis was performed on forty cases of spinal cord meningiomas, operated on at Dr. Shariati Hospital from 1976 to 1990. Age and sex distribution, clinical presentation and tumor location were comparable to those reported by others. In males the tumors were distributed evenly in cervical and dorsal areas and were often anterior to the cord. This finding makes a different surgical approach necessary. For prevention of postoperative CSF leakage and infection, repair and tight closure of the dura is mandatory. Concerning prognosis, even in paraplegic patients the chance of complete recovery is good. 1643 Special THALLIUM-201 STRESS TEST IN 156 PATIENTS WITH SUSPECTED CORONARY ARTERY DISEASE NOOHI F FIROOZABADY S.H RASTGOO F MOHEBBI A ABBASPOUR F DEHGHAN M YAGHOOBI N From the Departments of Nuclear Medicine and Cardiology, Shahid Rajai Cardiovascular Center. Tehran, Islamic Republic of Iran. 1 2 1996 9 4 295 299 17 11 2012 Currently, myocardial TI-201 scintigraphy is most often performed in conjunction with exercise stress testing in patients with suspected or known CAD. Stress thallium tests were performed for 156 patients with and without old myocardial infarctions complaining of chest pain. All of them underwent contrast coronary angiography. Perfusion defects were mostly manifested as reversible defects (R). Sensitivity of visual detection was generally 93%. The anteroseptal wall and septum showed defects more often than the other segments in patients with LAD stenosis. The inferolateral walls showed the least defects in RCA involvement. There was a significant difference between mean stenosis of LADs (90± 10%) and CXs (82±11 %) (P<O.0005), making sensitivity of detection low for stenosed CX arteries. 1641 Heart THE COMPARATIVE STUDY OF ANTIHYPERTENSIVE TREATMENTS (CSAT): BACKGROUNDS, METHODS, AND THE PRELIMINARY RESULTS (INTERIM REPORT) AREFI S.H KASSAIAN E MIRHAJI P ALI FEIZZADEH K From the Hypertension Clinic of the Cardiovascular Research Cerner, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 2 1996 9 4 285 293 17 11 2012 The "Comparative Study of Antihypertensive Treatments"-CSA T is a placebo-controlled, randomized, double-blind clinical trial, with the primary objective of comparing the efficacy of different pharmacological treatments of hypertension. Drug side-effects, patient compliance, and alterations in the patients' quality of life are also compared. Subjects with mild to moderate diastolic hypertension aged above 30 are randomized into either of 5 groups receiving methyldopa, atenolol, nifedipine, triamterene-H, or placebo. After a dose titration phase, the minimum drug dose required to achieve a therapeutic goal of less than 91 mmHg for diastolic blood pressure (DBP) is determined, and the patient then enters a maintenance phase of 6 months. This report presents the preliminary results of drug efficacy in 136 subjects who have completed the dose titration phase. Age, sex, baseline systolic blood pressure (SBP) and baseline DBP were all well balanced across placebo and drug groups: mean age ± SD = 51.9 ± 9.2 years sex distribution: 56.6% males: mean DBP ± SD = 98.5 ± 5.4 mmHg mean SBP ± SD = 152.1 ± 14.4 mmHg (SD = standard deviation, SBP and DBP values were measured in the sitting position). SBP and DBP reduction in the active treatment groups (mean ± SE: 17.8 ± 1.4 mmHg for SBP, 12.4±0.7 mmHg for DBP) were significantly greater than in the placebo group (mean± SE: 7.9± 1.6 mmHg for SBP, 7.23 ±0.9 mmHg forDBP) at the end of the dose titration phase (P < 0.00001). There was greater SBP reduction with atenolo1 23.9 ± 3.2 mmHg) than with either nifedipine (12.5 ± 2.3 mmHg) or triamterene-H (16.2 ± 2.7 mmHg), P<0.05. This difference was not observed in patients aged above 50, but was significant in the below 50 age group. Pharmacological treatment was more efficacious in SBP reductionin women than in men (22 ±2.1 mmHg in women versus 14.0± 1.7 mmHg in men, P<0.01). No similar difference between the two sexes was detected in the placebo group. This interim report of the CSAT emphasizes the importance of pharmacological therapy, and depicts significant differences in the antihypertensive efficacy of various drug groups. Establishing new research centers and reaching desired sample sizes are currently being undertaken. 1640 Surgery MYASTHENIA GRAVIS AND THYMECTOMY: A 10-YEAR STUDY IN SHIRAZ HODJATI H YOUSEFIPOUR G From the Departments of Surgery, Shiraz University a/Medical Sciences, Shiraz, Islamic Republic of Iran. From the Department of Neurology, Shiraz University a/Medical Sciences, Shiraz, Islamic Republic of Iran. 1 2 1996 9 4 281 283 17 11 2012 A retrospective comparative study was performed on 54 patients treated medically or surgically (thymectomy) for myasthenia gravis (MG) from 1979- 1989 in three Shiraz University Hospitals. Each surgical patient was compared with a medical patient on the basis of age, sex, severity and duration of disease. Complete remission was noted in 3 out of 27 thymectomized patients but in none of the medically treated patients. Improvements occurred in IS of 27 surgical patientS and 4 out of 27 medically treated patients during 4 years of follow-up. Patients undergoing thymectomy had a significantly better chance of long survival. Three patients in the medically treated group had died because of myasthenia gravis as compared to 1 in the surgically treated group. Concerning survival in relation to sex, duration of symptoms and age, there was no significant difference between the two groups. Until more effective treatment becomes available for myasthenia gravis, thymectomy deserves consideration for all patients with chronic symptoms. 1639 Orthopedic INCIDENCE OF CONGENITAL DISLOCATION THE HIP IN SHIRAZ ABDINEJAD F TAKAPOUY J ESKANDARI N Assistant Professor of Orthopedic Surgery, Department of OrthopedicSurgery, Shiraz University of Medical Sciences, Shiraz , Islamic Republic of Iran. Residents of Orthopedic Surgery, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran. Residents of Orthopedic Surgery, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran. 1 2 1996 9 4 275 280 17 11 2012 During an eight month prospective study, 8240 newborns were examined for detection of congenital dislocation of the hip from Oct. 23, 1991 to June 22, 1992. On fIrst examination we found 1302 neonates (158/1000 live births) to have abnormal hips 1063 (81.6%) were prone to subluxation (subluxatable), 218 (16.81 %) prone to dislocation (dislocatable), 17 (1.3%) were dislocated and 4 (0.3%) were teratologic. The newborns with abnormal hips were followed in a neonatal OPD held for this purpose. After the sixth month of life 1272 (97.7%) of the neonatally unstable hips had resolved spontaneously, leaving 30 hips with true congenital dislocation (3.6/1000 live births).