2 1016-1430 Iran University of Medical Sciences 1636 Medical Mycology and Biotechnology STUDY OF TWO CASES OF CUTANEOUS AND SUBCUTANEOUS NOCARDIOSIS KHOSRAVI A.R b EMAMI M b From the Department of Medical Mycology and Parasitology, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 169 172 17 11 2012 16 03 2013 Presence of fungal agents in lesions of two patients in Tehran was studied. One of them had clinical symptoms of mycetoma in his foot, and the other had a skin infection in his arm. Examination of the lesions indicated Nocardia asteroides. These patients did not show any evidence of nocardia infection in other parts of the body. Negative results were obtained from the cultures of blood and sputum.
1635 Surgery REFLEX BRADYCARDIA IN CRANIOFACIAL SURGERY: REPORT OF THREE CASES TAHER A.A d d From the Department of Oral and Maxillofacial Surgery, Baqiet Ulla General Hospital, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 167 168 17 11 2012 16 03 2013 Three cases who underwent surgery in different areas of the craniofacial region were reported with bradycardia developing intraoperatively during flap traction. Many cases of the oculocardiac reflex during treatment of the orbital region have been reported in the literature. This manuscript recorded that reflex bradycardia can occur during traction or stretching of any structure innervated by the trigeminal nerve and thus the name trigeminal-vagal reflex is better than the name oculocardiac reflex. 1634 Internal Medicine HYDATID CYST OF THE THYROID RAJABIAN R e TAVASSOLl M GHIASSI T SHAKIB I M e From the Departments of Internal Medicine, Surgery, and Pathology, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran. 1 11 1991 5 3 165 166 17 11 2012 16 03 2013 Thyroid is a rare localization for hydatid cyst. Although the incidence of hydatid cyst is high in this geographic area, we have had only two cases of thyroid involvement in the last 10 years in Ghaem medical center in Mashhad. 1633 Pediatric AORTO-LEFT VENTRICULAR TUNNEL. A CASE REPORT WITH AORTIC PRESSURE AND ECHOCARDIOGRAPHIC FINDINGS BORZOOE M i TABATABAEI M.B i Form the Department of Pediatric Cardiology and Surgery, Shahid Rajai Heart Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 163 164 17 11 2012 16 03 2013 A seven-year-old girl with clinical diagnosis of aortic insufficiency underwent echocardiographic and hemodynamic evaluation and referred for surgery with the same diagnosis. However, at surgery, aorto-Ieft ventricular tunnel was found and repaired successfully. Review of echocardiogram and catheterization data revealed interesting findings to differentiate this rare entity from congenital aortic regurgitation. 1632 Pediatric TREATMENT OF PRECOCIOUS PUBERTY BY A LONG-ACTING GONADOTROPIN-RELEASING HORMONE ANALOGUE IN CHILDREN MOSTAFAVI F k RABBANI A k rom the Department of Pediatric Endocrinology, Children's Hospital Medical Center of Ahari, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 159 161 17 11 2012 16 03 2013 The GnRH analogue has been shown to be effective in the treatment of precocious puberty when given as a daily subcutaneous injection. We studied the effectiveness of a long-acting GnRH analogue, Triptoreline, for the treatment of central precocity, by suppressing gonadotropin and estradiol secretion in three children with true precocious puberty. One month after single dose intramuscular injection of depot GnRH analog Triptoreline, our patients showed significant decreases in serum estradiol and blunting of the responses of LH and FSH to GnRH test. No adverse effects were noted during the first six to eight months of treatment. 1631 Clinical Biochemistry A REPORT OF RAPID AND EFFICIENT METHOD FOR MITOCHONDRIAL DNA EINOLLAHI N m FARZAMI B AZIMI-GARAKANI C m From the Dept. of Medical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 155 157 17 11 2012 16 03 2013 Based on the similarity of prokaryotic DNA to that of mitochondrial DNA, a rapid and efficient method for DNA purification from mitochondrial extracts obtained from different sources, was carried out based on the modification method described by Marmur (1983) which resulted in a high degree of purity (A260/A280=2). In addition we have applied the same technique for the first time to purify the mitochondrial DNA of platelets. 1629 Clinical Biochemistry THE EFFECT OF THEOPHYLLINE ON THE PRODUCTION OF COLONY STIMULATING FACTOR (CSF)BY THE LUNG RABBANI A p BOOJAR M GOLIAEI B p From the Institute of Biochemistry and Biophysics, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 149 154 17 11 2012 16 03 2013 The effect of theophylline on colony stimulating factor production by the lung tissue was investigated. Addition of various concentrations of theophylline to the lung conditioned medium enhanced CSF production at 10 µg/ml and at higher concentrations showed an inhibitory effect. Determination of the phosphate content of the medium showed a decrease at 1-3 hours of incubation. Addition of AMP to the cultures in the presence of theophylline had no effect on the CSF production but compensated phosphate content of the lung cultures. Exogenous cAMP or its dibutyryl derivative also stimulated CSF production. On the other hand IBMX, another inhibitor of phosphodiesterases, exerted similar effect as theophylline. The results suggest that cAMP regulates CSF production by the lung. 1628 Endocrinology SERUM LEVELS OF PROLACTIN, THYROTROPIN, THYROID HORMONES, TRH RESPONSIVENESS, AND MALE REPRODUCTIVE FUNCTION IN INTERMITTENT ISLAMIC FASTING AZIZI F From the Endocrine Research Center and the Department of Medicine, Shaheed Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 145 148 17 11 2012 16 03 2013 During the Islamic lunar month of Ramadan millions of Muslims abstain from drinking and eating from dawn to sunset. The objective of this study was to investigate the effect of intermittent Islamic fasting on reproductive function, hypothalamic-pituitary-thyroid axis and the peripheral metabolism of thyroid hormones in men. We measured serum levels of FSH, LH, testosterone, prolactin, TSH, T4, T3 and T3 uptake, and prolactin and TSH responses to TRH, before, at 10th, 20th and 29th days of Ramadan and four weeks after fasting month was terminated. Subj ects were nine healthy men who fasted 17 hours a day for 29 days. There were no significant changes in serum levels of any of measured hormones during Ramadan. Prolactin and TSH responses to TRH were also unaltered. The only positive finding 'Yas increased serum T4 of 1.5 to 2.8 Ilg/dl and increased free T4 index (FT4I) in five of nine subjects in the last days of Ramadan. We conclude that 1) Intermittent abstinence from food and drink for 17 hr a day, as is observed in Islamic fasting, does not alter male reproductive function, hypothalamic-pituitary-thyroid axis, or peripheral metabolism of thyroid hormones. 2) In some subjects slight increase in serum T4 may occur in the last days of Ramadan. 1627 Parasitology and Mycology STUDY OF THE ETIOLOGIC AGENTS OF MYCETOMA AND SPOROTRICHOSIS IN THE NORTH OF IRAN (GILAN AND MAZANDARAN PROVINCES) MOGHADDAMI M SHIDFAR M.R OMIDI K MAHMOODI T Form the Department of Medical Mycology, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 139 143 17 11 2012 16 03 2013 During 2 years, from March 1987 to April 1989, 600 samples of soil and plant were collected from different cities of northern provinces of Iran. Out of the six hundred samples 58 Actinomycetes, 9 Pseudallescheria boydii, 10 Sporothrix schenckii, and 4 Sporothrix schenckii-like fungi were isolated as the following: Streptomyces griseus from 31 samples (38.27%), Nocardia asteroides from 8 samples (9.87%), Actinomadura madura from 8 samples (9.87% ), Streptomyces lavendulae from 6 samples (7.4 % ), Nocardia autotropica from 3 samples (3.7%) Streptomyces rimosus from 1 sample(1.24%), Nocardia carnea from 1 sample (1.24%), Pseudallescheria boydii from 9 samples (11.11 %), Sporothrix schenckii from 10 samples (12.34%), Sporothrix schencii-like fungi induding ceratocystis sp.from 2 samples (2.48%), Doratomyces purpureofuscus from 1 sample (1.24%), and Scopulariopsis candida from 1 sample (1.24%). 1626 Pharmacology ANTICONVULSANT THERAPY-INDUCED ALTERATIONS IN CALCIUM HOMEOSTASIS GHAFGHAZI T JAMSHIDI H.R GHORBANI A From the Departments of Pharmacology and Neurology, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran. 1 11 1991 5 3 135 137 17 11 2012 16 03 2013 35 epileptic patients, aged 10 to 58 years (mean 23), who were taking anticonvulsant drugs were studied. The patients exhibited a 34% reduction in serum calcium levels, a 41 % increase in serum alkaline phosphatase activity and a slight but insignificant decrease in serum phosphate, compared to untreated controls. These changes appear to be related to the anticonvulsant drug taken, in the following order of decreasing importance: phenytoin + phenobarbital + carbamazepine phenytoin + phenobarbital phenytoin + carbamazepine,and phenobarbital + carbamazepine. It is possible that anticonvulsant drugs alter vitamin D metabolism which results in disturbance of calcium homeostasis. Moreover these changes in serum calcium and alkaline phosphatase activity in anticonvulsant treatment patients are similar to those in patients with osteomalacia. 1624 Health NEONATAL MORTALITY IN RELATION TO BIRTH WEIGHT EFTEKHAR H AZORDEGAN F From the School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 131 134 17 11 2012 16 03 2013 730 low birth weight (LBW) neonates and 1460 controls were selected from 13,123 neonates born from October 1988 to June 1989 in 17 hospitals and maternity units in Tehran, and were compared for mortality in the first seven and up to 28 days of life (early neonatal period). In this study all low birth weight newborns are divided according to four sub-groups of birth weight, and the mortality within the first seven (early neonatal mortality) and up to twenty eight days of life (neonatal mortality) is examined in both groups. Part of the results are as follows: I- low infants comprise 5.6% of total newborns, 2- 14.3% of LBW neonates die within the first seven days of life, 3-75% of very LBW neonates (less than 1500 g) die within the first seven days of life, 4- low birth weight neonates have a mortality rate twenty four times that of normal birth weight infants in the first and fourth weeks of life, 5- neonatal mortality rate in this study was 18 per thousand. 1623 Immunology THE STUDY OF OPSONIZATION ACTIVITY OF THE PHAGOCYTOSIS PROCESS IN MENINGITIS, SEPSIS, AND RECURRENT INFECTION IN CHILDREN NEZAM DIBA S FARHOUDI A From the Department of Immunology, the Children's Hospital Medical Center, Tehran university of Medical Sciences, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 125 129 17 11 2012 16 03 2013 In this survey, opsonization activity of sera in 110 patients with meningitis, sepsis and recurrent infection 12 patients after healing and 50 normal adults has been studied. Opsonization activity was measured by an assay depending on electronic particle counting to measure yeast uptake (alternative pathway activator) which was modified in our laboratory. Three classes of immunoglobulins (lgG, lgM, lgA) and C3 levels were also studied depending on single radial immunodiffusion by using Behring kit in our patients. 54 pathological sera with defective opsonization showed low C3 levels, two with lower than normal opsonization activity showed low C3 levels, 11 defective opsonization cases showed normal C3 levels, 3 of which were related to diabetic patients. 22 instances of decreased 19G, 14 cases of decreased 19M and 18 cases of decreased lgA were observed in 110 patients. The opsonization activity, C3 and immunoglobulin levels in 12 patients have become normal after healing. 1621 Community Medicine BLOOD PRESSURE COMPONENTS AS PREDICTORS OF ISCHAEMIC HEART DISEASE MORTALITY IN THE WEST OF SCOTLAND JANGHORBANI M HEDLEY A.J ZHIANPOUR M JONES R.B GILMOUR W.H From Department of Community Medicine. Kerman University 0f Medical Sciences, Kerman, Iran. From the Department of Community Medicine, University of Glasgow, Glasgow G12 8QQ. UK. From the Department of Community Medicine, University of Glasgow, Glasgow G12 8QQ. UK. From the Department of Community Medicine, University of Glasgow, Glasgow G12 8QQ. UK. From the Department of Community Medicine, University of Glasgow, Glasgow G12 8QQ. UK. 1 11 1991 5 3 117 123 17 11 2012 16 03 2013 The relative importance of systolic blood pressure (SBP) versus diastolic blood pressure (DBP) in predicting the risk of ischaemic heart disease (IHD) mortality is controversial. We have re-examined SBP compared to D BP and other combinations of SBP and D BP in predicting the risk of IHD mortality in a long-term cohort study oflO,541 men and women in the West of Scotland. During a mean follow-up of 11.6 years, 1,616 deaths occurred, among which 553 (34% 327 male, 181 female) were caused by IHD. In a multiple logistic regression (MLR) model the predictive values of SBP, DBP, mean arterial pressure (MAP), mean arterial index (MAl), and pulse pressure (PP) were examined in relation to IHD mortality after adjustment for age, body mass index (BMI), casual blood glucose, serum cholesterol and cigarette smoking at entry. All blood pressure measures were associated with IHD mortality in females the risk of IHD deaths was more strongly associated with SBP in males SBP and DBP had similar predictive strength. 1620 Microbiology and Anatomy LOWER LUNG FIELD TUBERCULOSIS: AN ANALYSIS OF 146 CASES HEIDARNEDJAD H BAHRAMI A From the Department of Medicine and Center for Tuberculosis Control, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran. 1 11 1991 5 3 111 116 17 11 2012 16 03 2013 Medical records of 146 patients with lower lung field tuberculosis were reviewed. There was a female to male ratio of5: 4. More than 75% of patients were under 35 years of age and average duration of symptoms before diagnosis was less than one month in 7% , between 1 -6 months the in 63 % and more than 12 months in 10% of our patients. PPD test was positive in 80% and direct sputum smear for acid-fast bacilli was positive in 88% of cases. Radiologically, tuberculous lesion was limited to right lower lobe (RLL) alone in more than 50% , left lower lobe (LLL) alone in 35% , while bilateral lower lobe involvement was found in 15% of our patients. Superior segments of right and left lower lobes were the most commonly involved segments respectively. Pulmonary infiltrates were nonhomogenous in more than 80% of cases while homogenous pneumonia-like consolidations were found in 15% of our series. 6 6% of patients had cavitary changes with air-fluid levels in 20%. Hilar adenopathy alone or in combination with paratracheal adenopathy was found in chest x-rays of 9% of cases. Fasting and two hour postprandial blood sugars were measured in 98 patients. Seven (7.1 %) had overt diabetes mellitus and all of them were diabetic at the time of diagnosis of tuberculosis. Five pregnant women, a medical student, a radiology technician, an old male with metastatic carcinoma of unknown primary origin under chemotherapy, a middle-aged woman with rheumatic heart disease (mitral stenosis) who acquired tuberculosis of superior segment of RLL after valve replacement, an old female with rheumatoid arthritis on nonsteroid anti-Inflammatory agents, a male with history of alcohol intake, a young male with alopecia totalis and a young female with tuberous sclerosis were included among our patients. 1618 Oncology CLASSIFICATION OF CONGENITAL MIDDLE AND EXTERNAL EAR MALFORMATIONS: CT STUDY SAVIC D JASOVIC A DJERIC D MITROVIC N From the Clinic of Otorhinolaryngology, University Clinical Center From the Institute of Oncology and Radiology, Pasterova 14, 1100 Belgrade, Yugoslavia. From the Clinic of Otorhinolaryngology, University Clinical Center From the Institute of Oncology and Radiology, Pasterova 14, 1100 Belgrade, Yugoslavia. 1 11 1991 5 3 105 109 17 11 2012 16 03 2013 The authors used high-resolution computed tomography (HRCT) for studying 52 congenitally malformed ears in 45 children between five and 10 years of age. In six children the malformations were bilateral. The malformations clinically manifested as microtia, atresia of the external auditory canal and conductive deafness. Analyzing anatomical details and pathological changes on HRCT axial sections the authors established three groups of malformations. In the first group, auditory assicles were malformed in almost all cases, in the second group besides deformed auditory ossicles in majority of cases, the mastoid was apneumatised, and in the third group there were malformed auditory ossicles and the mastoids were apneumatised and in more than half of cases cavum tympani was malformed or filled with mesenchyme. These features have great importance in surgical reconstruction of congenital middle ear malformations. 1616 Urology and Nephrology EXPERIENCE WITH BLADDER NECK INCISION TO RELIEVE BLADDER OUTLET OBSTRUCTION VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE IN SHIRAZ MANAHEJI F KHEZRI A.A From the Dept. of Urology, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran. 1 11 1991 5 3 101 103 17 11 2012 16 03 2013 TUR is cited as the treatment of choice for relief of bladder outflow tract obstruction in the male, but bladder neck incision (BNI) is an acceptable alternative when the gland is smalI.1,2,3 Sixty cases of BNIfTUR have been reviewed (BNI=35, TUR=25) from March, 1986 to April, 1988. BNI was done when the glands were less than 30 gr , and when there was no clinical suspicion of malignancy the operative technique of our single incision is given.4 In BNI the catheter stay was shorter, and there was less infection, a significantly reduced need for blood transfusion, and satisfactory outcome in terms of control and need forfurther surgery. BNI is a technically simpler procedure than TUR and is easy to teach and learn. Our results show it is safe and effective for patients in acute retention as well as those treated electively and is the operation of choice for a small benign prostate. In larger glands BNI may not be desirable. In matched cases this method provided better results and fewer complications than the standard transurethral resection. 1614 Infectious Disease FAMILIAL MEDITERRANEAN FEVER: A STUDY OF 32 CASES MONTAZERI A PAHLAVANAZDEH H From the Department of Medicine, Section of Infectious and Tropical Diseases, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran. 1 11 1991 5 3 97 100 17 11 2012 16 03 2013 From April 1983 to September 1990, 32 patients with familial mediterranean fever (FMF) were studied. FMF is characterized by short, self-limited, febrile episodes that occur with inflammation of serosal surfaces. Major symptoms include fever and abdominal pain, presenting as acute surgical abdomen. These attacks are associated with considerable morbidity and in some patients lead to unnecessary surgery. Diagnosis of this disease depends on the absence of any objective markers and the recognition of the symptoms in a susceptible individual. Duration of disease on admission was 1.5-19 years. Except in two pairs of siblings, no familial association was noted. This is the first review of the cases of FMF from Iran. 1612 Pathology PATTERN OF MALIGNANT TUMORS IN KERMAN PROVINCE GUPTA R.K TABRIZCHEE H From the Department of Pathology, Kerman University of Medical Sciences, Kennan, Islamic Republic of Iran. 1 11 1991 5 3 91 95 17 11 2012 16 03 2013 From March 1980 to March 1989 a total number of 2254 (7.6%) new malignant cases from Kerman province were diagnosed by examination of surgical specimens, blood films and bone marrow smears. The crude relative frequency of cancers was studied and compared with other areas of Iran. Gastric (11.36%) and urinary bladder (7.01 %) carcinomas were significantly more common in Kerman province than other parts of Iran. Esophageal malignancy was also common in this area. No significant difference was found in the pattern of lymphomas and leukemias. Frequencies of cancer of the cervix (3.24%) and oral cavity (3.73%) were less as compared to other parts of Iran. 1611 Neurosurgery THE PIVOTAL ROLE OF CRANIAL NERVER DECOMPRESSION TABATABAI A.F From the Dept. of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 1 11 1991 5 3 85 89 17 11 2012 16 03 2013 Reported are a total of 81 microsurgical operations for cranial nerve root decompression comprising of 66 trigeminal, 10 facial, one vestibular, one vagus and three accessory nerve dysfunction syndromes from 1983 to 1990. Almost all cases of trigeminal neuralgia (TNG) secondary to vascular (59 cases) and minute mass (10 cases) compression, and those with hemifacial spasm (HFS) (nine out of 10 cases) recovered with microsurgical decompression of these nerves. A comparison of results of different treatment modalities of TNG are discussed. Some recently reported series in the literature indicate the superiority of microvascular decompression (MVD) of the 5th nerve for the treatment of TNG. MVD of the 7th nerve has currently been accepted as a procedure of choice, albeit with reservations, in managing HFS. Despite our effective surgical outcome and satisfactory results obtained by others with MVD of the 8th, 10th and 11th nerves, long-term follow up of selected cases may further clarify the r9le of MVD on caudal cranial nerves.