Showing papers by "Tehran University of Medical Sciences published in 1996"

Traumatic aneurysms and arteriovenous fistulas of intracranial vessels associated with penetrating head injuries occurring during war: principles and pitfalls in diagnosis and management: A survey of 31 cases and review of the literature

Abstract: In the early days of the war between Iran and Iraq, reports of the sudden deaths of soldiers who previously had survived a penetrating head injury suggested the possibility that a late complication, traumatic aneurysm (TA), could be the cause of this catastrophe. In response, the authors planned a prospective study to perform cerebral angiography in victims with penetrating head traumas, especially in those who had artillery shells or bone fragments passing through areas of dense vasculature. Thirty-one TAs and arteriovenous fistulas were documented. Not all of the lesions, however, were deemed appropriate for surgical intervention. Six aneurysms (19.4%) healed spontaneously and shrank or disappeared on repeated serial angiograms. The authors present their cases and discuss the incidence of TAs, their natural course and behavior, and the special problems encountered in managing these interesting and potentially fatal complications of penetrating head injuries.

Meriones Iibycus and Rhombomys opimus (Rodentia: Gerbillidae) are the main reservoir hosts in a new focus of zoonotic cutaneous leishmaniasis in Iran

Abstract: Following an epidemic of zoonotic cutaneous leishmaniasis (ZCL) around Badrood city, central Iran, Meriones libycus were found to be naturally infected with Leishmania major zymodeme MON-26 (= LON-1) in the villages of Matinabad and Fami, 12 km north-west of Badrood. This is the first isolation and characterization of L. major from M. libycus in Iran, in an area where ZCL has been present recently. M. libycus is probably the principal reservoir host in this area, but the main reservoir host further east is Rhombomys opimus. Parasites were not found in Hemiechinus auritis. The main, proven vector to humans and gerbils is Phlebotomus (Phlebotomus) papatasi. The close contact between vectors and reservoirs creates a very efficient cycle for the transmission of the disease.

Epidemiological study of reservoir hosts in an endemic area of zoonotic cutaneous leishmaniasis in iran

Abstract: The study was carried out in the central part of the Islamic Republic of Iran over a 12-month period in 1991-92 in Borkhar, a rural district lying north of Isfahan city. The objective was to determine the ecology of natural reservoir hosts of leishmaniasis for possible future field trials of leishmania vaccine. The main reservoir host in this area is Rhombomys opimus, the great gerbil, followed by Meriones libycus, the Libyan jird, and Hemiechinus auritis, the long-eared hedgehog. Of the 179 small mammals examined in the Borkhar area, the great majority were R. opimus (82.1%), then M. libycus (15.7%), and last H. auritis (2.2%). The highest rate of infection of R. opimus was in September (90.5%), the rate varying between 22.2% and 80.4% in different villages. The average infection rate of M. libycus was 17.9%. These rodents probably play an important role as reservoir hosts in the epidemiology of zoonotic cutaneous leishmaniasis in this area. Sixteen domestic and stray dogs appeared to be uninfected because examination showed no active lesion or scar.

Is Estrogen Necessary after Hysteroscopic Incision of the Uterine Septum

Abstract: Study Objective. To evaluate the influence of estrogen after hysteroscopic incision of the uterine septum. Design. Prospective, randomized, blinded study. Setting. A national referral university hospital. Patients. Fifty women in whom hysterosalpingography (HSG) showed a fundal defect and had septate uterus confirmed by laparoscopy. Interventions . Preoperative HSG, hysteroscopic incision of the septum, and postoperative HSG. Four patients were omitted from the analysis because the angle of the uterus could not be corrected, as shown by postoperative HSG. Group 1 (23 women) received conjugated estrogen and progesterone postoperatively and group 2 (23 women) received no hormone. Measurements and Main Results. The ratios of the length of the septum to the length of the uterus in the HSGs obtained preoperatively (a/b) and postoperatively (a′/b′) were calculated and subtracted from each other (a/b-a′/b′). The means of the subtractions in the two groups were compared. Thet test was used for statistical comparison. The results showed no statistically significant difference. Conclusion . Estrogen has no apparent role after hysteroscopic incision of the septum.

Lead toxicity in employees of a paint factory

Abstract: Lead-based paint is an important cause of lead poisoning. This report describes our observation of excessive lead absorption among employees in a paint factory in which lead naphthenate and lead oxalate were used as drying agents in paint. In this study, blood levels of lead were compared between nineteen paint factory employees and twenty normal controls. The nineteen paint factory employees had a mean blood lead concentration of 50.71 �g/dL which was significantly (P<0.01) higher than that of controls (20.44 �g/dL). There was a good correlation between blood lead levels and job tenures of the employees [r= 0.55, confidence= 95% (0.13-0.81)]. Lumbar pain (47.37%), abdominal pain (42.1 %), renal complications (21 %), anxiety (39.1 %), nervousness (52.63%), headache (42.4%), peripheral pain (36.8%) and anemia (I 0.5%) were the chief complaints of these employees. The use of lead naphthenate and lead oxalate in paint is clearly associated with excessive air-borne exposure to lead. Technical and medical protective control of occupational exposures is needed in paint industries.

Effect of picrotoxin on antinociception in the formalin test.

Abstract: Subcutaneous injection of diluted formalin (0.25 microliter of 0.5%) caused a biphasic pain response in mice. The first phase of pain was observed during the first 5 min., while the second phase occurred 10-30 min. after formalin administration. With the formalin test, it was found that the antinociception produced by the GABA-A antagonist, picrotoxin, and the GABA-B antagonist, phaclofen, was abolished when employed in combination. The opioid antagonist naloxone and antimuscarinic atropine also decreased the picrotoxin response. However, sulpiride, SCH 23390, phenoxybenzamine and propranolol did not alter the picrotoxin response. Administration of naloxone, sulpiride and propranolol showed a pain response. The data indicate that dopaminergic and adrenergic mechanisms may not be involved in the picrotoxin antinociceptive effect. However, postsynaptic GABA-A and GABA-B may be involved in the drug effect, and involvement of opioid or cholinergic systems can not be excluded.

Monitoring of lead poisoning in simple workers of a copying center by flame atomic absorption spectroscopy

Abstract: Inorganic lead compounds are used most widely in paint and pigment industries. Because of exposure to lead dust in workers in a copying center, we compared blood lead levels in these workers to normal individuals and investigated the relationship between job tenures of the workers and their blood lead levels. This survey was performed on 20 simple workers in a copying center of Tehran University. The ages of the workers were between 27 and 62 years, and job tenures of the workers were between I and 27 years. Our results indicated that 94% of the workers had high blood lead concentrations (>49.9 Ilg/dl) and only 6% showed acceptable (30-49.9 Ilg/dl) blood lead levels. Blood lead levels of these workers were significantly higher than that of controls (P

Alterations of bromocriptine-induced penile erection by chronic lithium in rats.

Abstract: In the present study, the effects of chronic lithium pre-treatment (30 days) on penile erection (PE) induced by bromocriptine were investigated in rats. Intraperitoneal administration of the dopamine receptor agonist, bromocriptine (4-32 mg/kg) induced PE in a biphasic manner. The maximum response was obtained with 8 mg/kg of bromocriptine and the effect was decreased with increasing doses of the drug from 8 to 32 mg/kg. When animals were pre-treated with different doses of the D-1 dopamine receptor antagonist, SCH 23390, or the D-2 dopamine receptor antagonist, sulpiride, the PE response was decreased. The response induced by bromocriptine (4-32mg/kg) was reduced in animals pre-treated with chronic lithium. SCH 23390 did not produce a larger inhibitory effect on the bromocriptine response in animals pre-treated with chronic lithium, but the inhibitory effect of sulpiride was increased in this condition. It is concluded that chronic lithium treatment may alter the D-1/D-2 receptor activity and inhibit bro...

Effects of cyclosporine a on the functions of submandibular and parotid glands of rats

Abstract: 1 The present study was designed to investigate the possible effects of long-term (45 days) administration of therapeutic doses of cyclosporine A (25 mg/kg/day), on the functions of submandibular and parotid glands of rats Pure submandibular and parotid saliva were collected intraorally by microcannulation of the ducts 2 The weight gains of the treated animals during the study and the weights of the salivary glands at the end of 45 days were reduced significantly as compared with those of controls 3 Sialochemistry studies revealed a marked decrease in total protein concentration in saliva obtained from submandibular glands (P < 005) 4 Determination of electrolyte concentrations in saliva of submandibular gland and serum showed considerable differences between treated and control groups 5 Significant elevation of amylase activity in serum and parotid saliva was observed in the treated rats in comparison with controls (P < 0001) 6 Data presented here indicates that long-term administration of therapeutic doses of cyclosporine A causes significant alterations in salivary output and composition

Knowledge-based homology modeling and experimental determination of amino acid side chain accessibility by the laser photo CIDNP (chemically induced dynamic nuclear polarization) approach in solution: lessons from the small sialidase of Clostridium perfringens

Abstract: The success of knowledge-based homology modelling is critically dependent on the predictive potency of the program structure-based calculations, which attempt to translate homologous sequences into three-dimensional structures, and on the actual relevance of the crystal structure for the protein topology. As quality control, experimental data for selected parameters of the protein′s conformation are required. Using the crystal structure of the sialidase of Salmonella typhimurium as framework for model building of the homologous enzyme from Clostridium perfringens, a set of energy-minimised conformers is derived. These proteins present e.g. Tyr, Trp and His residues with an assessable area on the surface, since the side chains of these amino acid residues are responsive to chemically induced dynamic nuclear polarization (CIDNP), monitored by NMR. Hence, as first lesson, a comparative analysis for model-derived and experimentally determined values can be performed. The second lesson of this study concerns the notable impact of single amino acid substitutions (Tyr/Phe, Cys/Ser) on the surface accessibility of the CIDNP-reactive amino acid side chains in mutant forms of the sialidase. Corroborating the predictions from the theoretical calculations, the spectra of the engineered mutants reveal marked and non-uniform alterations. Thus, the effect of apparently rather conservative amino acid substitutions on a distinct conformational aspect of this protein, even at distant sites, should not be underestimated.

Laparoscopic ovarian transposition with subsequent intrauterine pregnancy

Abstract: A woman with a 3-year history of infertility underwent laparoscopic transposition of the ovary. This was followed immediately by a normal pregnancy.

The effect of concomitant use of neuroleptic drugs and lithium on the erythrocyte/plasma lithium ratio in Iranian patients with bipolar disorder.

Abstract: Patients treated with lithium (Li+) and neuroleptic drugs concomitantly are reported to show more pronounced adverse effects than patients on Li+ alone. There are conflicting results about the effect of neuroleptic drugs on the erythrocyte/plasma Li+ ratio and intraerythrocyte Li+ concentration, and methodological problems may be a reason for this. The effect of the concurrent use of neuroleptic drugs with Li+ on the Li+ ratio was studied in 66 patients with bipolar affective disorders during prophylactic Li+ therapy using the new direct method of measuring erythrocyte Li+ concentration. This new direct method has been shown to give much more precise and accurate results than the values obtained by other methods. No relationship was found between the Li+ ratio and sex, age, Li+ dosage, duration of treatment or plasma Li+ concentration. Results revealed that patients taking a combination of Li+ and neuroleptic drugs showed significantly lower Li+ ratios and intraerythrocyte Li+ concentrations as compared with those on Li+ alone. It is notable that this reducing effect of neuroleptic drugs was increased by the concurrent use of two types of neuroleptic drugs. The effect on neuroleptic drugs on the Li+ ratio may be mediated through a stabilizing effect of these drugs on the cell membrane and consequently Li+ transport in erythrocytes.

Down's syndrome: cytogenetic studies in 150 cases in tehran

Abstract: Cytogenetic studies were performed on 150 cases of Down's syndrome (DS) in Iran. The standard trisomy 21 was found in 132 (88 % ) and translocation-trisomy 21 (+21) in 18 (12%) patients, i.e., t(21,21) in 1(0.63%) and mosaicism in 17(11.33%) cases. The comparison of the frequencies for mosaicism between different populations such as Denmark, Hungary, Egypt, Iraq, India, Australia and Iran demonstrated a difference in geographic distribution. There was a high incidence in the north of Europe towards Egypt and Iraq which decreased towards Iran and further towards the eastern region in the Indian ocean and India and further decreased towards Australia. Statistical analyses demonstrated significant differences between the data in Iran and Copenhagen, Hungary and Australia for mosaicism and translocation +21, and India, for translocation +21. The occurrence of translocation +21 decreased significantly from Denmark towards Egypt in Africa and Iraq in southwest Asia, then it increased from Iran towards Australia in the Pacific ocean. The comparison of cells having satellite associations (SA), significantly indicated the involvement of two and three SAs in DS cases. The study on the position of chromosomes in the metaphase plate, the occurrence of chromatid breaks and endoreduplication did not present any significance in DS cases.

Sudden ventricular fibrillation during cathe terization due to lidocaine infiltration for local anesthesia in a 53 year old woman

Abstract: Mrs. Heidari, 53 developed ventricular fibrillation and cardiopulmonary arrest after receiving 15 mL lidocaine 2% for local anesthesia at the Dr. Shariati Hospital Cathlab. There was no identified risk factor for her arrest preoperatively. She had a history of exertional chest pain for about 5 years and an electrocardio­ gram showed only inverted T-waves at the time of angiography. The case is reviewed in detail and a discussion of lidocaine toxicity is presented.

Complication of Laparoscopic Coagulation of an Endometrioma Surface

Abstract: A 32-year-old infertile woman with a 9-cm right ovarian endometrioma with severe adhesions to nearby organs was treated with coagulation of the surface of the endometrioma during laparoscopy. Ultrasonography 6 months later showed a normal pregnancy with an 8-cm ovarian cyst. After a normal delivery at term, while cutting the adhesions on the right side, 200 ml of pus was released, the origin of which was not known. Another endometrioma was present on the left ovary. A drain was inserted into the peritoneal cavity and the operation was completed. Five months later the woman returned with a painful point of redness on the skin of her abdomen. Ultrasonography revealed an 8-week pregnancy. We drained the pus and the patient was discharged. The result of the culture was Escherichia coli. We believe this is a case of intestinal fistula caused by coagulation of the surface of the endometrioma in the first operation.

Clonidine-induced rhythmic activity in rabbit anococcygeus muscle

Abstract: 1. 1. Clonidine 0.5 mM induced an extremely regular rhythmic activity in isolated rabbit anococcygeus muscle. The movements were resistant to tetrodotoxin effect. 2. 2. Prazosin (5 × 10 −8 M-5 × 10 −6 M ) and yohimbine (1.5 × 10 −7 M-5 × 10 −4 M ) showed no remarkable effect on clonidine-induced rhythmic activity. 3. 3. The clonidine-induced contractions were dependent on extracellular calcium and could be inhibited by the omission of calcium from medium or the introduction of verapamil ( IC 50 =1.3 × 10 −7 M ) or nifedipine ( IC 50 =7.5 × 10 −8 M ). 4. 4. Pretreatment of animals with reserpine made the preparations 2800-fold more sensitive to this action of clonidine. 5. 5. It can be concluded from this study that clonidine is able to induce rhythmic activity in rabbit anococcygeus muscle through a mechanism that increases intracellular concentration of Ca ++ via membrane calcium channels.

Prevalence, patient awareness and control rates of high blood pressure in the adult population of tehran: a report from the tehran blood pressure s tudy, 1990-19911

Abstract: The \"Tehran Blood Pressure Study\" (TBPS) is an observational cross-sectional study performed on men and women aged 15 years or more during the years 1990-1991. The study has been designed and performed by the Tehran University of Medical Sciences' Cardiovascular Research Center, with the primary objective of determining the prevalence and distribution of high blood pressure in Tehrani adults. In addition, awareness levels, control rates, and the prevalence of other cardiovascular risk factors among those with high blood pressure, as well as associations between blood pressure (BP) levels and certain epidemiolo gic and anthropometric factors have been studied. The study population comprised 10180 male and female inhabitants of Tehran aged above 15, selected by random sampling in 50 districts of the city. The mean and the 95% confidence interval for systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 123 (122.8-123.4) and 75.4 (75.2-75.6), respectively. The prevalence of high blood pressure (SBP� 140 mmHg or DBP> 90 mmHg or drug consumption) was 17.6% in males, 17.9% in females, and 17.7% in generaL About 47% of the patients with high DBP readings were aware of their condition. In 20% of these, control of hypertension had been achieved by drug therapy; in 11 %, drug therapy had failed to control hypertension, and 16% were not receiving treatment despite their awareness. High body mass index and a history of diabetes were more frequent in those with high BP readings than the general population. Of those with high BP readings, most had only mild elevations of BP (90� DBP�99 or 140�SBP�159). Isolated high systolic blood pressure (SBP �140 mm Hg and DBP< 90 mmHg) was found in 36% of females and 30% of males aged above 64. The noticeable prevalence of high BP, the remarkable prevalence of isolated high systolic blood pressure in the elderly, the very low level of patient awareness and low control rates all necessitate the adoption of appropriate personal and community health policies. MJIRI, Vol. 10, No.2, 125-135, 1996. * The Tehran Blood Pressure Study group is affiliated to Tehran University of Medical Sciences' Cardiovascular Research Center. Please address consultations and reprint requests to M. Naghavi, 125 M.D .. Cardiovascular Research Center, Tehran University of Medical Sciences, Tehran, P. O. Box 14155 -6388,Islam ic Republic of Iran. D ow nl oa de d fr om m jir i.i um s. ac .ir a t 5 :4 7 IR D T o n F rid ay M ay 2 8t h 20 21 High Blood Pressure in Adults in Tehran

Myoma of the Round Ligament Causing Severe Groin and Thigh Pain

Abstract: A 40-year-old woman experienced severe right groin and thigh pain. Her history included abdominal hysterectomy 6 years and exploratory laparotomy 2 years earlier. During the latter, left oophorectomy and appendectomy were performed, but did not eliminate the patient's groin pain. At laparoscopy we found a 20-mm myoma on the round ligament, which was excised. Three months postoperatively the woman had no groin pain and was in good health.

De termination of neutralizing antibodies agains t the mumps virus in selected groups in tehran and two iranian villages

Abstract: A micro neutralization test was used for the detection and evaluation of mumps neutralizing antibodies. A total of 1037 blood samples from selected groups of students aged 7 to 22 years in south and east of Tehran, 139 blood samples from the umbilical cords of pregnant women at two Tehran hospitals at delivery time, and 190 samples from children under five years of age who were living in two villages located in Zandjan province, were tested. The results of this study indicated that the percentage of the above mentioned sera having mumps virus neutralizing antibodies with a titer of 1:2 or greater was 69.6%,92.8%, and 29.5%, respectively. Vaccination against mumps is optional in the Islamic Republic of Iran and therefore it is believed that the virus is circulating among susceptible subjects. These data also suggest that children could be a target for mumps vaccination. MJIRI, Vol. 10, No.3, 197-201, 1996. Voltime 10 Number 3 Fall 1375 November 1996

Comparison of Tc-99m Ethylenedicysteine (Tc-99m EC) with Tc-99m DPTA in evaluation of renal disease [Persian]

Abstract: Tc-99m-EC is a new renal radiopharmaceutical introduced as an alternative for Tc-99m MAG3. Twenty-three normal volunteers and patients in different .stages of renal disease were evaluated with Te-99m EC and Tc-99m DTPA. The mean initial uptake of EC was significantly higher as compared to DTPA. There was a high correlation between rectangular and hand-drawn ROls for kidney and background, 0.96 and 0.94 for right and left kidney, respectively. There was no significant difference between supra and subrenal background activities. A high correlation was also noticed between renal uptake of both agents divided by their injected original dose, and with correlation coefficient of 0.88 and 0.85 for the right and left kidneys, respectively. The relative right kidney uptake of two agents was nearly similar (with correlation coefficient of 0.92). The quality of the renogram generated with EC was belter than those obtained with DTPA. The results show that Tc-99m EC has good characteristics to be used as an agent for evaluation of renal function and morphology.