General survey of the present distribution of helminths in Iran and comparison with those of past years]

In this paper the literature on helminthiasis in Iran is reviewed and the distribution, prevalence and intensity of infections caused by helminths are discussed. A comparison of prevalence and intensity of infections was accomplished in the recent 10 years by the author. Hookworm infections are found mostly in the north along the Caspian sea, but its prevalence is declining. Trichostrongylus are found in Iran with a high prevalence in central country. Schistosoma haematobium is found in one Province in the south, but its prevalence is declining because of large scale control activities. The Guinea worm rarely occurs in Iran. The prevalence of Fasciola hepatica is high among livestock and is occasionally found in man. Taenia saginata is found in most parts of Iran. Taenia solium is seldom found in animals with a prevalence of 0.03%. Trichinella spiralis is infrequently found in animals. Dioctophyma renale is found in straying dogs in the north or Iran, the percentage is 13-35%. Oxyuriasis is widespread among children.     

Common misconceptions in the diagnosis and management of anemia in inflammatory bowel disease

Anemia is the most common systemic complication of inflammatory bowel disease (IBD); so common that it is almost invariably not investigated and rarely treated. Several misconceptions are the reason for these clinical errors, and our goal will be to review them. The most common misconceptions are: anemia is uncommon in IBD; iron deficiency is also uncommon; just by treating the intestinal disease, anemia will be corrected; iron deficiency is the only cause for anemia in IBD; ferritin is an accurate parameter for the diagnosis of iron deficiency in IBD; the impact of anemia on the quality of life of IBD patients is limited; iron supplementation is rarely needed in IBD; high-dose oral iron solves the problem of iron malabsorption in IBD; intravenous (IV) iron is dangerous and of no proven benefit in IBD; IV iron is useful only for severe anemia; and erythropoietin has no role in the treatment of IBD anemia. These misconceptions are not evidence-based. On the contrary, there is enough evidence to support the following statements: (a) anemia is very common in IBD, (b) anemia should be investigated with care because many factors can be responsible, (c) treatment of anemia results in clear improvement in the objective parameters of well-being, especially in the quality of life, (d) IV iron is safe and effective in the treatment of iron deficiency anemia in IBD patients, and (e) erythropoietin is useful in a subset of patients with refractory anemia. Anemia diagnosis and treatment must not be neglected in IBD patients, and several misconceptions should be promptly abandoned.     

The Toa Micro Cell Counter

Our study shows that the principle on which detection in the Toa micro cell counter is based, differs from the principle underlying detection in the Coulter counter. Detection in the Toa counter is based on the fact that a particle passing the capillary produces an impulse by virtue of a change in capacity. This is in accordance with the views of the manufacturer of the Toa counter. A non-linear relation is found between the amplitudes of impulses produced by erythrocytes in the Toa counter and the Coulter counter. Because the relation between the volumes of the erythrocytes and the amplitudes of the impulses they produce in the Coulter counter is linear, this relation is not linear in the Toa counter. It is established that the cause of this alinearity must be sought in the way in which the impulse is generated in the transducer.     

Difference in osteoporosis in men and women

Burden of osteoporosis in men on our society is increasing with aging in population. Prevalence of osteoporosis and incidence of osteoporotic fracture are less frequent in men than in women since bone mineral density is higher, bone size is greater, and hence the bone is stronger in men than in women. In spite of these facts, the number of male patients with osteoporosis was projected to be 3 million in 2005 and is increasing thereafter. Hip fracture was estimated to occur in 33,100 men in 2007 and is increasing as well. Once a man suffers from hip fracture, prognosis is worse in men than in women. However, screening methods for osteoporosis in men are not established, and this causes delay in diagnosis and treatment. Further studies are necessary to answer whether the current young adult value of bone density necessary for diagnosis is appropriate, whether therapeutic regimens are effective in men, whether the cost for diagnosis and treatment is comparable to benefit, whether a valid screening method for osteoporosis in men exists, and whether the screening method is cost-effective.     

Duodenal inhibition of gastric secretion by osmotic agents in normal subjects and patients with duodenal ulcer

Gastric secretion in man is inhibited by the presence in the duodenum of hyperosmolar and hypoosmolar solutions. Both acid and pepsin outputs are affected. There is no change in hydrogen, sodium, or potassium ion concentration in the gastric juice. Pepsin concentration, however, is reduced by all inhibitory stimuli. Inhibition is thought to act directly upon parietal and chief cells, and a possible basis for this mechanism is discussed. The response is similar in control subjects and duodenal ulcer patients; there is in particular no evidence of impaired inhibition in the ulcer group. An anomalous feature is the relatively small inhibition of acid output after hypertonic saline in control subjects compared with the duodenal ulcer patients.     

A hypothesis: is diverticulitis a type of inflammatory bowel disease?

It is accepted by epidemiologists that diverticula formation in the colon is related to a deficiency in dietary fiber intake, but the cause of acute diverticulitis remains unknown. A hypothesis is presented that acknowledges from the literature that fiber deficiency is also related to an altered intestinal microecology with a change in the bacterial flora. It is hypothesized that the change in the flora with a decrease in their influence on the immune process permits a low-grade chronic inflammation in the mucosa, which is the first step in developing an acute infection of diverticula or diverticulitis. There is some evidence that the low-grade chronic inflammation is present in subjects with diverticula, which is the forerunner of acute diverticulitis. This hypothesis is strengthened by early reports that anti-inflammatory mucosal agents such as mesalamine and immune process regulators such as probiotics may improve diverticulitis.     

Burkitt's lymphoma

Burkitt's lymphoma is a highly aggressive B-cell non-Hodgkin lymphoma and is the fastest growing human tumour. The disease is associated with Epstein-Barr virus and was one of the first tumours shown to have a chromosomal translocation that activates an oncogene (c-MYC). Burkitt's lymphoma is the most common childhood cancer in areas where malaria is holoendemic. The incidence is very high in immunosuppressed patients in non-endemic areas, especially when associated with HIV infection. Outcome with intensive chemotherapy has improved and is now excellent in children, but the prognosis is poor in elderly adults. The success of intensive treatment relies on good supportive care. The therapy offered in oncology units in low-income countries is not as aggressive as in centres in high-income countries and outcomes are less successful. Adjuvant monoclonal antibody therapy with rituximab shows promise for improved outcomes and reduced toxic effects in the future.     

Cardiac hypertrophy, dilatation and performance in top athletes

The authors have studied three groups of patients: 12 reference patients (REF) leading a sedentary life; 22 athletes of international fame, practising an endurance sport (END), including 10 long distance and middle-distance runners, 12 cyclists and 12 top (RES) athletes practising a resistance sport i.e. 12 sprinters. There is no age difference between the two groups. The RES have a larger body area than the REF and END. The cardiac frequency is lowered in the athletes without any difference between RES and END. There is no difference as far as the athletes' blood pressure is concerned. On the EKG, the Sokoloff index is significantly higher in END than in REF and RES. Sonographic data were especially analyzed. END present a hypertrophic myocardium and ventricular dilatation. The hypertrophy, more assymmetrical than that of RES, is more marked at the level of the septum. There is a non-significant tendency toward an excentric hypertrophy. RES present a marked hypertrophy with little or no dilatation. This hypertrophy is more symmetrical and concentric than in END patients. As far as the pump function is concerned (FR, FE, VES): it is not altered in RES (this fact is found in the literature). On the contrary, in END patients, the pump function (FR, FE) is diminished (this fact is debated in the literature), in spite of an increased systolic ejection volume. The total contraction function is not altered in RES nor in END patients. An increased septal contraction rate is noted, which is significant in RES patients and non-significant in END patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

乙状结肠憩室病急性出血1例

结肠憩室病是欧美等西方国家的常见病,首发症状多为并发症的症状,常见为憩室出血或憩室炎,其部位欧美人多在乙状结肠,而亚裔及我国多在右半结肠,本病例在我同实属少见。随着我国国民生活水平的提高,进食低纤维膳食的结构变化,结肠憩室病引起下消化道出血的可能性增加,应引起临床注意。     

Chelation therapy in liver diseases of childhood: Current status and response

Chelation is the mainstay of therapy in certain pediatric liver diseases. Copper and iron related disorders require chelation. Wilson’s disease (WD), one of the common causes of cirrhosis in children is treated primarily with copper chelating agents like D-penicillamine and trientine. D-Penicillamine though widely used due its high efficacy in hepatic WD is fraught with frequent adverse effects resulting discontinuation. Trientine, an alternative drug has comparable efficacy in hepatic WD but has lower frequency of adverse effects. The role of ammonium tetra-thiomolybdate is presently experimental in hepatic WD. Indian childhood cirrhosis is related to excessive copper ingestion, rarely seen in present era. D-Penicillamine is effective in the early part of this disease with reversal of clinical status. Iron chelators are commonly used in secondary hemochromatosis of liver in hemolytic anemias. There are strict chelation protocols during bone marrow transplant. The role of iron chelation in neonatal hemochromatosis is presently not in vogue due to its poor efficacy and availability of other modalities of therapy. Hereditary hemochromatosis is rare in children and the use of iron chelators in this condition is limited.     

Protein-solvent preferential interactions,protein hydration,and the modulation of biochemical reactions by solvent components

Solvent additives (cosolvents, osmolytes) modulate biochemical reactions if, during the course of the reaction, there is a change in preferential interactions of solvent components with the reacting system. Preferential interactions can be expressed in terms of preferential binding of the cosolvent or its preferential exclusion (preferential hydration). The driving force is the perturbation by the protein of the chemical potential of the cosolvent. It is shown that the measured change of the amount of water in contact with protein during the course of the reaction modulated by an osmolyte is a change in preferential hydration that is strictly a measure of the cosolvent chemical potential perturbation by the protein in the ternary water-protein-cosolvent system. It is not equal to the change in water of hydration, because water of hydration is a reflection strictly of protein-water forces in a binary system. There is no direct relation between water of preferential hydration and water of hydration.     

Radioactive iodine therapy for Graves' disease in childhood and adolescence

While the diagnosis of Graves' disease in childhood and adolescence is relatively straightforward, its treatment remains controversial. The first choice therapy is the use of anti-thyroid drugs, although side effects are more frequent than in adults and remission is low. Surgery is not usually indicated as initial treatment. Instead, it is generally recommended after recidive of the disease or due to side effects of medical treatment. The use of radioiodine therapy is increasing in this age group, especially in North America, and control of the hyperthyroidism is achieved in 3 to 6 months in 90% of the cases. There is no evidence that radioiodine therapy is associated with a higher risk of thyroid cancer, and the occurrence of side effects is lower than surgery. Based on the positive results obtained with this therapy, patients with poor responsiveness to medical treatment should be considered for early radioiodine therapy.     

Improvement of the method of collection of blood flowing from the adrenal glands in the experiment on dogs

Blood from the adrenal gland can flow in two directions--into the caudal vena cava and by anastomoses into the portal vein. A method of multiple blood procuring from these vessels in dogs for the purpose of studying the adrenal gland function is suggested. Polyethylene catheters, 0.9 mm in diameter and 35--40 mm in length glued to capron plates, mandrins, Gordeev's needles and blood-drawing needles are necessary. Transperitoneal surgical approach to the caudal and mesenteric veins is to be provided. Purse-string suture is applied on the wall of the mesenteric vein. The catheter is washed with heparin, the mandrin is introduced into it and it is inserted into the Gordeev's needle. A puncture is made in the centre of the purse-string suture with this needle, which is introduced into the vein together with the catheter. Gordeev's needle is withdrawn and the catheter is pushed through to the portal vein. The purse-string suture is tightened, and the capron plate is fixed in the wall of the vein. The mandrin is recovered from the catheter, heparin is administered into its canal, polyethylene plug is inserted and withdrawn through the abdominal wall outside with the aid of the blood-drawing needle. The catheter is introduced into the caudal vena cava in the same way. Blood samples can be obtained on the 14th postoperative day.     

Hypertension in pregnancy

Hypertension in pregnancy contributes significantly to both maternal and neonatal morbidity and mortality. Among different forms of pregnancy-associated hypertension, preeclampsia-eclampsia has the highest impact on morbidity and mortality. Chronic hypertension may result in preterm and small for gestational age infants, even when it is mild-to-moderate. Chronic hypertension is a risk factor for superimposed preeclampsia and results in higher rates of adverse outcome. Preeclampsia is a multisystemic disease that is thought to be initiated by abnormalities in placental perfusion and endothelial dysfunction, ultimately resulting in multiorgan failure. Preeclampsia is more common in women of minority ethnicity who are socioeconomically disadvantaged. Pharmacologic therapy for hypertensive disorders in pregnancy is limited by concerns regarding the safety of both mother and fetus. Although treatment of severe hypertension is not debated, there is no consensus on the rationale for pharmacologic therapy of mild-to-moderate hypertension in pregnancy.     

Seeking a home for a PET, part 2: Defining the appropriate place for positron emission tomography imaging in the staging of patients with suspected lung cancer

In patients who have a high likelihood of having lung cancer, there is little role for positron emission tomography (PET) imaging for diagnosis of the primary lesion. The primary impact of PET imaging is in extrathoracic staging, but it should not replace a clinical evaluation by a physician experienced in lung cancer. PET imaging is most useful for confirmation of the presumed extrathoracic stage in patients with intermediate stages of lung cancer. The role of PET imaging is limited in patients with strong clinical signs of metastatic disease, or in patients with a clinical stage I lung cancer and a negative clinical evaluation. With regard to intrathoracic staging, PET imaging has a definite role in communities in which mediastinoscopy is not available, whereas the impact is limited in institutions in which invasive mediastinal staging is available. The data suggest that a positive PET result in the mediastinum should be confirmed by biopsy. A mediastinoscopy is also reasonable in patients with clinical stage III lung cancer who have no mediastinal PET uptake. It is unclear and controversial whether a biopsy is needed in patients with clinical stage II lung cancer who have no PET uptake in the mediastinum.     

Mechanism of Carcinogenesis by RNA Tumor Viruses, I. An RNA-Dependent DNA Polymerase in Murine Sarcoma Viruses

A highly active and stable DNA polymerase was found in purified preparations of two murine sarcoma viruses. Enzyme activity is not detected in most virus preparations unless they are treated with low concentrations of a nonionic detergent such as Nonidet P-40. The incorporation of labeled thymidine triphosphate requires all four deoxyribonucleoside triphosphates and either Mg(2+) or Mn(2+). Enzyme activity is proportional to virus concentration and is linear with time up to 90 min. That the template is RNA is suggested by the reduction in polymerase activity upon treatment of murine sarcoma virus with RNase, and by the absence of detectable amounts of DNA in the virus. That the product is DNA is shown by the incorporation of all four deoxyribo-nucleoside triphosphates into an acid-insoluble product which is stable in alkali, is destroyed by DNase, sediments in alkaline sucrose gradients with a sedimentation coefficient of 7 S, and bands in isopycnic CsCl gradients with a mean buoyant density of 1.700.     

方形黄鼠蚤松江亚种的吸血活动

1984～1985年在实验室内,以小白鼠做为喂血动物,研究了方形黄鼠蚤松江亚种的吸血活动。结果表明:该蚤吸血率与温度的关系呈抛物线型,25℃左右时吸血率最高。繁殖蚤吸血率一般高于新羽化蚤。雌性吸血率一般高于雄性。在一定温度范围内吸血时,不同温度下吸血量近相等。繁殖蚤吸血量一般大于新羽化蚤。雌性吸血量一般大于雄性。血液消化速度在一定范围内随温度的升高而加快。25℃以下时,繁殖蚤消化速度一般较新羽化蚤为快;而30℃以上时,繁殖蚤和新羽化蚤消化速度相近。雄雌消化速度无大差别。     

The natural center of chromaticity space is not always achromatic: a new look at color induction

Although current theories of color vision differ in many respects, they all assume the existence of a uniquely defined neutral point in chromaticity space. It generally is assumed that this point satisfies several criteria simultaneously. One of these criteria is that it is perceived as achromatic. A further criterion shared by most theories is the structural assumption that lines in chromaticity space of constant hue converge on the neutral point. The basic assumption that these two criteria coincide is clearly true for isolated spots of light presented in darkness, and it usually is taken for granted that this coincidence generalizes to more complex visual stimuli. Here, we show that this is not the case. Our experiments with infields in chromatic surrounds revealed that the point in chromaticity space that appears gray is clearly different from the point on which lines of constant hue converge. A plausible interpretation of this apparently paradoxical finding in terms of color scission is proposed.     

Streptococcus suis meningitis: First case reported in Quebec

Very few Streptococcus suis infections in humans have been reported in Canada, although the condition is frequent in pigs. Meningitis, often accompanied by severe hearing loss, is the most common clinical manifestation. The disease is an occupational illness affecting persons in contact with pigs and may be underdiagnosed because of misidentification of the responsible bacterium. Since Quebec is the leading province for swine production in Canada, physicians and microbiologists should be aware of this infection, especially when a streptococcal meningitis is diagnosed in swine workers. The first case of S suis type 2 meningitis reported in Quebec is described.     

Germination and growth of neurospora at low water activities

When the water activity (a_w) of the medium is lowered by the addition of NaCl or nonelectrolytes, an inhibition of germination, growth rate, and total growth is observed in Neurospora crassa. Inhibition of conidial germination is separable from the other effects and is caused, in large measure, by the loss from conidia in media of low water activity of a substance that is essential for their germination. The substance is detectable in the medium and is also extractable from cultures. It is dialysable and thermostable, and it appears to be highly active. It is not detectable in complete medium.