Long-term Outcomes of Patients Undergoing War-related Amputations of the Foot and Ankle

Long-term clinical and functional outcomes for patients undergoing foot and ankle amputations are not well documented. We attempted to document long-term outcomes for patients who required lower extremity amputations as a result of wounds suffered during wartime. For this study, 27 Iranian soldiers who had wounds requiring amputation of the foot and ankle were selected for follow-up. The participants' wartime medical records were reviewed, a clinical examination was performed, and each participant completed a questionnaire. Postamputation follow-up averaged 17.5 years. The most prevalent (66.6%) cause of injury was a land mine. The prevalences of different clinical symptoms reported by the amputees at the time of the last follow-up were as follows: 11 (40.7%) with phantom sensation, 6 (22.2%) with phantom pain, 12 (44.4%) with stump pain, 12 (44.4%) with back pain, 9 (33.3%) with contralateral knee pain, and 4 (14.8%) with ipsilateral knee pain; 20 (74%) reported treatment for psychological conditions. In regard to social conditions, 13 (48.1) were currently employed, or had been employed, for a number of years after the amputation; 26 (96%) had children, and all of the patients were married. The results of this observational study indicate that individuals have significant long-term pain and discomfort after war-related lower extremity amputation. Although all 27 (100%) of the amputees were able to maintain satisfactory family functioning, only 13 (48.1%) of the study participants were able to remain productively employed after undergoing amputation, and 20 (74%) reported long-term psychological problems in addition to their physical pain.     

Diagnostic yield of CT angiography performed for suspected cervical artery dissection in the emergency department

Emergency Radiology - Computed tomography angiographies are frequently performed in the emergency department (ED) for the assessment of cervical artery dissection (CeAD) due to the high risk of...     

黄豆提取物的雌激素依赖作用对戊四唑诱发的大鼠癫痫的影响

目的：研究黄豆提取物对经戊四唑（pentylenetrazole,PTZ）诱发癫病发作的女性荷尔蒙缺失雌性大鼠与正常雌性大鼠的不同作用,以及因性别差异引起的植物雌性激素对行为的影响。方法：雄性Wistar大鼠被随机分为雄性生理盐水组,雄性低、中、高剂量黄豆提取物治疗组,每组8只;雌性Wistar大鼠随机分为假手术生理盐水组,假手术低、中、高剂量黄豆提取物治疗组,去卵巢生理盐水组,去卵巢低、中、高剂量黄豆提取物治疗组,每组8只。去卵巢大鼠在氯胺酮麻醉下行卵巢切除术。分别给予各组大鼠生理盐水及不同剂量黄豆提取物治疗2周后腹腔内注射戊四唑。将大鼠放置在树脂玻璃笼内,记录最小阵挛性癫痫发作（minialclonicseizure,MCS）潜伏期和强直性阵挛性癫痫发作（generalizedtonic-clonicseizure,GTCS）潜伏期。结果：与雄性生理盐水组大鼠比较,雄性低、中剂量黄豆提取物治疗组的MSC和GTCS潜伏期显著缩短（P〈10．05或P〈0．01）。雌性假手术大鼠在给予黄豆提取物治疗后,其MSC和GTCS潜伏期没有显著改变。与去卵巢生理盐水组比较,去卵巢低、高剂量黄豆提取物治疗组的MSC和GTCS潜伏期明显缩短（P〈0．05或P〈0．01）。结论：黄豆的植物雌激素能影响由PTZ诱发的癫痫发作的轻重程度,但其影响程度与卵巢激素水平有关。机制还有待进一步研究。     

Alterations of BDNF and NT-3 genes expression in the nucleus paragigantocellularis during morphine dependency and withdrawal

Locus coeruleus (LC) plays a key role in opioid dependence and withdrawal. Chronic morphine administration induces neurochemical adaptations in the noradrenergic system. The nature of signal responsible for opiate-induced adaptations of noradrenergic neurons in LC is not well defined. Neurotrophins-signaling pathways such as brain derived neurotrophic factor (BDNF) and Neurotrophin-3 (NT-3) play a key role for regulating the noradrenergic response of LC neurons to opiates. The nucleus paragigantocellularis (PGi) is one of the two major afferents to LC. The present study was designed to evaluate the expression of BDNF and NT-3 in the context of opiate dependence and withdrawal in PGi. Such data are important because they could reveal the role of PGi as an additional source of BDNF and NT-3 in the neurochemical plasticity of LC neurons. Opiate dependence was induced by a progressive intraperitoneal treatment of morphine. In morphine dependent group PGi nucleus was extracted for gene expression assay 6h after the last injection of morphine. In spontaneous withdrawal, rats received the same chronic treatment as morphine group. PGi was extracted for gene expression assay 24, 48 and 72 h after the last injection of morphine. PGi nucleus was assayed for the expression of BDNF and NT-3 using semi-quantitative RT-PCR normalized to beta-actin gene expression. Results showed that chronic administration of morphine significantly increased BDNF and NT-3 gene expression in PGi. In spontaneous withdrawal, BDNF/NT-3 genes expression were high in comparison to control group. It seems that BDNF/NT-3 -signaling pathway originating from PGi is essential for opiate-induced adaptations of the LC neurons.     

Cloning,and Molecular Characterization of Polymorphic Iranian Isolate Theileria annulata Surface Protein (Tasp)

Background

Because of the strong immunologic responses of surface protein TaSp in Theileria annulata infected host, we tried to characterize this protein in a T. annulata isolate from Iran.

Methods

The RNA prepared from T. annulata infected cells was used to produce SMART-DS-cDNA. The Double strand cDNA was then amplified with primers derived from TaSp mRNA sequences. The PCR product was cloned in pTZ57R/T vector, sequenced and registered under accession no. {"type":"entrez-nucleotide","attrs":{"text":"JQ003240","term_id":"371927237"}}JQ003240 in GenBank.

Results

The sequence analysis showed 90%–94% nucleotide sequence identity and 68%–94% amino acid homology to the corresponding sequences of TaSp gene by T. annulata, T. sp. china I, T. sp. china and T. lestoquardi and three T. annulata reported from Iran respectively. Interestingly, the sequence analysis also showed small nucleotide sequence region near the 5‘ end in which the presented TaSp protein differed very strongly from the other known TaSp sequences. For the preparation of the recombinant protein, the cDNA was cloned in pQE-32 vector, the recombinant protein was prepared and assayed by Theileria infected bovine serum.

Conclusion

The polymorphism in TaSp gene could be detected in intra- as well as inter species. The different characterized TaSp proteins had a common identic region, which may be helpful for development of broad band vaccine based on the recombinant proteins. The polymorphism in this gene, make this protein also interesting for the diagnostic purposes.     

Progressive Destructive Mycetoma Caused by Madurella mycetomi./Progressiv-destruktives Myzetom durch Madurella mycetomi

Summary: Mycetoma of the foot in an Iranian farmer caused by Madurella mycetomi is described. The infection began subsequent to a tractor-induced laceration on the patient's sole of the rigth foot
Early surgical debridement resulted in transient resolution of the lesion. The patient, however, did not return for continued treatment, resulting in enlargement of the lesion with bone involvement over a six-year period, ultimately necessitating amputation. Early medical treatment is stressed.
Zusammenfassung: Es wird ein von Madurella mycetomi verursachtes Myzetom am Fuß eines iranischen Bauern beschrieben. Die Infektion trat an einer Rißwunde der rechten Fußsohle nach einem Traktorunfall des Patienten auf. Das chirurgische Debridement führte zu vorübergehender Besserung der Läsion. Der Patient entzog sich jedoch einer Weiterbehandlung.
Dies führte innerhalb von sechs Jahren zur Fortdauer und Ausbreitung der Läsion mit Knochenbeteiligung, die schließlich eine Amputation notwendig machte. Die Wichtigkeit einer früh einsetzenden ärztlichen Versorgung wird betont.