proton induced X-ray emission [PIXE] analysis of concentration of trace elements in varicose veins

Proton induced X-ray emission [PIXE] has been applied as reliable and improved techniques in this study to compare concentration of various trace elements in normal and abnormal varicose veins. Five samples from normal veins and 13 samples from varicose veins bombarded by 2.0 MeV energy proton beams produced by a Van de Graff accelerator in vacuum. Two specimens from each sample, approximately 1cm, were processed for PIXE [proton induced X-ray emission] analysis. Both qualitative and quantitative analyses of potassium, iron, copper and zinc concentration were performed with respect to calcium concentration. The concentration of potassium and iron in the varicose vein group has been significantly higher than the normal group. Copper and zinc concentration were also higher in the varicose veins, and the elevation of bromine was seen in the normal group. PIXE analysis showed higher concentrations of trace elements in veins derived from varicos patients compared to normal group. The difference in normal and abnormal vein might be independent of age

[Fire work-related injuries in Tehran's Charshanbe Soori]

Fireworks are the leading cause of injuries in the ceremony of Chaharshanbeh Soori in Iran. The present study was designed to assess the prevalence and the severity of such injuries, the high-risk population, the causes and the accompanying morbidities in such ceremonies. This cross-sectional study was performed on individuals referred to different medical centers by Tehran Emergency Service due to fireworks- and Chaharshanbe soori-related injuries in 2007. The patients' demographic data, the cause of the accident, the type of the firework, the severity and the site of the injury, the performed prehospital and hospital care, and the patients condition at the time of discharge were extracted from the patients medical records. The information on the severity of the remaining morbidities in 8 months after the accident was also gathered. About 197 patients were enrolled in this study. The mean age of the patients was about 20.94 +/- 11.31 years. The majority of them were males. Crackers and home-made grenade were the most frequent cause of injury. The most frequently reported injuries consisted of bums, laceration and contusion, soft tissue injury and bone injuries, respectively. Fireworks should be produced and distributed based on standard regulations. Educating the families and students, and holding public ceremonies under the direct control of the families are considered as important strategies in reducing such injuries

[Trauma: an epidemiological study from a single institute in Ahvaz, Iran]

This prospective study was conducted to evaluate the characteristics and outcomes of trauma patients attending the emergency department of a university hospital in Ahvaz- Iran [2000]. We identified all trauma admissions due to blunt and penetrating injuries. Data were collected from emergency departments and intensive care log books at Golestan hospital by on-site data collectors. The total number of patients included in the study was 1141; of these, 952 [83.4%] were males. The mean age of the study sample was 26.7 +/- 17 years [range, 1- 84 years]. Injuries were predominantly of the blunt type [91.8%], with only a small percentage of penetrating injuries [8.2%]. The most common cause of injury was traffic accidents [59%]. There were a total of 96 deaths [8.4%], and only a small number had an ISS of

[Survey the patency rate and complications of groin A-V graft access]

Introduction: Construction of vascular access using subcutaneously placed to join an artery to a vien is increasly necessary in patients with poor peripheral veins or previously failed arteriovenous fistulas. Interposition grafts in the lower extremity are used for patients who have no usable vessels available in the upper arms. Experience with groin hemodialysis prosthetic access has been discouraging because of high infection rate and associated limb amputation

Objective: Determine infection rate, patancy rates, and possible prediative factors for prosthetic thigh angioaccess outcomes in our hemodialysis patient's population

Materials and Methods: In this prospective study 41 patients who were underwent placement of thigh vascular access graft at Sina Hospital ,Tehran University of Medical Sciences, were selected between Jan 2000 and July 2003. Data were recorded base on demographic and complications variables and analyzed by Kaplan-Meier and long rank tests

Results: In this study the primary of thigh prosthetic graft were, 76%, 70%, 67%, and 60% at 3, 6, 9, and 12 months after placement respectively. There were 14 [34%] access failures, related to infection in 2 case [4.8%], thrombosis in 10 cases [24.4%] and psuedoaneurysms in two cases [4.8%]. There was no limb ischemia, no significant difference in infection or graft patancy rate which were found by patient age and gender

Conclusion: In this study, infection and thrombosis rate of thigh access was not more than other studies. Thigh vascular access with PTFE could be used for patients who have no usable vessels available in the upper arms

Outcome of prosthetic thigh vascular access graft in hemodialysis patients: a prospective six year study

Arteriovenous fistulae traditionally have been placed in the upper extremity. Experience with groin hemodialysis access has been discouraging because of high infection rates and associated limb amputation. The aim of this study was to determine infection rates, patency rates, and possible predictive factors for prosthetic thigh angioaccess outcomes in our hemodialysis patient population. A prospective study was performed for 53 patients who underwent placement of thigh vascular access graft at Sina Hospital, Tehran University of Medical Sciences, between Jan 2000 and July 2005. Demographics, complications, and subsequent treatment were recorded. Survival distributions were plotted using the Kaplan-Meier method for graft survival [primary patency]. Log rank tests were used to evaluate for statistical differences in survival distribution between different groups. The primary patency rates were, 78.4%, 61.2%, 56.2%, and 50% at 3, 6, 9 and 12 months, respectively. There were 15 [28.3%] access failures, related to infection in 2 cases [3.7%], thrombosis in 10 cases [18.9%] and bleeding in 3 case [5.7%].There was no limb ischemia.No significant differences in infection rate or graft patency rates were found by patients' age and gender. A PTFE vascular access in the thigh is not associated with higher morbidity compared with the upper extremity, and should be considered as a promising alternative when upper extremity arteriovenous fistulas cannot be constructed .The incidence of infection and thrombosis in our series is comparable with rates reported in the literature for lower extremity polytetrafluoroethylene angioaccess grafts

Motives for cigarette smoking among high school students in Urmia: a qualitative study

Despite the explicit health warnings, large numbers of students continue to take up tobacco. To achieve significant long-term reductions in tobacco use and smoking-related death, the nature and scope of tobacco use in youths should be examined, the social, psychological, and marketing motives that influence young people in their decision to use tobacco products explored, and strategies and programs to prevent young people from becoming users developed. This qualitative study was conducted to explore motives for cigarette smoking among high school students in Urmia with financial support of Pakan Association- a Nursing NGO- in 2005. Focus groups and questionnaires were used for data collection. 2360 students in four high schools in educational districts 1 and 2 at Urmia city were recruited at the first stage of sampling and their cigarette smoking patterns were determined. At the second stage, five focus groups, each with 6-10 participants, were formed at the schools by volunteer students. Sessions were taped and transcribed and the themes of discussions were elicited by content analysis approach. Findings showed that the main motives of students for cigarette smoking included anger relief, curiosity, sense of dignity, fear of isolation, peer pressure, imitation, sense of joy, obstinacy, opposition to parents, lack of compassion in family, early love, unwanted stimulation of parents, smoking of family members, fight with loneliness, and opposition to social authorities. The major complaint of students was stringency of parents and an important motive for smoking was opposition to parents. Thus, strengthening compassion in families can somehow control smoking in youths

[Management of infected femoral pseudoaneurysm in intravenous drug abusers]

A plan for management of infected arterial pseudoaneurysm has evolved from our experience with forty two cases of such aneurysms treated between 1378 and 1382. Clinical data of 42 patients with femoral pseudoaneurysm resulting from addictive drug injection who presented in emergency department of Sina Hospital between 1378 and 1383 were retrospectively reviewed. All patients were men with the mean age of 36.9 years. Twenty eight patients were referred from other medical centers. The mean time of delay in presentation was 17.3 days. The mean duration of drug injection was 14 months. Primary repair and emergent vascular bypass were performed in 3[7.1%] and 2[4.8%] patients, respectively. 5[11.9%] patients undergone delayed revascularization. Thirty two [76.2%] patients returned to their normal lifestyle without any vascular bypass. One patient required amputation and one patient died due to sepsis and acute renal insufficiency. Management of infected femoral pseudoaneurysms is simple ligation of the external iliac or femoral artery. When Doppler is not available 'Operation Room and postoperative Direct Observation' is recommended in such patients to avoid unnecessary revascularization surgery

Prospective evaluation of endo venous laser therapy for varicose vein; early efficacy and complications. The first report from Iran

In recent years, the endovenous laser therapy [EVLT] has been proposed to treat the incompetent greater saphenous veins [GSV] to increase patient comfort, and to reduce cost as well as risk. EVLT causes vein wall thickening, luminal contraction and vein fibrosis. The purpose of this article, as the first report from Iran, is to review our experience and outline the early results and complication of EVLT. 22 patients [13 females and 9 males, mean age: 40.6 +/- 11 years, range: 25-64] underwent EVLT of incompetent GSV segments with 810-nm diode laser with an average energy of 89.2 J/cm [range, 50-123 J/cm]. Success rate was defined as absence of reflux throughout the entire treated segment on follow-up doppler ultrasound [DUS] and clinical resolution of symptoms. Short-term results in the EVLT of 22 GSV indicate a 100% rate of closure. Self-limiting complication were occurred in 18% of patients and included moderate ecchymosis and paresthesias in 3 [13.5%], and 1 [4.5%] patients, respectively. No major complications such as deep vein thrombosis and pulmonary embolism were occurred. DUS demonstrated 21 [95%] and 19 [90.9%] occluded GSVs at 12 weeks, and 24 weeks respectively. The early results of our experiences are excellent. EVLT of the incompetent GSV with an 810 nm diode laser appears to be an extremely safe technique. EVLT is a very effective and safe with best cosmetic results and rare side effects

Relative measurement of heavy elements in the bile, gallbladder and gallstone

PIXE [Particle Induced X-Ray Emission] is a suitable method for the analysis of biological samples in which heavy trace elements are contained in light matrix elements. It is very important to know which factors or probably elements act as initial seed and lead to growing the sands. The goal of this study was to compare the relative values of Fe/K, Cu/K and Zn/K for gallstones, gallbladder, and bile of a specific patient for studying the origination of forming the gallstones. Human gallbladder, bile, and gallstone samples were obtained by surgical operation from 15 patients and are bombarded by 2.0 MeV energy proton beams produced by van de Graff accelerator in vacuum. All the gallstones were chosen of pigment type of stones and, all the patients were adults. In contrast with conventional methods, the shell and center of the sands has been analyzed separately. The PIXE spectrum analysis was performed using the nonlinear least square fitting code AXIL and GUPIX. The results of detected minor and trace elements shows that the precipitation of calcium salt in the bile lead to reduction of crystals' formation. Elemental comparison of pigment type of gallstone and bile shows that the concentration of calcium in the shell of the stones is four times more than that in the bile. Precipitation of the calcium from the saturated bile on the cholesterols as a seed of gallstones led to reduced sands formation. Analysis of the gallbladder of the same patients revealed no relation between elemental concentrations of bile and gallstones

Epidemiologic study of 284 patients with urogenital trauma in three trauma center in Tehran

To perform an epidemiologic study of urogenital injuries in traumatic patients who were referred to three traumatic centers in Tehran during one year. This study included a part of data of National Trauma Registries, which was performed within one year. Questionnaires were completed by trained staff in three different geographical regions of Tehran: Shohada-e-Tajrish hospital [north of Tehran], Sina hospital [south of Tehran], and Shaheed Faiazbakhsh [west of Tehran]. Two hundred and eighty four [5%] out of 57367 patients who were referred to the above mentioned centers had genitourinary trauma, of whom, 145 [42%] were hospitalized. Males with a frequency of 92% [258 patients] were the most injured group. Patients mean age was 25 +/- 14 years, mostly between 20 and 29 years [33.6%] followed by 10-19 years age group with a frequency of 25.6%. Non-penetrating trauma with a frequency of 96% was the most common type and accident was the most mechanism of trauma. One hundred and one patients out of the studied population had associated injuries. The most frequent injuries were occurred in extremities [40%] and the less in head and neck [7%]. There were 22 [21.7%] intra-abdominal organ injuries. Sixty nine percent of patients developed mild injury [ISS<7], 20% developed severe injury and [ISS>12], and 4.2% of patients died. The most common injured organ was kidney [3.3%] and the least one was ureter, as no ureteral injury was reported. Although a low percentage of traumatic patients develop urogenital injuries, disregarding these injuries may lead to serious complications and it is recommended to consider these injuries while dealing with such patients. Considering the fact that these complications which could be preventable, are mostly developed in the youth, making solution for such problem is recommended

One-year efficacy of expanded polytetrafluoroethylene vascular graft in eighty-three hemodialysis patients

To evaluate the patency and efficacy of expanded Polytetrafluoroethylene [ePTFE] vascular graft in hemodialysis patients. In a prospective study from January 1999 to January 2001 at Sina hospital 41 patients underwent implantation of 6-mm vascular grafts and 42 underwent implantation of 8-mm grafts in order to make vascular assess for hemodialysis. They were followed up to 12 months, observing the complications. Mean patients' age was 52.2 years. Thirty-seven of them were females and 46 were males. Over a 12 months period of follow-up, 12 cases of graft infection [14.5%], 21 cases of thrombosis [25.3%], 7 cases with both complications [8.4%], and 1 case of pseudoaneurism [1.2%] were observed. One-year patency rate was 34.9%. Diabetes was the only factor associated with lower patency rate [27% versus 57%, p<0.05]. ePTFE vascular graft seems to be an appropriate substitute for arteriovenous fistula as a vascular assess in hemodialysis patients. Educating patients and good care can decrease the rate of infection, thrombosis, and other complications, resulting in a better patency and lower morbidity rate

Investigation of heavy trace elements in neoplastic and non-neoplastic human thyroid tissue: a study by proton - induced X-ray emissions

Within the context of developing techniques to facilitate the diagnosis of the thyroid diseases, the elemental composition of pathological thyroid tissue [neoplastic and non-neoplastic] was investigated by proton induced X-ray emission. The PIXE has been widely used as a sensitive technique for trace elemental analysis in both biological and medical fields. Materials and The twenty-eight specimen of thyroid tissue [neoplastic, non-neoplastic and grossly normal tissue] were obtained from operation of 14 patients with different thyroid diseases. Determination of the heavy trace elements distribution [Fe, Co, Ni, Cu, Zn, As, Se, Br, Rb, Mo, I] was carried out by irradiating of the sample surface with a focused proton beam. Fourteen grossly normal, eleven non-neoplastic and three malignant thyroid neoplasm cases were diagnosed. Trace element contents of the International Atomic Energy Agency [IAEA] MA-B-3/TM Fish tissue was used as standard for calibration of PIXE set up. The concentration of the heavy trace elements Co, Cu, Zn and Mo in neoplasm of thyroid were higher than other samples. The concentration of the heavy trace elements, Fe, As, Br, Rb, I, are found to be much lower in neoplasm of thyroid than non-malignant and grossly normal thyroid tissue. The concentration of the Se, Co and I in this study is consistent with the others study but there are differences in the concentration of Fe in our study and others works. Iodine concentrations was 11 times lower, on average in neoplasm compared with non-neoplasmic tissue of thyroid. The low levels of I in thyroid neoplasm are correlated to some pathological factors

pixe analysis for measuring the trace element concentration breast tissue of Iranian women

A powerful and improved technique, Proton Induced X-ray Emission [PIXE] has been performed-yielding the elemental composition of 17 samples of surgically excised malignant and normal tumors of breast tissue. The samples without any further process as thick targets were put on capton foil backing. There are no homogenizing processes. The PIXE spectra analysis was performed using he non-linear least square fitting code AXIL and GUPIX. Materials and The samples are taken from patients in the wide range of age and are bombarded by 2.0 Me v energy proton beams produced by van de graff accelerator in vacuum. The quantitative comparison between two types of tissues was evaluated by assessing the presence of c alcium, Potassium, Iron, Copper and Zinc, as minor and trace elements. Results in this study indicate that relative values of Cu / Zn, P / K and also Ca and S in benign type were higher than those in malignant type, but the concentration of Fe and Zn in cancerous tissues was significantly higher than those for benign type. Results suggest significant elevation of Zinc in the pathological tissues. Cu/Zn ratio for both type of tissues are evaluated. The results show that this ratio in patients with breast cancer is significantly lower than the normal group. Selenium and Arsenic was not obtained in any of 17 samples. Most of the tissues of benign kind [Fibrocystic and Fibro adenoma] contain Cadmium. Calcium concentration in normal tissues is significantly higher than tumorous tissues

concentration of heavy trace elements in pigment and cholesterol human gallstones: comparative studies by PIXE analysis

The method of proton induced X-ray emission [PIXE] has been widely used as a sensitive technique to trace elemental analysis in both biological and medical fields. The sensitivity of this powerful method is in the order of ppm.The aim of this work is to analyze structural composition of 4 heavy trace elements with Z greater than 24 [Mn, Fe, Cu, Zn] in two kinds of gallstones and to compare the results for various ages of patients by PIXE quantitatively. Materials and methods: The pigment and cholesterole gallstones were obtained from 12 patients during surgical operations and were used for in vitro study. The age of the patients were between 22 and 78 years. Both cholesterol and pigmented types were analyzed for shell and center. The samples were bombarded using a 3.0 MeV van-de-Graff accelerator at nuclear research center of Atomic Energy Organization of Iran for the PIXE measurement. In pigment gallstones, the mean value of Mn, Fe, and Zn in shell is greater than in the center and Cu in the shell is smaller than center. In cholesterol gallstones, neither in the shell nor in center, Zn was not observed. The composition of Mn and Fe in center is greater than in shell. In the patients older than 40 years, the concentration of heavy trace elements increases, and those in cholesterol stones are nearly two times larger than in pigment stones. Comparison of two types of gallstones shows that the center of the pigment stones is very similar to cholesterol type.It is concluded that the origination of gallstone in human is common but formation and growth are different