Prevalence of human papilloma virus in sinonasal papilloma in southern Iranian population

Statement of the Problem: Sinonasal papilloma [SNP] is a rare benign lesion characterized by high recurrence rate and malignant transformation

Purpose: This study aimed to investigate the prevalence of human papilloma virus [HPV] infection in these lesions in South of Iran

Materials and Method: In this cross sectional retrospective study, a total of 41 patients, 38 SNP and 3 SNP/Squamous cell carcinoma cases, from 2007 to 2014 were studied. Human papilloma virus [HPV] DNA detection was performed by nested PCR method and positive cases were analyzed for high risk HPV-16 and HPV-18

Results: HPV was detected in 31.7%; HPV- 16 in 4.9% and HPV 18 was not detected at all. Dysplastic epithelium was detected in 53% that was not associated with HPV. Three cases were accompanied with malignant transformation that HPV genome was detected in only one case and none of them were positive for HPV16 /18 genomic DNA

Conclusion: Current research suggests that HPV may be involved in the development of SNP. But the high risk HPV is not important in malignant transformation. More studies are needed to elucidate the possible etiologic mechanism between HPV, inverted papilloma, and squamous cell carcinoma

Facilitated percutaneous coronary interventrion: a new treatment strategy for acute myocardial infarction

Restoring patency of infarct related artery [IRA] is the ultimate goal which can be achieved either pharmacologically [using thrombolytic therapy] or mechanically [through percutaneous coronary intervention [PCI]. The latter needs a sophisticated setup, an equipped Cath. Lab. and a skilled team. Such a system might not be always available, and a full dose thrombolytic therapy is the next best alternative. Recently there is a trend towards "facilitated PCI" whereby low dose thrombolytic and/or antiplatelet therapies are used prior to primary PCI, aiming at an early, complete, and sustained epicardial flow and myocardial perfusion. To compare the efficacy and safety of facilitated PCI with standard primary PCI, we studied 40 pts with acute myocardial infarction [AMI] divided into 2 groups. A study group consisted of 20 pts [18M, 2F, mean age 46.3 +/- 11.5y], all received 750.000 u of streptokinase combined with GP IIb/IIIa receptor inhibitor "tirofiban" 0.4ug/kg/min over 30min followed by 0.1ug/kg/min over 48 hours. Twenty pts [15M, 5F, mean age 54 +/- 8.6y] served as control group [no thrombolytic nor antiplatelet therapy]. Both groups underwent PCI within [73 +/- 18min] from randomization. Angiographic patency was expressed in terms of TIMI flow grading system, ECG criteria comprised extent and rapidity of ST segment resolution and laboratory criteria involved early peaking of CK-MB within 12 hours from randomization. Besides clinical evaluation in terms of major adverse cardiac events [MACE], echocardiographic parameters [LVEDD and LVEF] were used to assess LV function before and after PCI and monthly thereafter for 6 months. Compared to the group subjected to PCI alone, those who had preceding adjunctive pharmacological therapy "facilitated PCI" exhibited significantly greater TIMI 3 flow [84%: vs 60%, p<0.05], smaller LVEDD [5.0 vs 5.5, p<0.05], significantly higher LVEF [55.4% vs 50.7%, p<0.05] and lower rate of MACE [0% vs 20%]. Patients with facilitated PCI also exhibited significantly higher ST segment resolution, [58% vs 45%, p<0.05] and earlier peaking of CK-MB [85% vs 35%] compared to control group. Facilitated PCI offers an excellent way of circumventing the time delay preceding PCI that is frequently encountered on hospital admission of pts with acute MI. Through combining interventional, fibrinolytic and GP IIb/IIIa inhibitor therapy, facilitated PCI provides a more rapid, complete and sustained patency of IRA than primary PCI alone without the adverse effects of full dose thrombolylic therapy and a with better outcome in terms of lesser MACE and preserved LV function

Objective assessment of the severity of stress urinary incontinence by urodynamic tests and introital ultrasound

To determine whether objective differences exist in the results of urodynamic tests and introital ultrasonography between patients with grade 1 and 2 stress urinary incontinence. The study included fifty premenopausal women with the diagnosis of stress urinary incontinence as proved by urodynamic findings [cystometric exclusion of detrusor hyperactivity]. Patients were classified into grade 1 and 2 according to the degree of physical activity required to produce urinary leakage. Twenty five patients had grade 1 and 25 had grade 2 stress urinary incontinence. Parameters of uroflowmetry filling crystometry, urethral pressure profile and introital ultrasound were compared between grade 1 and 2 stress urinary incontinence. Urodynamic measurements showed that in uroflowmetry, there were no significant differences in maximum flow rate or residual urine between grade 1 and 2. In Filling crystometry, there were no significant differences in the first desire to void or maximum cystometric capacity between the two groups. There were also no significant differences in any of the urethral pressure profile parameters. Intorital ultrasound revealed no significant differences in posterior urethrovesical angle, bladder neck descent or urethral funneling between grade 1 and 2. There are no differences in objective related parameters between patients with grade 1 and 2 stress urinary incontinence, as documented by both urodynamic and ultrasound studies. The development of more objective tests as 3D ultrasound, ultrasound with contrast media, color Doppler and MRI is required to accurately classify stress urinary incontinence

Introducing a new model for studying retinal detachement/replacement: a light microscopy and electrophysiological study

The toad's [Bufo maranus] retinal pigment epithelium [RPE] has been used in many studies as a model for understanding its role and interaction with the neural retina. In the current study, the toad's retina has been used to establish a new in vitro model of experimental retinal detachment [RD] and replacement. The toad was chosen according to a previous study of our research group showed that the toad RPE is similar to the mammalian RPE. In this report, light microscopy was used to characterize the morphologic changes that occur in the RPE and neural retina following RD/replacement and to correlate these findings with recovery of electrophysiological function. The neural retina was completely detached from the RPE in vitro and then replaced. At various times after replacement, neural retina-RPE tissues were processed for light microscopy. At 30 min. after replacement, the subretinal space was greatly expanded, and the apical processes that normally ensheath the outer segments of neural retina were short and no longer contacted the outer segments of neural retina. The RPE was swollen, contained many vacuoles and the apical surface was rounded. By 2 hours after replacement, the subretinal space was significantly resorbed and contained many shredded neural retina outer segments; RPE cells were still, although less, swollen. During the next 5-10 hours, shredded neural retina outer segment in the subretinal space appeared decreased. RPE cells regained their normal size and interdigitation of apical processes and neural retina outer segment were observed. In conclusion, these results demonstrate the re-establishment of morphological interactions between the RPE and neural retina within hours following RD/replacement. Morphological recovery coincides with recovery of electrophysiological parameters. This is a good model to investigate the retinal pigment epithelium [RPE] and neural retina mechanisms involved in retinal adhesion and recovery from retinal detachment and is easier to be applied than previously described models