[ introduction of the first case of jarcho- levin syndrome from Iran]

Jarcho-Levin syndrome is a rare central skeletal system defect with the involvement of ribs and vertebrae and association of short trunk stature and some other organ anomalies. One of the common problems is different rate of respiratory abnormalities. Chest X-Ray is the primary base for the diagnosis, but spiral 3D CT scan give us more accurate evaluation of the ribs situation. There are also cardiac problems associated with this syndrome. In this case we present a 9- month- old infant who had Jarcho-Levin syndrome with right-sided heart failure

[Acral lentiginous melanoma misdiagnosed as chronic ulcer: a case report]

Acral lentiginous melanoma [ALM] is the most common type of cutaneous melanoma which can occur on the palms, soles or beneath the nail plate. Diagnosis of ALM is usually delayed and melanomas can only be diagnosed at advanced clinical stage so the prognosis is often poor. We report a case of Acral lentiginous melanoma which misdiagnosed as chronic ulcer. Chronic lesions even if benign in appearance deserve close observation. Biopsies are required to prevent misdiagnosis, mistreatment and delay in diagnosis

Hepatic doppler ultrasound in assessment of the severity of esophageal varices in cirrhotic patients

Endoscopy is the gold-standard technique for the assessment of acutely hemorrhagic esophageal varices in patients with hepatic cirrhosis. The objective of this study is to determine the value of different hepatic vasculature Doppler ultrasonography and their flow characteristics for non-invasive assessment of esophageal varices. Fifty-five [31 male, 24 female] consecutive patients with a mean +/- SD age of 55 +/- 16 [range: 20-88] years, with biopsy-proven hepatic cirrhosis were prospectively studied using Doppler ultrasonography. All of these patients were also examined endoscopically and by echocardiography. None of patients had clinical or echocardiographic signs of right heart failure, tricuspid valve regurgitation or previous history of therapeutic interventions on varices. An ordinal logistic regression [OLR] model was used for determining the adjusted associations between sizes of esophageal varices and hepatic hemodynamic determinants. There was a significant correlation between the size of esophageal varices and maximum portal vein velocity, which was lower in patients with varices [p= 0.04]. Other parameters though not statistically significant, were of clinical importance. Those included portal vein mean velocity [p = 0.08], hepatic artery volume flow [p = 0.06] and hepatic venous waveform pattern [p = 0.15]. OLR model did not show any significant adjusted associations between these parameters and the size of esophageal varices. The maximum portal vein velocity and to a lesser extent, hepatic artery volume flow were superior to Doppler ultrasonographic spectral waveform pattern of hepatic vein in differentiating patients with esophageal varices from those with no varices. None of hepatic vasculature Doppler measurements had a significant role in predicting the size of esophageal varices, nonetheless

[Yellow nail syndrome, a case report]

Yellow nail syndrome [YNS] is a rare disorder characterized by a triad of yellow discoloration and destructive changes of nails, lymph edema and a variety of pathologies in the respiratory system. This disorder can be associated with and herald the presence of internal diseases. An increased awareness of these conditions may help with the early diagnosis and therapy of the associated disorders. We report a 24 years old whom with yellow nail syndrome whom was admitted at hospital. She also had fever, lymph edema and pulmonary manifestations

Agreement determination between coronary calciumscoring and coronary stenosis significance on CT-angiography

The most important lesions in coronary artery disease [CAD] are coronary artery plaques, many of which are calcified. Multi-slice spiral CT [MSCT] scanners can concurrently perform coronary calcium scoring [Ca-Score] as a predictor of CAD and coronary CT-angiography [CCTA] as the determining factor in therapeutic decision-making. We aimed to determine the agreement of a Ca-Score more than 100 [based on Agatston technique] with coronary artery stenosis significance on CCTA. Using ECG-gated MSCT, 65 patients who were referred for CCTA were assessed both for their Ca-Score and a significant [>/= 50% diameter reduction] coronary stenosis, simultaneously. Their total Ca-Score were classified in three groups [a-O, b-less than 100, and c- >/= 100]. The severity of coronary stenosis was categorized to further three groups [1-lack of stenotic lesion, 2- presence of non-significant stenosis, and 3-presence of significant stenosis]. Of 65 patients referred for CCTA, 42 [64.61%] had no CAD, 8 [12.3%] had non-significant lesions' and 15 [23.09%] had significant stenoses. Forty-three [66.2%] out of 65 subjects had a zero. 14 [21.5%] had scores < 100, and 8 [12.3%] had >/= 100 Ca-Score. In the first group [Ca-score = 0], only one had significant stenosis; while 50% of the patients in the second group [Ca-score < 100] and 87.5% from the third group [Ca-score of >/= 100] had significant stenosis. Significant coronary stenosis has a moderate-to-good agreement with a Ca-Score of 100 or higher, compared to those with a Ca-Score of less than 100, and this was statistically significant [P < 0.0001]. In patients with a calcium score of 100 or more, performing CCTA may be advisable to assess the likelihood of significant CAD

[Modification of naloxone-induced withdrawal signs by ascorbic acid in morphine-dependent guinea-pigs]

Ascorbic acid, an antioxidant vitamin, is found throughout the mammalian central nervous system. Although, the centeral role of ascorbic acid is unclear, but there is good evidence that ascorbic acid modulates opiate withdrawal syndrome. This study was done to determine the effect of ascorbic acid [A.A.] on naloxone-induced withdrawal signs in morphine-dependent guinea-pigs. In this experimental study, male guinea-pigs [300-400 g; 8-10 animals/group] were rendered dependent on morphine by subcutaneous [s.c.] injections of morphine sulfate 3 times a day for 3 days, and withdrawal signs were induced by intraperitoneal [i.p.] administration of naloxone [15 mg/kg] 2 h after the tenth injection of morphine sulfate on day 4; then animals were placed individually into a cylindrical glass [25 cm in diameter, 180 cm height] and the withdrawal signs were recorded over a 60-min period. Chronic pretreatment of guinea-pigs with A.A., 200 mg/kg, s.c. 3 times daily for 3 days, reduced withdrawal jumping, digging, writhing, rearing, face- washing, head and body shakes, penile licking and diarrhea. The mixed dopamine D1/D2 receptor agonist apomorphine [0.5 mg/kg, s.c.] markedly antagonized the inhibitory effect of A.A. on the withdrawal signs. The effect of apomorphine was blocked by the dopamine D1 receptor antagonist SCH23390 [0.5 and 1 mg/kg, i.p.] but not by the dopamine D2 receptor antagonist sulpiride [50 mg/kg, s.c.] nor the peripheral dopamine receptor antagonist domperidone [1 mg/kg, s.c.]. It is concluded that chronic administration of ascorbic acid inhibits opiate withdrawal, via a central dopamine D1 receptor mechanism

Evaluation of the best condition for ex vivo expansion of hematopoietic stem cells for the propose of cord blood transplantation

Umbilical cord blood [CB] has been identified as a rich source for hematopoietic stem cells [HSCs], and has provided an alternative to bone marrow transplantation. The use of ex vivo expanded cells has been suggested as a possible means to accelerate the speed of engraftment in cord blood [CB] transplantation. The main aim of our study is to find the best culture media and condition to increase number of CD34+/CD38- hematopoietic stem cells in cord blood for transplantation. Mononuclear cells [MNCs] were seperated from cord blood and cultured in RPMI1640 with 10% fetal calf serum [FCS] or 10% cord blood plasma [CBP] or serum free media [SF]. Culture media contained 50ng/ml of Interlukin 6 [IL6], IL3, Thrombopoietin [TPO] Stem cell factor [SCF] and flt3-ligand. Cells were cultured for two weeks and number of CD34+/CD38- cells and total MNCs measured at days 0, 7 and 14. At 14 days culture mean fold of expansion of CD34+ and CD34+/CD38- cells was 20.4 and 57.4 for FCS, 5.6 and 10.3 for SF and 10.8 and 4.7 for CBP culture media. Due to efficacy and predictability of SF media for cell expansion and because of its better safety for allergic reactions and microbial contamination [in comparison to animal products containing media] and enough expansion for clinical applications, we suggest that SF media is better than CBP or SF from clinical points of view