Apoptosis of human lymphocytes after exposure to hydatid fluid

Modulation of the immune response is an important strategy by which establishment and growth of hydatid cyst in the internal organs of human is warranted. Induction of apoptosis in the lymphocytes might be a considerable component. This study was designed to evaluate apoptotic impact of hydatid fluid [HF] on human lymphocytes. Human lymphocytes were treated with hydatid fluid. After 6 hours of exposure, caspase-3 activity, the central enzyme of apoptosis cascade, was measured by fluorometric assay in the HF-treated lymphocytes and control cells. In addition, the expression of Bax [a pro-apoptotic protein] and Bcl-2 [an anti-apoptotic protein] mRNA was assessed by RT-PCR after 12 hours of exposure. Both the ratio of Bax/Bcl-2 mRNA expression and Caspase-3 activity were higher in the HF-treated lymphocytes relative to the control group. Apoptosis could be as a possible mechanism by which Echinococcus granulosus overwhelms host defenses

[Etiologic evaluation of patients with dysphagia admitted to ENT and thorax surgery wards of Ghaem hospital, Mashhad, northeast of Iran]

Dysphagia is a common chief complain of various diseases with different benign or malignant etiologies. Iran is one of countries with a high incidence rate of esophageal cancer. The aim of this study was to evaluate the common causes of dysphagia for earlier diagnosis and treatment of this disease and reduction of its morbidity and mortality rate. In this descriptive study, we analyzed the etiology of dysphagia in 200 patients who were admitted to ENT and thorax surgery wards of Mashhad Ghaem Hospital during 2005-2007. Of 200 patients, 79 patients were female and 121 patients were male. The most prevalent cause of dysphagia in these patients was esophageal SCC and the most common endoscopic presentation was the ulcerative view. Other common etiologic factors were esophageal stenosis, adenocarcinoma, mediastinal tumors, achalasia, lyomyoma, sarcoma and diffuse esophageal spasm, respectively. According to these results, the complaint of dysphagia with or without odinophagia has particular clinical importance, especially in our country with high frequency of esophageal malignancies

[ role of ultrasonography guided transthoracic needle biopsy in diagnosis of peripheral pulmonary mass]

Transthoracic needle biopsy [TNB] is a well established method for obtaining pathologic diagnosis in the lung masses that is performed after a previous negative bronchoscopy. The goal of this study was evaluation of the safety and accuracy of ultrasonography guided TNB in diagnosis of peripheral lung masses. This descriptive study was done from 2005 to 2006 in Ghaem Hospital. 30 patients with peripheral lung mass, greater than 3[cm] in diameter and within 5[cm] from the chest wall, underwent ultrasonography guided TTNB. Data was gathered in a questionnaire and analyzed by descriptive statistics and frequency distribution tables. Male to female ratio was about 1:2, and mean age was 61.2 years. 60% lesions were located in the right side. Adequate biopsy specimens were obtained in all patients; but TNB was diagnostic in 86.6%, 13.3% patients underwent thoracotomy for definitive diagnosis. Pathological diagnoses were malignant in 83.3%, with SCC and ACC being the most common, and benign in 16.6%, the most common of which was tuberculosis. Complications were observed in 13.3%, including pneumothorax in 6.6%, and hemoptysis in 6.6%; mortality was not observed. According to this study, TNB with ultrasonography guide due to appropriate diagnostic accuracy and low complication rate with low cost and good availability is recommended for diagnosis of peripheral lung mass

Clinical results of thymectomy in myasthenia gravis patients

Myasthenia gravis is an autoimmune disorder affecting postsynaptic acetylcholine receptors of voluntary muscles. Since Blalock et al. first demonstrated the beneficial effect of thymectomy in 1939. The procedure has become increasingly accepted in the treatment of myasthenia gravis. we studied clinical results of thymectomy in myasthenia gravis cases during 12 years retrospectively and antegradly. Our variables included: patient's age, sex, and signs at the time of admission, disease onset to operation interval, postoperative complications, and duration of hospitalization, thymus histology and clinical response to thymectomy. Data were analyzed appropriate analysis. 16 women and 11 men with median age of 29.8 [ +/- 12.7] years were operated on by median sternotomy approach. Thymectomy was done during less than 1 year after disease onset in 44%, 1-3 years later in 42% and later than 3 years in 14%. Most had mild to moderate generalized myasthenia. Thymic hyperplasia was reported to be the most common pathologic finding. Clinical response to thymectomy was good [70.4%]. The best results were obtained in female less than 40 years old, with out thymoma, disease onset to operation interval less than 2 years and mild myasthenia. Because of its high beneficial rate thymectomy is an advantageous therapeutic option. The chance of benefit increases when the history of myasthenia gravis is short and the stage of the disease is early

Mucormycosis of the lung, a rare cause for lung cavitations. case report

Cavitary lung lesion is caused by serious lung pathology. Among rare causes is mucormycosis that should not be overlooked. High index of suspicion is necessary to avoid missed diagnosis especially in diabetic and immunosuppressed patients. We present two cases with lung mucormycosis diagnosis. Case 1: A 58 year old male with history of diabetes, presented with hemoptysis. Chest X ray [CXR] showed cavitation. Bronchial lavage revealed mucor hypha that was proved again with lobectomy. Case 2: A 39 year old female with history of chronic renal failure and lung cavitary lesion due to previous necrotizing pneumonia. She suffered from cough, dyspnea and hemoptysis. Comparison of old and new CT scan showed increasing of cavity thickness. Lobectomy was performed and mucor was proved in histopathology. We present two cases of pulmonary mucormycosis who referred with hemoptysis and other respiratory tract symptoms and lung cavitations. Surgical resection and amphotericin was very successful in their management. We recommend investigation of fungus in BAL fluid or tissue material of patients with cavitary lesion

Manegment of malignant esophagorespiratory fistula

The development of a malignant esophagorespiratory fistula is a devasting complication. The only effective treatment is to exclude the fistula from the alimentary tract. This may be achieved by intubation or esophageal bypass, and we describe our experience with these two procedures. To assess the results of therapy, we reviewed our experience in 8 patients with esophagorespiratory fistula due to esophageal carcinoma from 1994 to 2002 at Omid and Ghaem Hospitals. Age ranged from 45 to 73 years [median 57.7 years] the male / female ratio was 3:1. Primary tumor site was squamous cell carcinoma of midesophagus in all patients. All patients experienced an approximately equal average weight loss of 10kg. Three patients were intubated by a traction [pull-through] technique with plastic stent named Mousseau-Barbin tube and the other five patients were treated by substernal gastric bypass of the excluded esophagus. There was one cervical anastomotic leak in the bypass group that healed conservatively and also one hospital death in the bypass group [hospital mortality rate 20%]. Due to pulmonary infection, with no hospital death in the intubated group. The mean hospital stay in the intubation group was 13 days and in the bypass group was 19 days. All patients in both groups had acceptable quality of remaining life and were able to eat soft or regular diet without any serious pulmonary complications. The mean survival in the intubated group was 125.5 days [range 105 to 145 days] and in bypass group 137.5 days [75 to 180 days]