Comparison and Evaluation of Different Treatment Plans with IFRT Field and 6 and 18 MV Energies in Hodgkin's Lymphoma Involvement Neck and Mediastinum.

BACKGROUND: Radiotherapy with large mantle field is an effective technique in increasing the risk of secondary cancers among HL (Hodgkin Lymphoma) patients; therefore, it is essential to choose an effective treatment field including the least medical conditions in radiotherapy. OBJECTIVE: The present study aimed to plan separate fields for neck and mediastinum using various energies, to compare dose distribution with MLC and to block field formation. MATERIALS AND METHODS: In this study, 3D conformal treatments, Siemens Oncor accelerator equipped with multi-leaf collimator (MLC) were performed to create anterior-posterior fields. CT-scan data of 18 female patients with neck and mediastinal involvement was imported in TIGRT treatment planning system, and then treatment plans were introduced. RESULTS AND CONCLUSION: Using treatment plan 1, photon 6 MV in neck weighting 1 from interior, 0.5 from posterior, photon 18MV in mediastinum weighting 1 from interior and 0.5 from posterior, it was shown that regarding the common treatment plan used with photon 6 MV, mean dose delivered to breast, lung, esophagus and larynx reduced 6, 7, 41 and 10 percent, respectively and uniformity index improved by 10 percent. Using block compared to MLC in all treatment plans offered improved average dose in all organs under study. To protect breast and lung while using MLC and block in the first treatment plan seemed to be more appropriate; however, using blocks in comparison to MLC increased delivered mean dose in all organs under study. Using separate fields with Pb blocks, though, showed smaller increase.

The effect of prior endoscopic correction of vesicoureteral reflux on open ureteral reimplantation: Surgical outcomes and costs.

INTRODUCTION: Endoscopic injection of a bulking agent is a common first-line approach to the treatment of vesicoureteral reflux (VUR). While early outcomes are comparable to open ureteroneocystotomy, 5-25% of children will eventually develop recurrent reflux necessitating repeat injections or open ureteral reimplantation. OBJECTIVE: To determine whether prior endoscopic injection of a bulking agent impacts outcomes of subsequent open ureteral reimplantation. STUDY DESIGN: Using a retrospective cohort design, radiographic and clinical outcomes of open ureteral reimplantation were compared between patients with and without prior endoscopic correction of reflux. Surgical and hospitalization data were also compared between groups and a cost comparison was performed to assess differences in healthcare costs between the two cohorts. Units of analysis included total ureters or total patients. For certain variables, subanalysis of unilateral versus bilateral reimplantation was included. RESULTS: A total of 258 patients underwent open reimplantation for VUR between 2007 and 2016 by five pediatric urologists. Final analysis (see Summary Table) included 192 patients with pre-operative and postoperative voiding cystourethrogram (VCUG) and follow-up data at a median 4.95 months. Among 317 reimplanted refluxing ureters, radiographic resolution was reached in 26/27 (96.3%) patients with and 279/290 (96.2%) without prior endoscopic treatment (P = 0.981). Clinical success was achieved in 17/17 (100%) patients with and 174/175 (99.4%) without prior endoscopic treatment (P = 0.755). There were no statistically significant differences between duration of surgery or length of hospital stay. There were no statistically significant differences between total charges, total costs, and operating room (OR) costs between groups. DISCUSSION: This study indicated that prior endoscopic injection of a bulking agent did not impact the outcomes or costs of subsequent open ureteroneocystotomy. While prior studies have demonstrated tissue changes associated with injection of a bulking agent, these did not seem to significantly impact the difficulty of later open surgery or the success rates compared to patients who proceeded directly to open correction of reflux. CONCLUSION: Open ureteral reimplantation for recurrent VUR after failed endoscopic injection of a bulking agent was safe and effective, with comparable outcomes and costs to open surgery in patients without prior endoscopic correction.

Anaesthetic efficacy of lidocaine/clonidine for inferior alveolar nerve block in patients with irreversible pulpitis.

AIMS: This prospective, randomized, double-blind study aimed to compare the efficacy of lidocaine with epinephrine versus lidocaine with clonidine for inferior alveolar nerve block (IANB) and hemodynamic stability (heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure) in patients with irreversible pulpitis. METHODOLOGY: One hundred patients with irreversible pulpitis in mandibular molar teeth randomly received 1.8 mL of 2% lidocaine with clonidine (15 µg mL-1 ) or 1.8 mL of 2% lidocaine with epinephrine (12.5 µg mL-1 ), using a conventional IANB technique. Endodontic access cavities were prepared 15 min after solution deposition, and all patients were required to have profound lip numbness. Success was defined as no or mild pain (visual analog scale recording) upon endodontic access cavity preparation or initial canal instrumentation. The hemodynamic parameters were measured before, during and 5, 10 and 30 min after administration. Finally, the collected data were subjected to independent t-test, chi-square and Fisher's exact test using spss software ver.20 at a significant level of 0.05. RESULTS: The success rates for IANB using lidocaine with epinephrine and lidocaine with clonidine solutions were 29% and 59%, respectively. The clonidine group exhibited a significantly higher success rate (P < 0.05). Five minutes after drug administration, systolic blood pressure and heart rate significantly increased in the lidocaine with epinephrine group and insignificantly decreased in lidocaine with clonidine group. CONCLUSION: For mandibular molars with irreversible pulpitis, addition of clonidine to lidocaine improved the success rate of IANB compared to a standard lidocaine/epinephrine solution.

Ninety-day perioperative complications of pediatric robotic urological surgery: A multi-institutional study.

BACKGROUND: Robotic technology is the newest tool in the armamentarium for minimally invasive surgery. Individual centers have reported on both the outcomes and complications associated with this technology, but the numbers in these studies remain small, and it has been difficult to extrapolate meaningful information. OBJECTIVES: The intention was to evaluate a large cohort of pediatric robotic patients through a multi-center database in order to determine the frequency and types of complications associated with robotic surgery for pediatric reconstructive and ablative procedures in the United States. STUDY DESIGN: After institutional review board approvals at the participating centers, data were retrospectively collected (2007-2011) by each institute and entered into a RedCap(®) database. Available demographic and complication data that were assigned Clavien grading scores were analyzed. RESULTS: From a cohort of 858 patients (880 RAL procedures), Grade IIIa and Grade IIIb complications were seen in 41 (4.8%); and one patient (0.1%) had a grade IVa complication. Intraoperative visceral injuries secondary to robotic instrument exchange and traction injury were seen in four (0.5%) patients, with subsequent conversion to an open procedure. Grade I and II complications were seen in 59 (6.9%) and 70 (8.2%) patients, respectively; they were all managed conservatively. A total of 14 (1.6%) were converted to an open or pure laparoscopic procedure, of which, 12 (86%) were secondary to mechanical challenges. DISCUSSION: It is believed that this study represents the largest and most comprehensive description of pediatric RAL urological complications to date. The results demonstrate a 4.7% rate of Clavien Grade IIIa and Grade IIIb complications in a total of 880 cases. While small numbers make it difficult to draw conclusions regarding the most complex reconstructive cases (bladder diverticulectomy, bladder neck revision, etc.), the data on the more commonly performed procedures, such as the RAL pyeloplasty and ureteral reimplantation, are robust and more likely represent the true complication rate for these procedures when performed by highly experienced robotic surgeons. CONCLUSION: Pediatric robotic urologic procedures are technically feasible and safe. The overall 90-day complication rate is similar to reports of laparoscopic and open surgical procedures. COMPLICATIONS: n (%) Life threatening (IVa): 1 (0.1%) Requiring radiologic and or surgical intervention (IIIa and IIIb): 41 (4.8%) Secondary to robotic system: 4 (0.5%) Mechanical failure leading to conversion: 14 (1.6%).

Some Epidemiological Aspects of Cutaneous Leishmaniasis in a New Focus, Central Iran.

Following the epidemic of cutaneous leishmaniasis in Khatam County, Yazd Province, this study was carried out to determine vector, and animal reservoir host(s) and investigate the human infection during 2005-2006. Four rural districts where the disease had higher prevalence were selected. Sticky paper traps were used to collect sand flies during April to November, biweekly. Meanwhile rodents were captured using Sherman traps from August to November. Households and primary schools were visited and examined for human infection in February 2006. The parasite was detected by RAPD-PCR method. The rate of ulcers and scars among the inhabitants was 4.8% and 9.8%, respectively. Three rodent species were captured during the study: Meriones libycus, Rhombomys opimus, and Tatera indica. Six sand fly species were also collected and identified; among them Phlebotomus papatasi had the highest frequency. Leishmania major was detected as the agent of the disease in the area. It was detected from R. opimus and native people.

Facial injuries in Iranian veterans during the Iraq-Iran war (1980-88): differences from recent conflicts.

Our aim was to identify the pattern and mechanism of facial injuries in Iranian veterans during the Iraq-Iran war and to assess the effectiveness of current protective equipment by retrospectively evaluating 100 Iranian veterans of that war. We randomly included veterans with injuries to various parts of the face, with or without injuries to other organs. None died. We recorded anatomical distribution, incidence, and mechanism of injury as well as injury scores using common references scales. Data are expressed as mean (SD) or number. Fragmentation injuries were the most common (n=40) followed by blast (n=37), shock wave (n=18), and gunshots (n=5). Thirty-five patients had mandibular fractures with a mean (SD) score of 3.7 (1.4). Fifteen patients had injuries to the upper face and 79 to the midface. Twenty-four patients had facial lacerations more than 10 cm long, with a mean facial injury score of 2.4 (2.0). Nineteen had ocular injuries with a mean (SD) ocular trauma score of 64.9 (12.9). Despite recent developments in protective equipment we have seen no significant reduction in the incidence of facial injuries in battle, which could indicate that we need better facial support equipment and more effective education in its use. However, using protective equipment such as goggles and a mandibular protector is highly recommended.

Predicted Distribution of Visceral Leishmaniasis Vectors (Diptera: Psychodidae; Phlebotominae) in Iran: A Niche Model Study.

Visceral leishmaniasis (VL) is an important vector-borne disease in Iran. Till now, Leishmania infantum has been detected from five species of sand flies in the country including Phlebotomus kandelakii, Phlebotomus major s.l., Phlebotomus perfiliewi, Phlebotomus alexandri and Phlebotomus tobbi. Also, Phlebotomus keshishiani was found to be infected with Leishmania parasites. This study aimed at predicting the probable niches and distribution of vectors of visceral leishmaniasis in Iran. Data on spatial distribution studies of sand flies were obtained from Iranian database on sand flies. Sample points were included in data from faunistic studies on sand flies conducted during 1995-2013. MaxEnt software was used to predict the appropriate ecological niches for given species, using climatic and topographical data. Distribution maps were prepared and classified in ArcGIS to find main ecological niches of the vectors and hot spots for VL transmission in Iran. Phlebotomus kandelakii, Ph. major s.l. and Ph. alexandri seem to have played a more important role in VL transmission in Iran, so this study focuses on them. Representations of MaxEnt model for probability of distribution of the studied sand flies showed high contribution of climatological and topographical variables to predict the potential distribution of three vector species. Isothermality was found to be an environmental variable with the highest gain when used in isolation for Ph. kandelakii and Ph. major s.l., while for Ph. alexandri, the most effective variable was precipitation of the coldest quarter. The results of this study present the first prediction on distribution of sand fly vectors of VL in Iran. The predicted distributions were matched with the disease-endemic areas in the country, while it was found that there were some unaffected areas with the potential transmission. More comprehensive studies are recommended on the ecology and vector competence of VL vectors in the country.

Results of combination chemotherapy and radiation therapy in non-metastatic gastric cancer in Yazd--Iran.

BACKGROUND: Gastric cancer is the first cause of cancer death in Iran. Most of the patients are diagnosed in advanced stages and survival rate is low. The aim of this study was to evaluate the survival rate of patients with gastric and gastroesophageal junction adenocarcinoma receiving combination chemotherapy and radiation therapy in Iran. MATERIALS AND METHODS: This study was conducted on 53 patients with gastric or gastroesophageal junction adenocarcinoma referring to Shahid Ramezanzadeh Radiation Oncology Center between 2004 and 2010. All patients underwent surgical operation, chemotherapy, and radiotherapy. Data contained in patients' records were extracted and follow-up was conducted through telephone contacts. To analyze the data, Kaplan Meier curves, and SPSS software were employed. RESULTS: Seventeen (32.1%) patients were female and 36 (67.9%) were male. Mean age was 58.32 years. In 14 patients (26.9%) no lymph node was resected or reported by the pathologist. In 29 patients (54.7%) one to six lymph nodes were found, and in10 patients (18.9%) seven lymph nodes or more were detected. In two patients, (3.77%) more than 15 lymph nodes were resected. Surgical staging was impossible for 16 patients (30.2%). Mean survival was 50.9 months and median survival was 51 months. 3,5 and 7 year survival rates were 73%, 36%, and 18% respectively. None of the variables had a significant relation to survival. CONCLUSIONS: Despite inadequate surgery, the survival rate in our study is one of the best one reported in our country. We think this advantage may be due to poly drug chemotherapy and sequential radiation therapy.

Field evaluation of phostoxin and zinc phosphide for the control of zoonotic cutaneous leishmaniasis in a hyperendemic area, central Iran.

BACKGROUND & OBJECTIVES: ZCL is a growing threat in many rural areas of Iran which involves 17 out of 31 provinces. This study was conducted from April to November 2011 for evaluation of the efficacy of phostoxin and zinc phosphide against rodents. METHODS: Rodent control operations were carried out using phostoxin and zinc phosphide. To evaluate the effect of rodent control operation on the main vector density, an entomological survey was carried out. The effects of the operation on the disease incidence were also evaluated. RESULTS: After intervention, the reduction rate of rodent burrows was 32.68% in the village treated with phostoxin and 58.14% in the village treated with zinc phosphide. The number of rodent holes in the control area showed 6.66-fold increase at the end of the study. The incidence of the disease decreased to 19.23 and 11.40 in areas treated with phostoxin and zinc phosphide, respectively. A total of 4243 adult sandflies were collected and identified. The most common and dominant species was Phlebotomus papatasi. In the village treated with phostoxin, the density of P. papatasi in outdoors was lower than indoors. Nevertheless, the density of P. papatasi in the village treated with zinc phosphide was higher in outdoors. INTERPRETATION & CONCLUSION: It is concluded that phostoxin is less effective and has low safety in comparison with zinc phosphide, so that this rodenticide can be used only in special situations such as lack or ineffective rodenticides and only in the colonies far from human and animal dwelling places in small scales.

Clinicopathologic characteristics and outcome of childhood and adolescent Ewing's sarcoma in center of Iran.

BACKGROUND: Ewing's sarcoma family is a group of small round cells tumors. The aim of this study is to evaluate clinicopathologic characteristics and outcome of Ewing's sarcoma in children and adolescents in Yazd, Iran. MATERIALS AND METHODS: All patients under 19 years with documented pathology of Ewing's sarcoma family tumor who referred to Shahid Ramazanzadeh Radiotherapy center between 2002 to 2010 were enrolled in this retrospective study. Overall survival and disease free survival and prognostic factors were evaluated. RESULTS: Among approximately 80,000 patients who referred to Shahid Sadoughi pathology department, over an 8-year period, the total number of patients with Ewing sarcoma was 32, of which, 18 cases were under the age 19 . The mean age was 13.72 years. Five patients (27.8%) had metastatic disease at the time of diagnosis. Complete response had been achieved in 8 (44.4%) of the patients. Local recurrence occurred in 4 (22.2%) of the patients. During the follow up 13 (72.2%) of the patients showed metastases. The mean overall survival was 34.79 months (95% CI: 22.27-47.32) .One, two, four and five year survival was 72%, 39%, 25% and 17% respectively. Complete remission occurred in 10 patients (63.6%). A trend of better overall survival was found in these patients (p=0. 55). When the brain and bone metastases occurred, the overall survival decreased significantly (p=0. 003 ). CONCLUSIONS: The overall survival rate of Ewing's sarcoma is very low in comparison with other parts of the world.

Interleukin 4 (IL-4) gene promoter polymorphisms in Rhombomys opimus, the main reservoir of zoonotic cutaneous leishmaniasis.

Great gerbils (Rhombomys opimus) are the most common gerbils in center to northeast of Iran as well as central Asia and serve as reservoirs for the zoonotic agents, including Leishmania major, the principal etiologic agent of zoonotic cutaneous leishmaniasis (ZCL). The outcome of L. major infection in gerbils is not uniform. Among several immune-related factors including cytokine genes, the polymorphism in interleukin 4 (IL-4) promoter gene showed a great impact on outcome and pathological symptoms of L. major infection at least in mouse model. In this study gerbils' IL-4 promoter gene polymorphism is assessed. Specific primers were designed to develop a PCR-based assay to amplify IL-4 promoter gene to possibly define IL-4 promoter gene polymorphism in great gerbil populations with a range of Leishmania infection and symptoms collected from different foci of the central, north and northeast regions of Iran. The results showed that the designed primers amplify 689bp of the promoter gene. Sequence analysis of the promoter gene revealed five polymorphic sites assembly six haplotypes among the gerbil populations. Further studies are needed to assess whether or not the five polymorphisms cause different outcome phenotypes following infection with L. major in great gerbils. The data might be used to characterize the immune responses of R. opimus against L. major infection.

Triterpenes from Euphorbia spinidens with immunomodulatory activity.

Dried aceton-chloroform extract of aerial parts of Euphorbia spinidens Bornm. ex Prokh. endemic to Iran, yielded two new triterpenoids, lup-20(29)-ene-33, 28 diol commonly known as betulin and (3ß,23E)-Cycloarta-23-ene-3,25-diol. The structures of the isolated compounds were elucidated by 13C- and 1H-NMR as well as 2D-NMR, IR and by the aid of mass fragmentation pattern. In phagocyte chemiluminescence assay, different concentrations of compounds were incubated with the human whole blood in triplicate and the chemiluminescence activity of phagocytic cells were measured by using serum opsonized zymosan and luminol. For lymphocyte proliferation assay, peripheral human blood lymphocytes were incubated with different concentrations of the test compound in supplemented Roswell Park Memorial Institute (RPMI) 1640 medium along with 5.0 µg/ml phytohemagglutinin (PHA) at 37°C in CO2 environment for 72 h and proliferation level was determined by Beta-scintillation counter. In phagocyte chemiluminescence assay, betulin showed moderate inhibitory effect on the oxidative burst in the neutrophils, while addition of betulin triterpene was able to stimulate the proliferation of the phytohemagglutinin (PHA) treated human peripheral blood lymphocytes (hPBLs).

Molecular detection of Leishmania infection in sand flies in border line of Iran-Turkmenistan: restricted and permissive vectors.

A molecular study was carried out to incriminate sand fly vectors of cutaneous leishmaniasis (CL) in rural areas of Sarakhs district, Khorassane-Razavi Province, northeastern Iran, in 2011. Sand flies of Sergentomyia with three species and Phlebotomus with six species respectively comprised 73.3% and 26.7% of the specimens. Phlebotomus papatasi was the most common Phlebotomine species in outdoor and indoor resting places. Leishmania infection was found at least in 17 (22%) specimens including Ph. papatasi (n=9 pool samples), Phlebotomus caucasicus (n=6), Phlebotomus alexandri (n=1), and Sergentomyia sintoni (n=1). The parasites were found comprised Leishmania major (n=5), Leishmania turanica (n=10), and Leishmania gerbilli (n=4). Infection of Ph. papatasi with both L. major and L. turanica supporting the new suggestion indicating that it is not restricted only with L. major. Circulation of L. major by Ph. alexandri, and both L. gerbilli and L. turanica by Ph. caucasicus, in addition to previous data indicating the ability of Ph. alexandri to circulate Leishmania infantum and Leishmania donovani, and Ph. caucasicus to circulate L. major, suggests that these two species can be permissive vectors. The results suggest that Ph. papatasi and Ph. alexandri are the primary and secondary vectors of CL where circulating L. major between human and reservoirs, whereas Ph. caucasicus is circulating L. turanica and L. gerbilli between the rodents in the region.

Wild rodents and their ectoparasites in Baluchistan area, southeast of Iran.

During 2008-2009 a total of 67 individuals of rodents, Tetera indica, Meriones hurrianae, Meriones libycus and Gerbillus nanus were trapped in three areas, Bampor, Daman and Qasre Qand from Iranshahr and Nikshahr districts. There is a significant difference between comparative abundance of four species (P<0.05). A total of 1422 ectoparasites collected including 299 mites (21%), 127 fleas (8.9%), 972 lice (68.4%) and 24 ticks (1.7%). Significant findings amongst the ectoparasites is the lice group with three species identified, Laelaps accuninata, Andralaelaps hermophrodita and Paracheylaellaps pyriformis being the first record in the study areas. All four captured genera of rodents are known as main/ potential reservoir hosts of zoonotic cutaneous leishmaniasis. The migration habit of rodents may affect the spatial distribution of parasitic ticks and their transmitted diseases like CCHF, which has been reported in recent years from Sistan and Baluchestan province. Monitoring of rodent populations and their ectoparasites will help to predict the potential of zoonotic arthropod-borne diseases.

Baseline insecticide susceptibility data of Phlebotomus papatasi in Iran.

BACKGROUND & OBJECTIVES: Phlebotomine sandflies (Diptera: Psychodidae) play main role in the transmission of different forms of leishmaniasis in the world. Phlebotomus papatasi is the main vector of zoonotic cutaneous leishmaniasis (ZCL) in Iran. There are several control measures for vector control using different classes of insecticides. The aim of this study was to breed the sandflies which were collected from a hyperendemic focus of the disease in central Iran in the laboratory condition and to determine its baseline susceptibility to commonly used insecticides. METHODS: Sandflies were collected from the field and were reared in insectary. Susceptibility tests were carried out on their generation. Baseline susceptibility of sandflies to DDT and pyrethroids was evaluated based on LT50 values. A total of 1305 specimens were tested using different time intervals. The LT50 and LT90 values were measured according to the WHO standard tests. The results were plotted using probit analysis and regression lines. RESULTS: The results against female sandflies revealed the LT50 values of 1312.66, 253.66, 36.04, 9.38 and 6 sec to DDT (4%), permethrin (0.75%), deltamethrin (0.1%), cyfluthrin (0.15%) and lambda-cyhalothrin (0.05%), respectively. The figures for male sandflies were 1200.97, 310.10, 18.63, 6.08 and 0.77 sec respectively to the above insecticides. CONCLUSION: The results of this study could help to provide a clue for implementation of currently used insecticides. Furthermore, a specific guideline is needed for monitoring and evaluation of insecticide susceptibility test against sandflies.

Unusual presentation of disseminated cutaneous leishmaniasis due to Leishmania major: case reports of four Iranian patients.

We report four disseminated cutaneous leishmaniasis(DCL) cases referred to leishmaniasis laboratory at the School of Public Health, Tehran University of Medical Sciences with multiple nodular, ulcerative and crusted lesions extended on the face, trunk, and extremities. None of the patients had any complication and historical involvement in their immunological system conditions that suggest as the criteria for DCL. Direct smears of ulcers were positive for Leishmania parasite. The parasite was isolated from the active lesions and identified as Leishmania major (L. major) using PCR-RFLP assay and sequencing analysis.

Low voltage cycling of programmable metallization cell memory devices.

Future nanoscale memory technologies must ultimately be able to operate at power supply voltages in the order of 0.6 V or less. We have demonstrated in this work that it is possible to utilize symmetric program-erase (P-E) cycling for Ag/Ag-Ge-S/W programmable metallization cell devices at voltages below 0.6 V and still maintain an OFF/ON resistance ratio well in excess or 10 over a wide range of program and erase currents (0.27, 1.6, 55 and 220 µA) as set by a series resistance. The distributions of resistance values for 10(4) P-E cycles indicate that the margins between the highest on- and lowest off-state resistances are sufficient for unambiguous differentiation in all but the lowest current case in which there is some overlap. In addition, there is no substantial change in switching speed for up to 1.5 × 10(6) P-E operations, the maximum number of cycles attempted in this study.

Temporal expression pattern of sodium channel Nav 1.8 messenger RNA in pulpitis.

AIM: To determine mRNA expression levels of Nav 1.8 in inflamed pulps of rats. METHODOLOGY: Inflammation was induced by creating pulp exposures in rat incisors. Histopathological changes in the induced pulpitis were evaluated 1, 3, 7 and 10 days after exposure. Using real-time PCR, the relative mRNA expression levels of Nav 1.8 in the inflamed rat dental pulp was determined. RESULTS: At day 1, no inflammation was evident in the pulp tissue, whereas increased levels of inflammatory responses were identified at day 3 and day 7. No pulpal inflammation was evident in day 10 or in the control group. Nav 1.8 was expressed in the rat dental pulp and increased at day 3 and day 7. Time course study of dental pulp inflammation indicated that differences in relative mRNA expression levels of Nav 1.8 were correlated with the severity of inflammation. CONCLUSIONS: Nav 1.8 channels seem to be expressed significantly more under a temporal control so as to be associated with a severity of inflammation during pulpitis. As Nav 1.8 has been considered to have a role in neuropathic pain, its expression within dental pulp may contribute to the pathophysiology of tooth pain.

Ossifying fibromyxoid tumour: a rare soft tissue tumour of intermediate malignancy.

Ossifying fibromyxoid tumours (OFTs) are uncommon soft tissue tumours. A 73-year-old male presented with a painless exophytic mass located in the left scapular area which was identified 1 year earlier. An incisional biopsy was performed and microscopic features were compatible with OFT. Radiologic evaluation revealed multiple pulmonary metastasis. Although many cases persue an indolent biologic behaviour, local recurrence and metastasis have been reported and long-term follow-up should be considered.

Dynamics of Leishmania infection rates in Rhombomys opimus (Rodentia: Gerbillinae) population of an endemic focus of zoonotic cutaneous leishmaniasis in Iran.

Zoonotic cutaneous leishmaniasis (ZCL) due to Leishmania major is a great public health problem in the Old World. Leishmania major is widely distributed in populations of rodents in arid and savannah regions. In this study, seasonal variation of natural infection with Leishmania parasites in Rhombomys opimus (Rodentia: Gerbillinae) population of an endemic focus of ZCL in Iran was monitored. The study was conducted from October 2007 to October 2008 in the central part of the country. Nested polymerase chain reaction (PCR) assay was used for the detection and identification of Leishmania parasites, and the results were confirmed by PCR-restriction fragment length polymorphism (RFLP). The results showed that Leishmania infection rate was 55.8% (29 out of 52 gerbils) using nested PCR. The highest and lowest Leishmania infection rates were observed in fall and summer, respectively. Gerbils that were found to be infected only with L. major were 5.8%, and that with Leishmania turanica were 23.1%. A mixed natural infection was seen in the rodents with L. major and L. turanica (21.2%), with L. major and L. gerbilli (1.9%), and with all the three species (3.9%). Leishmania major infection alone was seen in fall and winter whereas mixed infection of L. major and L. turanica was observed in all seasons except in summer. Leishmania turanica infection was observed throughout the year. It is concluded that L. major, L. gerbilli, and L. turanica circulate in the population of R. opimus in central part of Iran. Leishmania major infection is usually accompanied by L. turanica in naturally infected gerbils with the highest rate in fall. It is recommended that the role of L. turanica in the epidemiology and transmission of ZCL should be reconsidered.