Diagnostic utility of autopsy in a university hospital in Iran.

OBJECTIVE: The objective of this study were to evaluate the diagnostic utility of the autopsy in University hospital in Tehran, Iran. METHODS: In this retrospective descriptive-analytic survey during a six years period from 1998 to 2003, autopsies in the Bahrami Children Hospital, a teriary care hospital in Tehran, were studied. The clinical and autopsy diagnoses were compared and categorized as follows: 1. Change (clinical and autopsy diagnoses discordant), 2. Add (significant unexpected findings noted on the autopsy, although the clinical diagnosis was not altered), 3. Confirm (clinical and autopsy diagnosis concordant), 4. Autopsy inconclusive. RESULTS: Eighty four autopsies were studied. Out of 350 neonatal deaths in the period, autopsy was performed in 74 neonates (21%) and of 249 under 5 year deaths (except neonates) autopsy was performed in only 10 cases (4%). In 61 cases (73%) the autopsy diagnoses confirmed the clinical diagnosis, in 10 cases (12%) it changed the clinical diagnosis, in 11 cases (13%) it significantly added to the clinical diagnosis and in 2 cases (2%) it was inconclusive. CONCLUSION: This study demonstrated that neonatal and infantile autopsy continued to provide clinically useful data in 25% of cases and remains an invaluable tool in pediatric medicine.

The cerebral arterial circle (circulus arteriosus cerebri): an anatomical study in fetus and infant samples.

BACKGROUND: Many studies have investigated the variations in the anatomy of each segment of the cerebral arterial circle while a few have addressed the variations of the cerebral arterial circle as a whole. METHODS: Thirty brains of recently deceased Iranian infants and fetuses were dissected. The dissection process was filmed and digitized so as to be readily available for further studies. The variations of the circle as a whole and segmental variations were evaluated. RESULTS: Variants with uni- and bilateral hypoplasia of posterior communicating arteries (PcoAs) were the most common in our study, similar to previous works. No aplasia of the precommunicating part of the anterior cerebral artery (A1), the precommunicating part of the posterior cerebral artery (P1) and anterior communicating artery was seen. Hypoplasia of the right and left PcoA was observed in 8 and 5 cases, respectively. Aplasia of the right PcoA was found in 16.6% and of the left PcoA in 3.3%. CONCLUSION: In this study, we confirmed the previously described finding that the symmetrical, circular configuration of the circulus arteriosus cerebri is present in only about 42.1%. The main differences between the fetal and adult disposition are the diameter of the PcoA and the circular part of the posterior cerebral artery. According to previous studies, the fetal brain older than 4 months has anatomical characteristics very similar to the adult's circle; our finding was mostly similar to adult samples as most samples were from infants, not fetuses.

Trend in incidence of gastric adenocarcinoma by tumor location from 1969-2004: a study in one referral center in Iran.

AIM: In recent years several studies have shown increasing rate of upper gastric cancers regarding to decrease in distal gastric cancers. The aim of this study was to describe the trend of gastric cancers by location in Iran, which is one of the countries with high prevalence of gastric cancers. METHODS: All registered cases of gastrectomy in Tehran Cancer Institute from 1969 through 2004 were re-evaluated clinicopathologically. The stomach was anatomically divided into the upper, middle, and lower third. The prevalence of gastric cancers in 5 year periods estimated by location and the changes trough the time was evaluated independently and in aspect of age and sex. RESULTS: Over 36 years, the prevalence of cancers in the upper and middle third of the stomach have increased and that of the lower third has decreased. These changes were seen in both sexes and age groups under and over 50 and it was more significant in younger. CONCLUSION: The results are the same as most previous reports in other countries. This can indicate different risk factors as well as confrontation with them. However in regard to few numbers of cases in this study, a population-based study is recommended for confirmation.