Effects of open rhinoplasty on upper lip position in profile and frontal views.

Examining the upper lip position is a key indicator of facial beauty. This study aimed to examine the upper lip position following cosmetic rhinoplasty at the frontal and profile views. The medical records of 67 patients who underwent rhinoplasty with no history of any facial skeletal surgery were obtained from archives. Complete preoperative and postoperative photos including the profile view at rest and the frontal view at rest, were prepared and analysed using Adobe Photoshop CC 2015 software. Interpupillary distances of two eyes in frontal views and Glabella to Pogonion (POG) distance in profile views were considered as fixed landmarks to calibrate the preoperative and postoperative photos. Upper lip length, subnasal area, and vermilion points were marked and compared between preoperative and postoperative photos. Data analysis was carried out using one-sample t-test and p<0.05% was considered as the significant level. Lip length (frontal view) was increased in 46 subjects. There were changes in the profile view of vermilion and subnasal positions in 56 patients and 53 patients, respectively. In surgical procedures on columella strut, maxillary augment, alar resection, spreader graft, columella retraction, and depressor septi muscle release, vermilion and subnasal protrusion in the profile view was statistically significant and lip length increased significantly in the frontal view. In tip rotation surgery techniques, the vermilion and subnasal position showed also significant protrusion. The depressor septi muscle cutting methods had only led to a significant protrusion of the vermilion position and upper lip length. Despite all covariants interfering in rhinoplasty, this cosmetic surgery most often may increases maxillary lip length and helps that maxilla look more protruded.

The Influence of Brass Compensator Thickness and Field Size on Neutron Contamination Spectrum in 18MV Elekta SL 75/25 Medical Linear Accelerator with and without Flattening Filter: A Monte Carlo Study.

BACKGROUND: One of the most significant Intensity Modulated Radiation Therapy treatment benefits is a high target to normal tissue dose ratio. To improve this advantage, an additional accessory such as a compensator is used to deliver doses. Compensator-based IMRT treatment is usually operated with an energy higher than 10 MV. Photoneutrons, which have high linear energy transfer and radiobiological effectiveness, are produced by colliding high-energy photon beams with linear accelerator structures, then they deliver the unwanted doses to patients and staff. Therefore, the neutron energy spectra should be determined in order to calculate and reduce the photoneutron risk. OBJECTIVE: We have conducted a comprehensive and precise study on the influence of brass compensator thickness and field size on neutron contamination spectrum in an Elekta SL 75/25 medical linear accelerator with and without the flattening filter by Monte Carlo method. MATERIAL AND METHODS: MCNPX MC Code version 2.6.0 was utilized to simulate the detailed geometry of Elekta SL 75/25 head components based on Linac's manual. This code includes an important feature to simulate the photo-neutron interactions. Photoneutrons spectrum was calculated after the Linac output benchmarking based on tuning the primary electron beam. RESULTS AND CONCLUSION: Based on the Friedman and Wilcoxon nonparametric tests results (P<0.05), photoneutron fluence directly depends on the field size and compensator thickness. Moreover, the unflattened beam provides lower photoneutron fluence than the flattened beam. Photoneutrons fluence is not negligible in compensator-based IMRT treatment. However, in order to optimize treatment plans, this additional and unwanted dose must be accounted for patientss.

The effect of walnut on the weight, blood glucose and sex hormones of diabetic male rats / Efecto del nogal sobre el peso, glucosa en la sangre y hormonas sexuales de ratas macho diabéticas

Diabetes leads to reproductive dysfunctions by producing free radicals. It seems that using walnut can be effective in the damage induced by diabetes. The aim of the present study was to evaluate the effects of walnut consumption on sex hormones in diabetic Wistar male rats induced by STZ (streptozotocin). Diabetes animals were induced by STZ (60 mg/kg). Rats were randomly divided into 5 groups (n=6), including normal diet and healthy (Sham), Diabetic by normal diet (control) and diabetic by 6, 9 and 12% walnut in their diet (experimental groups), and were examined for 6 weeks. Body weight, blood glucose (3 times), and sex hormones (testosterone, FSH and LH) were measured. Overall, in terms of the mean index, there was a significant difference in the percentage of weight changes between the groups (p<0.001). Blood glucose (3 times) significantly increased in experimental and control groups in comparison with sham group (p<0.001). FSH concentration significantly decreased in control group (p<0.05) and testosterone hormone decreased in experimental and control groups compared to sham group (p<0.05). Oral administration of walnut seems to prevent severe weight loss in the experimental models of diabetic rats and exerts appropriate and useful changes in blood glucose level as well as positive effects on the secretion of sex hormones.

La diabetes conduce a disfunciones reproductivas mediante la producción de radicales libres. Parece que el uso del nogal puede ser eficaz para contrarestar el daño inducido por la diabetes. El objetivo fue evaluar los efectos del consumo de nueces sobre las hormonas sexuales en ratas Wistar macho diabéticas, inducidas por estreptozotocina (STZ). La diabetes en los animales fue inducida por STZ (60 mg/kg). Los animales fueron divididos aleatoriamente en 5 grupos (n= 6 ): saludable con dieta normal (Sham), diabéticos con dieta normal (control) y diabéticos con consumo de nogal en 6, 9 y 12% en su dieta (grupos experimentales), quienes se examinaron durante 6 semanas, donde se midieron el peso corporal, glucosa en la sangre (3 veces) y hormonas sexuales (testosterona , FSH y LH). En general, en términos del índice promedio, hubo una diferencia significativa en el porcentaje de cambios de peso entre los grupos (p<0,001). La glucosa en sangre aumentó significativamente en los grupos experimentales y de control en comparación con el grupo Sham (p<0,001). La concentración de FSH se redujo significativamente en el grupo control (p<0,05); la testosterona disminuyó en los grupos experimentales y control en comparación con el grupo sham (p<0,05). La administración oral de nogal parece prevenir la pérdida severa de peso en los modelos experimentales de ratas diabéticas y ejerce cambios apropiados y útiles en el nivel de glucosa en la sangre, así como efectos positivos sobre la secreción de hormonas sexuales.

Seroprotection after hepatitis B vaccination in children aged 1 to 15 years in central province of Iran, Semnan.

INTRODUCTION: There are controversies over the long-term persistence of post vaccination immunity to hepatitis B and the need for booster doses of the vaccine. The aim of this study was to verify antibody levels of antibody against hepatitis B virus surface antigen (anti-HBs) in children aged 1 to 15 years who received vaccination against hepatitis B in the central province of Iran, Semnan. MATERIALS AND METHODS: We performed a seroepidemiological survey (n = 210) of anti-HBs in 2011 in the central province of Iran, Semnan using enzyme-linked immunosorbent assay (ELISA). The levels of anti-HBs < 10 mIU/mL were considered to be negative and samples showing an anti-HBs titer ≥ 10 mIU/mL was considered protective. RESULTS: Protective antibody levels were detected in 88% of the children less than 5 year after vaccination, decreased to 78% between 5 to 10 years after vaccination, and further declined to 74% in 10 years after vaccination, respectively. CONCLUSION: The vaccination program has been proven effective in Semnan and immunological protection against hepatitis B infection was found in the majority of children even more than 10 years after being vaccinated.

Compensatory growth in juvenile roach Rutilus caspicus: effect of starvation and re-feeding on growth and digestive surface area.

The aim of this study was to investigate compensatory growth in juvenile Rutilus caspicus during starvation and re-feeding periods. The results confirmed the existence of compensatory growth in R. caspicus which depended on the duration of food deprivation. Complete compensatory growth occurred in the fish that were food deprived for at least 3 weeks. Starvation and re-feeding had no significant effect on the digestive somatic index and intestinal surface areas in the fish that were food deprived for 1 week, while they showed a significant decrease and increase, during starvation and re-feeding in the fish that were food deprived for 2 and 3 weeks. This knowledge may have application in aquaculture, as appropriate exploitation of compensatory growth can give increased growth rate and feeding efficiency.

Effects of gradual salinity increase on osmoregulation in Caspian roach Rutilus caspicus.

This study was carried out to determine the effects of gradual salinity increase on osmoregulatory ability of the Caspian roach Rutilus caspicus, under conditions which mimic stocking conditions of hatchery-raised fish. Initially, 30 juvenile fish (mean ± S.D. 3.20 ± 0.34 g) were transferred to 20 l circular tanks, in which salinities were changed in a stepwise fashion, from 0 to 5, 10 or 15 at 48 h intervals. The fish at salinity 15 were held for an additional 48 h at this salinity. Forty-eight hours after salinity transfer, survival rate, haematocrit, plasma Cl(-) , Na(+) and K(+) concentrations, osmolality and gill Na(+) /K(+) -ATPase (NKA) activity were measured. The only effect of exposure to 5 was a significant reduction in haematocrit compared to the freshwater control group. Exposure to salinity 10 raised haematocrit, Cl(-) and Na(+) concentrations and osmolality. At 48 h exposure to salinity 15, haematocrit, Cl(-) and Na(+) concentrations and osmolality were significantly higher than freshwater controls, and gill NKA activity was significantly lower, but the effect on NKA was no longer evident at 96 h exposure. There were no effects on survival. These results indicate that R. caspicus juveniles experience an initial non-lethal iono-osmotic perturbation following salinity increase but can adapt to brackish water at salinity 15.

Prognostic role of Helicobacter pylori infection in acute coronary syndrome: a prospective cohort study.

In a prospective cohort study, we evaluated the effect of Helicobacter pylori seropositivity on the risk of future adverse cardiovascular outcomes among patients with acute coronary syndrome (ACS). In 433 patients, IgA and IgG antibodies to H pylori, along with classic risk factors, including hypertension, diabetes, hyperlipidaemia, smoking and family history of coronary artery disease (CAD) were determined. Short and long-term follow-up information on adverse outcomes, defined as recurrence of unstable angina, myocardial infarction, coronary angioplasty, coronary artery bypass graft surgery, and sudden cardiac death was obtained. None of the classic CAD risk factors correlated with incidence of either short- or long-term outcomes. Seropositivity for H pylori was significantly associated with risk of short-term adverse outcomes, and independently predicted their incidence in multivariate regression (R = 3.05, p < 0.001). Results failed to show such an association between H pylori seropositivity and long-term adverse outcomes. H pylori infection may affect short-term prognosis in patients with ACS. Randomised trials are needed to evaluate the role of H pylori eradication in these patients.

Relationship between disease activity and serum levels of vitamin D and parathyroid hormone in rheumatoid arthritis.

OBJECTIVE: Measuring vitamin D and its regulating hormones in the serum might be an accurate method for assessment of rheumatoid arthritis (RA) activity. We tested the hypothesis that the serum levels of vitamin D and parathyroid hormone (PTH) are associated with the grade of disease activity in an unselected cohort of patients with RA. METHODS: A total of 158 patients who met the American College of Rheumatology criteria for RA were examined and categorized as the patients with the active RA (n = 87) and silent RA (n = 71). Blood samples were obtained after at least eight-hour overnight fasting and the levels of 25-OH-vitamin D and PTH were measured. RESULTS: The levels of the vitamin D in patients with active RA were significantly lower than in those with silent RA (49.38±38.21 versus 64.64±43.61 nmol/l; p = 0.022). The PTH serum level lower than the normal range (< 0.8 nmol/l) was statistically observed similar in the active RA group compared with another ones (10.3 % versus 4.2 %, p = 0.149). Serum levels of vitamin D and PTH were not influenced by patients' gender and age as well as the duration of disease. CONCLUSION: Serum level of vitamin D was inversely related to RA activity and this relationship might be independent of PTH secretion or activity.

The role of religiosity, coping strategies, self-efficacy and personality dimensions in the prediction of Iranian undergraduate rehabilitation interns' satisfaction with their clinical experience.

OBJECTIVE: to investigate the relationship between religiosity, coping styles, self-efficacy and personality dimensions as predictors of satisfaction with clinical experience in rehabilitation interns during transition from academic study to clinical internship. DESIGN: a cross-sectional survey design. SETTING: five rehabilitation faculties. PARTICIPANTS: three hundred and eighteen undergraduate rehabilitation interns, including physical therapy, occupational therapy and speech and language pathology students. MAIN OUTCOME MEASURES: Islamic Religiosity Scale, Ways of Coping Questionnaire, General Self-efficacy Scale, NEO Five Factor Inventory, and Satisfaction with Clinical Experiences Questionnaire. RESULTS: religiosity, problem-focused coping and general self-efficacy had significant positive correlation with satisfaction with clinical internship in rehabilitation students. Among personality dimensions, openness, agreement and consciousness had significant positive correlation with satisfaction with clinical experience and neuroticism had significant negative correlation with satisfaction with clinical experience. The results of regression analysis demonstrated that religiosity and self-efficacy had important roles in the prediction of satisfaction with clinical experience in all the rehabilitation intern students of three disciplines (physical therapy, occupational therapy, and speech and language pathology). CONCLUSION: religiosity, problem-focused coping and general self-efficacy seem to be good predictors of satisfaction with clinical internship in rehabilitation students.

Effect of metoclopramide on nosocomial pneumonia in patients with nasogastric feeding in the intensive care unit.

This study in the Islamic Republic of Iran aimed to determine whether metoclopramide can prevent nosocomial pneumonia in the intensive care unit (ICU). Of 220 patients admitted to the surgical ICU who had a nasogastric tube for more than 24 hours, 68 case patients received oral metoclopramide (10 mg every 8 hours) and 152 control patients did not. Similar proportions of cases and controls developed nosocomial pneumonia (33.8% versus 33.6%). Endotracheal intubation was a risk factor for nosocomial pneumonia (odds ratio 7.70). There were no significant differences between groups in mortality rate or time of onset of nosocomial pneumonia. Metoclopramide appears to have no effect on the development of nosocomial pneumonia with nasogastric feeding.

Effect of metoclopramide on nosocomial pneumonia in patients with nasogastric feeding in the intensive care unit

This study in the Islamic Republic of Iran aimed to determine whether metoclopramide can prevent nosocomial pneumonia in the intensive care unit [ICU]. Of 220 patients admitted to the surgical ICU who had a nasogastric tube for more than 24 hours, 68 case patients received oral metoclopramide [10 mg every 8 hours] and 152 control patients did not. Similar proportions of cases and controls developed nosocomial pneumonia [33.8% versus 33.6%]. Endotracheal intubation was a risk factor for nosocomial pneumonia [odds ratio 7.70]. There were no significant differences between groups in mortality rate or time of onset of nosocomial pneumonia. Metoclopramide appears to have no effect on the development of nosocomial pneumonia with nasogastric feeding

Obesity in the Iranian population.

There is an obesity epidemic worldwide, which has been increasing in recent years. An epidemiologic cross-sectional study was conducted among 3799 persons who were 30-70 years old in Semnan Province, Iran. Multistage cluster sampling was performed, and subjects were selected from urban and rural populations. Body weight, height and waist circumference (WC) were measured, and body mass index (BMI) and waist to hip ratio (WHR) were calculated. Overweight and obesity were defined as 25 < or = BMI < 30 and > or =30 respectively in men with WHR > or = 0.9 or WC > or = 102 cm, and women with WHR > or = 0.8 or WC > or = 88 cm were considered centrally obesite. Prevalence of obesity and overweight was 26.3% and 40.6% respectively. Prevalence of obesity was more among women (39.5%) than men (14.5%) with central obesity prevalence using WHR and WC cut-points of 72.2% and 26.6% respectively. There was a significant association between obesity and age, gender, residential area and educational level (P < 0.01). In conclusion, prevalence of obesity and overweight among 30-70 years old, especially among women, was higher than expected. A comprehensive educational programme on obesity risk factors and obesity-related diseases is necessary.

Endocrinopathies in patients with transfusion-dependent beta-thalassemia.

Thalassemia is common in Iran. Appropriate therapy for this disease includes a regular blood transfusion and chelation therapy. However, in this approach patients will inevitably experience side effects, particularly iron overloads in critical organs, including heart, ductless glands, and liver. This study attempted to determine prevalence of adenoidal abnormality between Iranian thalassemia patients for prediagnosis and to offer necessary medical measures. This is a descriptive nonrandomized study and included all the patients suffering from thalassemia major referring to medical centers linked with the Iranian blood transfusion organization from January 2004 to January 2005. All patients were sampled for CBC, FBS, 2-h BS, HbAlC, liver function, renal function, and endocrine disease. Initially, reports of adenoidal experiments as well as other associated parameters were provided from medical records. A total of 437 patients enrolled in the study: 5.4% suffered from diabetes, 1% had hypothyroid, and 1 person showed hypoparathyroidism. The mean levels of ferritin in diabetic and nondiabetic groups and hypothyroid and nonhypothyroid groups were not significantly different. The mean levels of ferritin among various age groups also were not significantly different. Results of a comparison between present research and similar studies conducted throughout Iran and those performed abroad on adenoidal abnormalities in thalassemia patients show that subject patients of this study statistically suffered from fewer difficulties than diabetes patients in other studies.

Peripheral intravenous catheter-related phlebitis and related risk factors.

INTRODUCTION: Peripheral intravenous catheter-related phlebitis is a common and significant problem in clinical practice. This study aims to investigate the incidence of phlebitis and to evaluate some important related factors. METHODS: 300 patients admitted to medical and surgical wards of hospitals in Semnan, Iran from April 2003 to February 2004 were prospectively studied. Variables evaluated were age, gender, site and size of catheter, type of insertion and underlying conditions (diabetes mellitus, trauma, infectious disease and burns). Phlebitis was defined when at least four criteria were fulfilled (erythema, pain, tenderness, warmth, induration, palpable cord and swelling). Any patient who was discharged or their catheter removed before three days were excluded. RESULTS: Phlebitis occurred in 26 percent (95 percent confidence interval [CI] 21- 31 percent) of patients. There was no significant relationship between age, catheter bore size, trauma and phlebitis. Related risk factors were gender (odds-ratio [OR] 1.50, 95 percent CI 1.01-2.22), site (OR 3.25, 95 percent CI 2.26-4.67) and type of insertion (OR 2.04, 95 percent CI 1.36-3.05) of catheter, diabetes mellitus (OR 7.78, 95 percent CI 4.59-13.21), infectious disease (OR 6.21, 95 percent CI 4.27-9.03) and burns (OR 3.96, 95 percent CI 3.26-4.82). CONCLUSION: Phlebitis is still an important and ongoing problem in medical practice. In patients with diabetes mellitus and infectious diseases, more attention is needed.

Effects modification of iron hematoxylin on neuron staining.

Iron weigert staining methods is used as nuclear staining. In present study we introduce a modification iron weigert hematoxylin for staining neuron without astrocytes. Whole brain of adult wistar rats (12-13 week old) were removed, immersed in formaldehyde fixative and embedded in paraffin. Sections, 5-7 microm (from brain cortex, hippocampus, cerebellum) divided to three groups: one for staining by Hematoxyllin and eosin, second for staining by cresyl fast violet (that specially performed for Nisl substances in neuron) and last for staining by modification iron hematoxyllin methods, but different in quantity and quality. In new method general and specific architecture of neuron, nucleus and nuclear envelope was clearly visible reactions of neuron were predominant. Astrocyte did not respond to staining methods. Also spines (axon) of purkinje cells clearly visible. Modification iron weigert hematoxylin can be replacement to cost and time consuming chemical staining method for staining neurons.

Conductometric simultaneous determination of acetic acid, monochloroacetic acid and trichloroacetic acid using orthogonal signal correction-partial least squares.

A simultaneous conductometric titration method for determination of mixtures of acetic acid, monochloroacetic acid and trichloroacetic acid based on the multivariate calibration partial least squares is proposed. It is possible to obtain an adjustable model to relate squared concentration values of the mixtures used in the calibration range by conductance. The effect of orthogonal signal correction (OSC) as a preprocessing technique used to remove the information unrelated to the target variables is studied. The calibration model was build using conductometric titrations data of 16 mixtures of three acids. The concentration matrix was designed by a orthogonal design. The root mean squares error of prediction (RMSEP) for acetic acid, monochloroacetic acid and trichloroacetic acid with and without OSC were 0.08, 0.30 and 0.08, and 0.15, 0.40 and 0.18, respectively. The results obtained by OSC-PLS are better than the PLS and this indicate the successful application of the OSC filter as a good preprocessing method in multivariate calibration methods. The proposed procedure allows the simultaneous determination of these acids, in the synthetic mixtures.

Dermatofibrosarcoma protuberans of the vulva: clinicopathologic and immunohistochemical analysis of four cases, one with fibrosarcomatous change, and review of the literature.

Only 18 cases of dermatofibrosarcoma protuberans (DFSP) of the vulva have been reported. This article describes the clinicopathologic and immunohistochemical findings of four additional vulvar DFSPs. The median patient age was 54 years (range, 36 to 69 years) and the most common clinical presentation was a slowly growing vulvar mass. The tumors occurred in the left paraclitoral area (1 case), right labium majus (1 case), left labium majus (1 case), and mons pubis (1 case). The tumor size, known in three cases, ranged from 1.2 to 5.0 cm in greatest dimension. Microscopically, the tumors were composed of bland spindle cells with oval or wavy nuclei arranged in a cartwheel pattern; in one case, fibrosarcomatous areas were apparent. CD34 immunostaining was positive in the three cases in which it was performed; positive staining was also seen in the area of fibrosarcoma. Estrogen and progesterone receptor immunostains were negative in three cases. Of the three patients who underwent surgery, one had tumor recurrences every 2 to 4 years for 18 to 20 years but has remained free of tumor in the 7 years since the last excision, one was free of tumor for 12 years before dying of an unrelated cause, and the other has been free of disease for 6 months. The fourth patient refused treatment and has persistent disease in the vulva. This study shows that the behavior of DFSP in the vulva is similar to its behavior in its more common locations.

Intragraft angiotropic large-cell lymphoma of T cell-type in a long-term renal allograft recipient.

Chronic immune suppression is a risk for the development of post-transplantation lymphoproliferative disorders, which are frequently caused by a B-cell dyscrasia. We report a unique primary presentation of the rare angiotropic lymphoma in a kidney allograft, 18 years after transplantation. The diagnosis was made by a percutaneous allograft biopsy specimen when the recipient presented with renal dysfunction and intermittent hematuria. Immunostaining of the biopsy specimen revealed a T-cell lineage of the neoplastic cells rather than the more common B-cell source. At the time of biopsy, there was no evidence of systemic dissemination of lymphoma. The intragraft lymphoma resolved completely after chemotherapy, but the patient died 6 months later as a result of an intracerebral hemorrhage. At autopsy, intravascular lymphoma was only found in the cerebral vessels. To the authors' knowledge, this is the first report of angiotropic T-cell lymphoma in a kidney allograft. A description of the clinical, pathologic, and immunohistochemical features of this case is provided, as well as reviews of previous reports of renal angiotropic lymphoma and post-transplantation T-cell lymphomas.

Oral aspirin and ibuprofen increase cytokine-induced synthesis of IL-1 beta and of tumour necrosis factor-alpha ex vivo.

We investigated the effect of oral aspirin and ibuprofen on the ex vivo synthesis of interleukin-1 alpha (IL-1 alpha), IL-1 beta, IL-2, IL-6, tumour necrosis factor-alpha (TNF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) by stimulated peripheral blood mononuclear cells (PBMC) from healthy volunteers. Seven volunteers took 325 mg of aspirin daily for 14 days. Three weeks after ending aspirin medication, ex vivo IL-1 beta and TNF synthesis induced by exogenous IL-1 alpha was elevated threefold compared to the pre-aspirin value (P = 0.01 and P = 0.005, respectively). Using lipopolysaccharide (LPS) as a stimulus, no influence of oral aspirin was observed. The increase in cytokine synthesis did not parallel decreased synthesis of prostaglandin E2 (PGE2). Seven weeks after discontinuation of aspirin, cytokine and PGE-2 production returned to pre-aspirin levels. Another seven volunteers took 200 mg of ibuprofen daily for 12 days. Again, there was no effect on LPS- or Staphylococcus epidermidis-induced cytokine synthesis. However, IL-1 alpha-induced synthesis of IL-1 beta was elevated to a mean individual increase of 538% (P < 0.001) and synthesis of TNF was elevated to 270% (P < 0.001) at the end of ibuprofen medication and 2 weeks after discontinuation of ibuprofen. There were parallel increases in PGE2 and both returned to their pre-ibuprofen levels 5 weeks after stopping. Although inhibitors of cyclo-oxygenase blunt PGE2-mediated symptoms such as fever and pain, we conclude that short term use of either aspirin or ibuprofen results in a 'rebound' increase in cytokine-induced cytokine synthesis that is not observed in LPS-induced cytokines.