School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Non-hemolytic Chronic Jaundice in Children - Introducing a Family with Rotor Syndrome 1 7 OTHER Mohammad Hossein Marandian Homa Bahmanian Khalil Zareian Amir Salehyar Ahmad Bahvad Morteza Lesani Les auteurs presentent quatre cas familiaux de l'ictcre chronique, non hemolytique, benin, avec une hyperbilirubinemie a predominance conjuguee. Deux malades ont ete soumis a des investigations plus poussees. Les. voies biliaires etaient visib1es a la cholecystographie ora1e et le taux plasmatique de la BSP, elevc au depart, presentait une pente d'elimination progressive sans remontee secon­dairc. L'integrite de la structure hepatique a ete  ,,erifiee dans un cas par Ia Iaparoscopie et la ponc­tion-biopsie du foie. Ces donnees correspondent  aux criteres de diagnostic du syndrome de Rotor, dont la physiopathologie semble independante de celle de l'ictere chronique idiopathique de Dubin· Johnson. 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 55 Cases of Iron Deficiency Anemia 8 15 OTHER Seyed Jalaledin Sharifi Tekiyeh 55 cases of iron SUMMARY deficiency anemia were hos­This pitalized type at of anemia Bahrami was Hospital found in to be one the year. most Our frequent study cause showed of that anemia in in infants infants, in malnutri­Iran. tion older· was age the other main causes cause such of as anemia, GI while leeding,in ethiologie parasitosis of and the chronic disease. Most infection infants were withthe apettion iron ite, deficiency while at anemia older age were pale growth with retarda­poor with spoon nails were the most frequent finding. Prevention is the most important factor in  Hence controlling improving this disease. the nutritional status,treatment   of one should infectioI ol low in  cy main anemia.steps

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Research on 27 Patients with Jaundice 16 34 OTHER Hooshang Saghari Manoochehr Rokhsar This article has no abstract.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 News About the Treatment of Diabetes with Insulin 35 39 OTHER Ebrahim Nemati Pour Vahab Fatoorechi One of the most important advances in imsulin therapy has been the commercial production of highly purified single peak and single component insulin. The routine use of these pre9ara -tions have reduced insulin allergy and abolished insulin lipo­atrophy.  The subject of low dose insulin infusion in diabetic keto - acidosis in still controversial,but is based on sound theoreti - cal and experimental basis and offers advantages over the ciassic method. We believe that its routine use should be allowed only under expert supervision. Artificial pancreas is on its way for routine application in treatment of acute conditions in hospitalized patients and in diabetic coma. Chronic use of artificial pancreas for management of diabetic patients has to wait for further technical advances. 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Pancreatitis in Pregnancy 40 44 OTHER Saeed Kamrava Parviz Ghare Khani One should be cautious in using long term tetracyclines, thiazides or steroids during pregnancy.  In toxemic pregnant patients who are com­plaining of epigastric pains, pancreatitis should be ruled qu t. Two patients who developed pancreatitis during their pregnancy are introduced and the dilemma of diagnosing this process from other causes of acute abdomen are discussed. It is suggested not to hesitate to do exploratory laparatomy when in doubt. It is also stressed that the Ideal manaJ(e­ment of acute pancreatitis during pregnancy would be intensive medical care unless there is doubt m diagnosis or until a complication arises. The mortality rate of this condition during pregnancy has de­creased in recent years 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Primary Lymphoma of the Thyroid Gland 45 47 OTHER Mostafa Hashemi One Case of primary malignant lvmphuma of the Thyroid is presented this article. The primilry lym­phoma of the thvroid gland 1s very rare. All reports agree that the distinction clinically and grossly be­tween lymphoma and undifferentiated carcinoma is extremely difficult.  The (qnphoma of thyroid is often associated with Hashimoto disease. The treatment of the primary m.ilignar:t lymphoma of the thyroid gland consists of ,su rgery and radintherapy.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Respiratory Resuscitation in Drug Poisoning 48 51 OTHER Ali Zarbalian Abdolhamid Badiee Korosh Banayan We have described the more important re­spiratory complications relating to poison­ing. Particular attention has been directed for the prevention of aspiration of stomach contents, and treatment of acid aspiration syndrome because of its poor progvosis. Re­spiratory complications may occur in 3p.c. of poisonings. In comatose patient possibility of aspiration is great. Respiratory assistance with positive and, expiratory pressure with high percentage of oxygen is necessary for the treatment of respiratory distress of de­pression with interstitial edema. Frequent hlood gas determination is necessary for achievement of better results for the re­spiratory care of the patients. Particular at­tention must he paid to the urene output. 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Anesthesia and the Risk of Stillbirths 52 55 OTHER Kavoos Javiani methods _or wn, and preventing our mater­know­ the standard nal ledge of deaths such are hazards well knolity inceais ses, continue but unfortu­d.ay, nately obstetric morta although is expected to be rare. the most common causes of obstetric deaths are:  1- Haemorrhage 2- Infection 3- Anaesthesia 4-Toxaemia 5-The supine hypotensive syndrome 6- Aspiration of Stomach contents in to the lungs. so it is clear that anaesthesia for obstetric patients should be performed by experienced and skilled anaesthesists. It is suggested that the employment of oral antacid in all obstet­ric patients prior to general anaesthesia would reduce the attendant risks . 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Anesthesia and Resuscitation in Neonatal Diaphragmatic Hernia 56 62 OTHER Atiyeh Samimi Anesthesie et Reanimation pour Hemie diaphragmatique du Nouveau -ne. Le diagnostic de la hernie diaphragrnatique du nouveau -ne se fait tres tot et souvent dans lasallle d'accouchement. La compression et le deplacemen t des or­gan es thoraciques ainsi que les gros vais­seaux du rnediastin provoquent rapidernent une insuffisance cardio respiratoire aigue. La chirurgie est indiquee desque le diag­nostic est fait. La rnortalite est tres elevee, rnais le pronostic pourrait etre tres arneliore si le nouveau-ne est reanime de facon agres­sive avant la chirurgie. Nous discutons d'abord les caracteristiques physiologiques du nouveau -ne et la reanima­tion pre-operatoire, puis les techniques d'anesthesie, et parla suite les soins intensifs delaperiode post-operatiore,. 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Causes of Hospitalization for Children with Diabetes and the Principles of Dietary Guidelines 63 68 OTHER Mahin Sadr Tahereh Moheb From 23,231 total admission to three chil­dren's hospitals in Teheran over 3years and 6 months to 8 years period, 83 patients were found to have diabetes, 23 per thousand. The incidence of diabetes in children in­creases with age and is maximum in adoles­cence.  In 83 diabetic children 59 were male and 24 female (F /M:(0.4.)  From 83 diabetic patients 25 (31.2p.c.) were admitted with ketoacidosis. The main symp­toms present upon hospitalization of children with ketoacidosis consist of coma, precoma, vomiting and abdominal pain and lassitude. From 25 patients with· ketoacidosis only 10 cases were admitted for the first time and the rest of the patients had been admitted sever­al times before. The importance of treatment, control of diabetes and follow up of diabetic children as well as recent arguments and re­commendations for diet in juvenile diabetes is discussed. 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Enzymatic and Immunogenic Changes of Myocardial Infarction 69 75 OTHER Bijan Razi Mohammad Hossein Jed Babaee Diagnosis of myocardial infarction is very important in a patient with chest pain. Chest pain is not always present or it may be from other causes rather than myocardial infarction. Q wave is present in 30] of infarction. ST,T wave changes are present in all myocardial infarctions, but these changes also are present in myocardial ischernia.  For these reasons diagnosis of myocardial infarction can be done with enzymatic changes in the serum. CPK, MB and LDH isoenzymes are specific for myocardial injury. Serum Glutamic Oxalacetic Transaminase.This enzyme will rise 6 hours after infarction  and peak level reach at 12-24 hours and gradually will return to normal within 6-7 days.  Serum Lactic Dehydrogenase. LDH increases 10 hours after  infarction and maximum level reached in 48-72 hours. LDH returns to normal after 10 days.  There are five kinds of LDH, which can be separated with Electrophoresis techinc. LDHl, LDH2 are the fast part of enzyme and is specific for myocardial injury. LDHl and LDH2 are resistant to 65 centigrade tempera­ture for 30 minutes and by this technic also can be measured.  Creatinine phosphokinase. This enzyme increase in  myocardial infarction 6 to 8 hours post infarction. maximum level reach at 24 hours and return to normal at 36 hours after infarction. CPK isoenzyme is very specific for myocardial injury.  This part of enzym is called CPK, MB. Relation of enzyme level and Prognosis of myocardial infarction Prognosis of myocardial infarction has direct relation to CPK and SGOT level. 40% of 125 patients with myocardial, whom died, enzymes were five times normal. 81).' of these patients had arrythrnia, enzymes level were 4 times normal.  Myocardial infarction size can be estimated with following formola CPK-22x myocardial infarction size-318 if myocardial infarction size is more 68 grams most of these patients will die or complicate with congestive heart failure.  Antlmyocardial Antibodies estimated with antinuclear antibodies, complement fixation, immunoflurescent and hemagglutination tech­nics. 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 The Hemodynamic Effects of Drugs on Myocardial Oxygen Use 76 79 OTHER Hayedeh Yamin Alamtaj Heravi The circulatory responses to high equinalgesic doses of morphine are compared with those of pethidin. The decrease in mean arterial blood pressure in case of morphine was 28p.c., with a paralleled and identical de­crease in total peripheral resistance and no negative inotropic effects.  Pethidine decreased blood pressure 54p.c., as a result of peripheral vasodilation of 46p.c. and a sharp drop in dp/dt Max of 59p.c., indi­cating myocardial depression (dp/dt max/Ip is 14p.c. and the fall in cardiac output is 33p.c.). This drop in both cases is offset by the increase in heart rate. (morphine 27p.c.; pethidin IOlp.c.). The coronary blood flow sufficiently met the myocardial energy de­mand, which did not change with the altered haernodynamics.  Both morphine and pethidin produce coro­nary vasodilation, indicated by increased coronary blood flow and coronary venous ox­ygen saturation.  The mechanism for the change in vasodilation is still under discussion. It seems that in case of morphine this is due to Histamin release. 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Computed Tomography in the Diagnosis of Lesions in and Around the Saddle Area 80 88 OTHER Mansoor Tafasoli Kazem Abbassion Computed tomography is the method of choice for initial evaluation of pa tints with potential suprasellar masses. In our ex­perience during the last 2 years C.T. has proved reliable for detecting or rulling out the presence of a suprasellar mass.  It shows the direction and degree of parasellar extension and the presence of any calcific or cystic component of the le­sion. When C.T. was negative furthere diagnostic procedure was unrewarding, when C.T. was positive additional studies have been required in some cases to rule out aneurisme.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Assessment of Immunology Tests for Pregnancy Diagnosis 89 93 OTHER Mohammad Nayebi Bijan Roosta Alireza Armin This article has no abstract

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Cardiac Scintigraphy with Thallium-201 and Technetium Pyrophosphate 94 100 OTHER Mehdi Homayoonfar Behrooz Shahrad Mohsen Saghari myocardial Scintigraphy ischemia can deor mc_mstrat_e mfarction. and It  has a higrs after onset of an mfarctl has a higrs after onset of an mfarctln and localizeh sensitivity in the first six to.twenty can belabelled pyrophosphate scan becomes four.  houuseful in the coronary care umt. The positive trction. Since the pyrophosphate scan 99mTc welve to twenty hours after onset of an becomes infate negative between in old old and infarction fresh it can m/arct1on; dif­ ferentialso give additional information about it right can aventricular involvement of the mfarction. 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Secondary Reduction of Immunity 101 111 OTHER Ozra Fakhari Abbas Tahsili Deficiences imunitaire acquises Les , deficits nnmumtaires pathologiques af­ systeme des phagocytes, l'immunite a mechation_ cellulare :t la synthese des im­ Illfnoglobulmes so1t separement, soit con­Jom temen t. La manifestation .clinique de ces deficits est la ,frequence _des mfections bacterielles, vir­ales et mycotiques.  Le triteJent s deficits immunitaire a part la therap1e antnnfectieuse consiste:  I-en une therapie substitutionnelle granulocytes,. innmunoglobulmes)  2 et nouvellement en l'immunostimulation et : l'nnmunopotentialisation 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Deliberately Lowering Blood Pressure with Sodium Nitroprusside 112 116 OTHER Shokooh Tamadon The goal of hyp􀁽tensive anesthesia is the safe reduction of intraoperative blood loss, thus reducing transfusion risks.  Previous hypotensive technics had a narrow margin of safety in that cardiac output was usually reduced in proportion to the degree of induced hypotension. This is in contrast to the results of our study, in which Sodium Nitroprusside was used as the sole hypotensive agent. Nitroprusside, a potent direct odilator,  reduces the afterload on the anesthesia depressed heart. The improvement in cardiac output plus better tissue perfusion appears to widen the margin of safety over that of earlier tech-nics. 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Complete knee replacement surgery 117 125 OTHER Mohmmad Esmaiel Pour Arbab In normal activities such as walking, r􀀁n­ning, kneeling, climbing stairs and gettmg in and out of chairs the loa􀀗 pu􀀙 OI.the human knee joint can exceed five times the weight of the body. Nowadays large num­bers of people make ! urtrer d mands on the knee in participatmg 1_n sucli sport  as football, tennis and long distance runn􀀯ng. It is no wonder that many people go mto their later years with one knee ?r 􀀼oth knees so badly deteriorated as to cnpplmg.   It is now possible to. replace such a knee with a mechanical device that imitates the subtle and complex motions of which around knee is capable.  In this article the use of a n_ew kmd 􀁉f artificial knee ( Sp hero Cen tenc Knee) is discussed. the indications and advantages of this new device which is currently have been used are encountered, but patients, surgeons and engineers have beE:n. w􀁖rr­ned that the natural human ki:1ee Jomt is a remarkable product and also  ca1;1 be im­itated with increasing success, it will 11ever be duplicated. 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 Morphogenesis and Morphology of the Neck and Trunk Muscles in Humans 126 135 OTHER Ali Foroohi At about the 20-30 day of embryonic life "Somites" start to appear. In the middle of the fourth week the dorsal portion of each Somite differentiates into an epithelially­arranged mass of cells called der­momyotome (from which the skin and mus­cles originate).  The lateral part of the sermomyotome then proliferates to form dermatome (from ·which originates the derm and Hypoderm).  The medial part of the dermomyotome proliferates to form myotome (which gives origin to muscles).  At the end of the fifth week of embryonic life, myotomes divide into the dorsal por­tion, called Epimere and the ventral por­tion, called Hypomere.  The spinal nerve of each myotome di­vides in to the posterior primary Ramus, with which the Epimeric muscles are sup­plied and the Anterior Primary Ramus, with which Hypomeric muscles are sup­plied.  In this article, the development of Cervi­cal, Thoracic, Lumbar, Sacral, and Coc­cygeal myotome and their division into Epimeric and Hypomeric portions, as well as the muscles to which they give rise and their synonymities are discussed.  In my opinion, the study of synonymities in different layers of muscles in the neck and trunk could explain most of muscular and neural reff erral pains . 

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 7 1 1981 3 1 A Case Report of Visceral Migratory Larvae 136 140 OTHER Mahmood Kabiri Shams Shariat Parvin Mirbod Nasir Behravan Dogs and wild canidae in Iran are highly infected with Toxocaria­sis  This and the poor hygienic conditions ruling in rural regions  let to expect the visceral larva migrans to be an entity of high incidence in this-country. Therefore, Patients Presenting with hepatomegaly, fever, leucocytosis and eosinophilia-specially when originating from villages-have to be surveyed for this syndrome. An effective therapy is not known. Monthly veterinary examination of domestic dogs and preventing small children to play with earth and materials which might be infected with dogs' feces-is the best way of prophylaxis.