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Vascular anastomosis is commonly done by hand-sewn methods which not only are slow in pace, but also need experiences in surgeons' hands. As the old techniques are replaced by the new ones all the time, it is sensed that a new sutureless approach should be welcomed in the field of vascular anastomosis. Although lots of efforts have been done, such previous recommended techniques are associated with adverse consequences and here is where the need for new methods is still sensed. In this manuscript, we bring all the benefits from other methods together and conclude a novel one for end-to-end vascular anastomosis which uses biological glue as connecting material and also an absorbable stent to keep vessel patency while using balloon catheter and tacking suture., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Herein, a series of separate dynamic (1)H NMR effects are reported at different temperatures within a particular enaminoester involving a phenanthridine. These effects are attributed to restricted rotation around the two single bonds such as carbon-carbon (H(a)-C-C-H(b)) and nitrogen-carbon (NCCOOCH(3)). Activation energies (E(a)) for these interconversion processes in their rotational isomers are equal to 20 and 20 ± 1 kJ mol(-1), respectively. In addition, three dynamic (1)H NMR effects are investigated at different temperatures for a particular phosphorus ylide involving a 2-indolinone around the carbon-carbon single bond (H-C-C-PPh(3)) within the two Z- and E-rotational isomers and partial carbon-carbon double bond (OCH(3)-C=C-PPh(3)). Activation energies (E(a)) for these interconversion processes in rotational isomers are equal to 53, 63 and 73 ± 1 kJ mol(-1) , respectively. This behavior was also observed for other phosphorus ylide containing 2-mercaptobenzoxazole around the carbon-carbon single bond and partial carbon-carbon double bond with their relevant activation energies containing 13, 10 and 75 ± 1 kJ mol(-1), respectively., (Copyright © 2011 John Wiley & Sons, Ltd.)

Introduction: Maintenance of kidney graft function is essential, averting infection and coinfection. Cytomegalovirus (CMV) and BK polyomavirus (BKV) coinfection have been reported. There are a few studies of CMV and BKV infection in kidney transplant recipients in Iran, but no studies of their coinfection., Objective: To assess the coexistence of CMV and BKV infection in renal transplant recipients., Patients and Methods: The presence of CMV and BKV was assessed using real-time polymerase chain reaction in a cross-sectional study in 91 renal transplant recipients at 1 month posttransplantation. Assessment of CMV was performed only in blood samples, whereas BKV was assessed in both serum and urine samples., Results: The 91 patients included 57 men (62.6%) and 34 women (37.4%), who ranged in age from 19 to 76 years. Simultaneous evaluation of CMV in plasma and BKV in urine demonstrated no significant association. Of 24 patients positive for BKV in urine, 8 (33.3%) were positive for CMV in plasma. Sixty-seven patients tested negative for BKV in urine, whereas 23 (34.4%) tested positive for CMV, which is unremarkable. Comparison of coinfection with plasma CMV and plasma BKV demonstrated no significant correlation. In 3 patients positive for BKV in plasma only, 1 (33.3%) was positive for CMV, whereas in 88 patients negative for BKV in plasma, 30 were positive for CMV., Conclusion: No significant association was observed between CMV and BKV infections in kidney transplant recipients., (Copyright © 2011 Elsevier Inc. All rights reserved.)

This study aimed to determine the correlation between of ESR, C3, C4, anti-DNA, and lupus activity and also the construct and criterion validity of the British Isles Lupus Assessment Group (BILAG) index for assessing disease activity in systemic lupus erythematosus (SLE). Patients with SLE were recruited into a cross-sectional study. Data were analyzed for estimating of SLE disease activity [scores on the BILAG index and Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)]. Overall BILAG scores were determined by the highest score achieved in any of the individual systems in the respective index. Erythrocyte sedimentation rates (ESRs), C3 levels, C4 levels, anti-double-stranded DNA (anti-dsDNA) levels, and SLEDAI-2K scores were used in the analysis of construct validity. Statistical analyses were performed using ordinal logistic regression for construct validity. Of the 100 patients with SLE, 90% were women. Their mean ± SD age was 31.1 ± 9.8 years. Increasing overall scores on the BILAG index were associated with increasing ESRs, decreasing C3 levels, decreasing C4 levels, elevated anti-dsDNA levels, and increasing SLEDAI-2K scores (all P < 0.01). These findings show that the ESR, C3, C4, and anti-DNA should be used in the evaluation and management of patients with SLE. Also the results show that the BILAG index has construct validity.

Objective: To evaluate the true efficacy of the 308-nm excimer laser for darkening striae alba using a modified approach., Methods: Ten subjects were treated using the excimer laser on the white lines of striae, while the normal skin near to and between the lines was covered with zinc oxide cream. Assessment of efficacy was performed by colorimetric scores based on mexameter measurement and also digital photographs showing before-after laser therapy, which were compared by two independent dermatologists., Results: The mexameter-based data analysis showed that the excimer laser was weakly effective in the repigmentation of the lines of striae. The analysis using before-after photographs showed that 80% of patients had a poor or moderate result., Conclusions: The results of this study showed the weakly positive effect of the 308-nm excimer laser in the repigmentation of striae alba; the splaying of pigment was a major side effect.

Granuloma faciale (GF) is a rare cutaneous disorder categorized as a localized form of small vessel vasculitis. Clinically, it manifests as single or multiple, well-demarcated, red-brown plaques, papules and nodules, nearly always confined to the face. Herein, we report a 39-year-old man with multiple red-brown, infiltrated plaques on his face and extrafacial lesions on the back, shoulders, and both arms. Skin biopsy revealed typical histopathological findings of GF. The patient failed to respond to pulsed dye laser, but intralesional triamcinolone combined with cryotherapy led to an acceptable response.

Aim: Atrophic gastritis is defined as a chronic inflammatory process in gastric mucosa leading to loss of glandular cells. It is considered a precancerous condition, thus its early diagnosis is of importance. Although histo-pathologic studies remain as the gold standard of diagnosis, non-invasive methods suitable for screening purposes are being developed. This includes measurement of serum gastric profile., Methods: Two hundred and fifty 250 patients who were planned to undergo upper gastrointestinal endoscopy were randomly selected to be included in this study. Serum levels of pepsinogen I and II, gastrin-17 and anti-Helicobacter pylori (Hp) antibody were measured and the results were compared with that of histopathologic assessment of biopsy specimens obtained during endoscopy., Results: IgG anti-Hp, PGII and PGI/PGII ratio showed correlation with age. PGI/PGII ratio showed best sensitivity (96.1%) and negative predictive value (97.7%). PGI has the highest specificity (94.6%), and PGII also had a high negative predictive value (90.7%). IgG anti-Hp showed poor sensitivity and specificity (58.8% and 26.5%, respectively)., Conclusions: Pepsinogen I/II ratio appears to be the most suitable single measurement for screening purposes in atrophic gastritis.

Hearing sense is one of the key elements which may have impact on the driver's task quality. This cross-sectional study investigates the hearing status of 500 truck drivers by pure tone audiometry (AC) in one of the cities in Fars province, Iran. Hearing threshold levels of the subjects were measured in frequencies of 500Hz-8000Hz. Screening and determination of permanent threshold shift (PTS) was the first aim of this study. Hence tests were done at least 16 hours after any exposure to noticeable sound. The effect of age as a confounding factor was considered using ISO equation and subtracted from whole hearing threshold. The threshold of 25 dB HL and above was considered abnormal but the calculation of hearing was also carried out using 0 dB HL as reference. Subjects were categorized into two groups on the basis of working experience and the hearing threshold of 25 dB was considered a boundary of normal hearing sense. The results of Pearson Chi-Square test showed that working experience as an independent variable has significant contributing effect on hearing thresholds of truck drivers in frequencies of 500, 1000, 2000 and 4000 Hz (p greater than 0.05). Also, it was shown that currently nine and 12.6 % of truck drivers suffer from impaired hearing sense in left and right respectively (hearing threshold level greater than 25 dB) in mid frequencies (500, 1000, 2000 Hz) and 45% in high frequencies of both ears (4000 and 8000 Hz). The results indicated that hearing damage of professional drivers was expected to occur sooner at 4000 and 8000 Hz than lower frequencies. Finally it was deduced that the occupational conditions of truck drivers may have bilateral, symmetrical harmful effect on hearing threshold sense in all frequencies mainly in frequency of 4000 Hz, so health surveillance programs such as education and periodic medical examinations are emphasized for pre-diagnosing and prevention of any possible impairment and an urgent need to take up some interventions such as better maintenance of roads, automobile industry efforts to reduce the noise level emission of vehicles and reducing number of working hours per day of drivers are highlighted to improve the harmful working conditions of truck drivers.

Aim: The intent of our study was to determine the efficacy of oral naltrexone, an opioid antagonist, in the treatment of pruritus in patients with chronic eczema., Methods: This double-blind, placebo-controlled study recruited 38 patients with eczema complaining from pruritus. Pruritus scores were evaluated. Patients were given placebo (n = 20) or naltrexone 50 mg (n = 18) for 2 weeks period. During the study, pruritus scores based on visual analogue scale system (VAS) were assessed three times: at the start of study, after 1 week, and after 2 weeks., Results: In both groups, decreased VAS scores were observed, but naltrexone showed to be significantly more effective than placebo in decreasing VAS score after 1 week (P < 0.005) and 2 weeks (P < 0.001)., Conclusion: Naltrexone is more effective than placebo in the treatment of pruritus in patient with eczema. Naltrexone might be considered as an adjunct treatment in the treatment of pruritus. However, further studies in this aspect are highly fostered.

Objective: To determine the factors affecting survival, following resection of large bowel for colorectal carcinoma., Method: From the cancer database of a single referral institution, a total of 1090 patients who had undergone colorectal resection between 1999 and 2002 were identified. Cases with recurrent colorectal cancer or previous history of neoadjuvant chemotherapy were excluded. Survival curves were plotted using the Kaplan-Meier method. Univariate analysis of factors thought to influence survival was then made using Logrank test. Criteria studied consisted of age, sex, TNM stage, T-status, nodal status, distant metastasis, histological grade, lymphatic and vascular invasion, tumour location, preoperative carcinoembryonic antigen (CEA) level and liver function tests. Multivariate analysis was conducted using Cox regression analysis., Results: The mean survival time for all patients was 42.8 (SEM = 2.8) months. The overall 1-, 3- and 5-year survival rates were 72%, 54% and 47%, respectively. In univariate analysis, patients' age (P < 0.0001), TNM stage (P < 0.0001), T-status (P = 0.015), nodal status (P = 0.016), distant metastasis (P < 0.0001), grade (P = 0.005), lymphatic and vascular invasion (P < 0.0001) and presurgery CEA level > 5 ng/ml (P = 0.021) were found to be predictors that could affect survival. In Cox regression analysis, age (P < 0.0001), TNM stage (P = 0.001) and grade (P = 0.008) were determined as independent prognostic factors of survival., Conclusion: Age, TNM stage, T-status, nodal status, distant metastasis, grade, lymphatic and vascular invasion and presurgery CEA level can predict the postsurgical survival rate in patients with colorectal cancer.

Lipoid proteinosis is a very rare genodermatosis characterized by infiltration of hyaline material into the skin, oral cavity, larynx and internal organs. It usually presents in infancy with hoarseness. Although about 300 cases have been reported in the literature, the occurrence of the disease is rare in siblings. In this report we introduce three siblings with this disease.

Background: Acne is a chronic inflammatory disease of pilosebaceous units. In addition to an unpleasant appearance, it may result in scarring in some cases. Despite the introduction of different treatments, oral isotretinoin is the most effective treatment and affects all the factors involved in the pathogenesis of this disease. This study was performed on patients with acne to examine the therapeutic effects, recurrence rate, and adverse effects of this drug., Methods: One hundred patients with acne, who were visited at the Bou-Ali Hospital during 2000 - 2001, and found eligible to take part in this study were selected. The severity of acne was graded at the beginning, during, and after a 6-month treatment course with oral isotretinoin. Necessary laboratory tests were done., Results: The data of 83 of 100 patients who continued the treatment for 6 months were analyzed. The mean +/- SEM severity score of acne improved from 3.15 +/- 0.10 to 0.58 +/- 0.09 (P < 0.0001). Complete cure was achieved in 65% of patients. The mean +/- SEM follow-up was 8.7 +/- 2.3 months and the acne severity score was 1.04 +/- 0.13 during the follow-up period. Overall, the recurrence rate was 19%; 4% of patients had to undergo retreatment. A rise in triglyceride level was the only significant laboratory alteration observed., Conclusion: Oral isotretinoin appears to have favorable results and the least adverse effects in treatment of carefully-selected patients with acne.

The transverse wave condition is not applicable to the refracted electromagnetic wave within the context of geometrical optics when absorption is involved. Either the TM or the TE wave condition can be assumed for the wave to locally satisfy the electromagnetic boundary condition in a ray-tracing calculation. The assumed wave mode affects both the reflection and the refraction coefficients. As a result, nonunique solutions for these coefficients are inevitable. In this study the appropriate solutions for the Fresnel reflection-refraction coefficients are identified in light-scattering calculations based on the ray-tracing technique. In particular, a 3 x 2 refraction or transmission matrix is derived to account for the inhomogeneity of the refracted wave in an absorbing medium. An asymptotic solution that completely includes the effect of medium absorption on Fresnel coefficients is obtained for the scattering properties of a general polyhedral particle. Numerical results are presented for hexagonal plates and columns with both preferred and random orientations.