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Background: For replacement of the lost tissue due to trauma and burns, several methods were used; tissue expander in one of them, but few studies has been done about it. This study aimed to compare vascular density in the expanded tissue versus normal tissue in patients with missing tissue. Methods: In a clinical trial study in 2015-2016, 25 candidates for tissue expander were enrolled. Subcutaneous tissue expander was placed and after completion of treatment, at the time getting expanders out of the body, 5 samples were given from expanded capsule, subcutaneous of expanded tissue, subcutaneous of not-expanded tissue, expanded skin, and not-expanded skin. Vascular density of the samples were determined by a pathologist and were compared with healthy tissue of adjacent area. Findings: The mean vascular density in expanded capsule, subcutaneous of expanded tissue, and subcutaneous of not-expanded tissue were 8.96 ± 4.73, 7.36 ± 3.29, and 5.08 ± 2.40 per mm2, respectively; vascular density of subcutaneous of expanded and not-expanded tissue was statistically different (P < 0.001). Conclusion: Using expanded tissue for destroyed tissue replacement is an efficient method in patients who need it; developing tissue with this method leads to development of vascularity in expanded tissue.

Background: One of the probable etiologic risk factors of oral squamous cell carcinoma (OSCC) is Candidal infection, especially by Candida albicans, whose role has not definitely been confirmed. Some have assigned a primary role to Candida, whereas others consider it as a transient inhabitant. The debate may be due to lack of an accurate and sensitive revealing technique. By identifying the presence of Candida, especially in deeper parts of OSCC, the etiologic role may be verified. The present study was conducted to detect the presence of Candida in OSCC by fluorescence staining technique. Materials and Methods: This study was descriptive experimental. Calcofluor-white, which is applied in fluorescence staining, is a specific staining substance for Candida and has a higher accuracy compared with other common methods. 100 specimens of well-differentiated OSCC with adequate amount of tissue were retrieved from the archive and two serial sections were obtained from each one. The first section was stained using the popular histochemical (periodic acid-Schiff [PAS]) method and then evaluated under a light microscope to detect the presence of Candida. The second section was stained using fluorescence staining technique. The sum of counted Candida in each technique was fed into SPSS software and analyzed by McNamara test. P < 0.001 was considered as significant. Results: The amount of Candida present in OSCCs was 74% measured by fluorescence technique. The sensitivity and specificity of the two staining techniques were significantly different. These parameters in the fluorescence technique were higher than those of the histochemical (PAS) method, confirmed by McNamara test showing significantly different results for them (P < 0.001).The results obtained from the fluorescence technique had higher accuracy compared with the histochemical (PAS) method. Conclusion: Some researchers couldn′t find a considerable number of fungi in OSCC, while our results revealed more presence of Candida, especially in deeper parts of tissue samples and probably a more important role for Candida as an etiologic risk factor for OSCC. However, since the fluorescence technique had a higher accuracy in the identification of Candida and it was nearly evident in two-third of the samples, the role of fungi as a primary cause is suggested to be studied in future investigations.

BACKGROUND: Some studies showed that smoking follows an upward trend in Asian countries as compared with other countries. The purpose of this study was to examine the effect of cigarette smoking on cardiovascular diseases and risk factors of atherosclerosis in patients with hypertension. METHODS: This study was conducted on 6123 men residing in central Iran (Isfahan and Markazi Provinces) that participated in Isfahan Healthy Heart Project (IHHP). Subjects were randomly selected using cluster sampling method. All the subjects were studied in terms of their history of cardiovascular disease, demographic characteristics, smoking, blood pressure, physical examination, pulse rate, respiratory rate, weight, height, waist circumference, and blood measurements including LDL-C, HDL-C, total cholesterol, triglyceride, fasting blood sugar and 2-hour post prandial test. RESULTS: While 893 subjects suffered from hypertension, 5230 subjects were healthy. The hypertension prevalence was 2.5 times more in urban areas compared to rural areas that showed a significant difference as it increased to 3.5 times smoking factor was considered. The prevalence of risk factors of atherosclerosis and also cardiovascular complications in patients with hypertension were significantly higher than healthy people. Furthermore, they were higher in smokers with hypertension and those exposed to the cigarette smoke than nonsmokers. CONCLUSION: Smoking and passive smoking had an increasing effect on the prevalence of risk factors of atherosclerosis and consequently the incidence of cardiovascular diseases in patients with hypertension. Keywords: Hypertension, Cigarette Smoking, Cardiovascular Disease, Risk Factor.

Background: The presence of significant carotid stenosis in coronary artery bypass grafting (CABG) patients increases the risk of either transient ischemic attack or stroke. However, there is a dearth of data on the risk for patients with unilateral total occlusion of the carotid artery. We herein report our results of cardiac surgery in patients with unilateral total occlusion of the carotid artery. Methods: We examined 10,000 patients who underwent carotid artery duplex scanning before CABG or other cardiac procedures between January 2001 and September 2006 at Tehran Heart Center. The occlusions were detected via carotid Doppler screening and were confirmed through conventional or MR angiography. Among these patients, 15 (0.15%) patients had unilateral total occlusion of the internal carotid artery, and all of them underwent elective cardiac surgery. During cardiopulmonary bypass, the mean arterial pressure was maintained at above 60 mmHg with vasopressure drugs and increasing flow pump. Results: There were 4 patients with left and 11 patients with right carotid occlusions. Four patients had a history of cerebrovascular accident. The mean cross-clamp time (min) and perfusion time (min) was 50.7±17.3 and 94.2±26.7, respectively. The mean graft number was 4.1±0.9. One of these patients expired intraoperatively because of low cardiac output. In one (6.66%) patient, postoperative cerebrovascular accident occurred on the contralateral side of the totally occluded region. All the patients recovered uneventfully. Conclusion: Our results suggest that CABG can be performed in patients with unilateral total occlusion of the internal carotid artery without ipsilateral stroke using our strategies.

BACKGROUND: Cardiovascular diseases are the major causes of mortality worldwide and acute myocardial infarction (AMI) is the leading cause of mortality among cardiovascular diseases. Thrombolytic therapies, especially during the first few hours after the disease onset, can significantly reduce AMI-related mortality. METHODS: The current study aimed to determine the prevalence and causes of non-administration of thrombolytic therapy for AMI patients admitted to Hajar Hospital, Shahrekord, Iran, from May until November 2000. Non-probability convenient sampling method was used to select 106 subjects with Q-wave AMI. Data was collected by completing a questionnaire, reviewing medical records, and interviewing with patients. SPSS7.5 was for data analysis. RESULTS: A total number of 106 AMI patients were studied among whom 62 (59%) individuals received thrombolytic therapy. Delayed referral to the hospital was the major cause of failure to provide thrombolytic therapy. The cause of non-treatment could not be identified in 15 (19.5%) subjects eligible to receive therapy. CONCLUSION: Training general practitioners and individuals involved in this regard along with accelerating the process of patient referral to hospitals can reduce AMI-related mortality. Keywords: Acute Myocardial Infarction, Thrombolytic, Therapy

Background: We sought to evaluate the routine echo-Doppler screening of carotid artery stenosis in patients undergoing coronary artery bypass grafting. Methods: A total of 2179 consecutive patients who underwent coronary artery bypass grafting alone or with other cardiac surgery at Tehran Heart Center, Tehran-Iran, between January 2005 and January 2006 were included in this retrospective study. Carotid Doppler was performed for 1604 (81.48%) of these patients. Results: The patients’ age ranged between 20 and 84 years (mean: 58.33, SD: 10.08 years). Of the 1604 patients studied, 1186 (73.9%) were men, 592 (36.9%) had diabetes, 598 (37.3%) were smokers, and 194 (12.1%) cases had significant left main stenosis. Twenty-one (1.3%) patients had significant carotid stenosis (> 60% stenosis), which constituted 0.9% of all the bypass surgery candidates. Post-operative cerebrovascular accident was not detected in any of the patients with significant carotid stenosis, but cerebrovascular accident occurred in 22 (1.4%) of the patients without carotid stenosis. Magnetic resonance angiography (MRA) was conducted in 15 patients. In our univariate analysis, female gender (p value = 0.023), hypertension (p value = 0.055), peripheral vascular disease (p value < 0.001), and age (p value = 0.001) were significant in the development of carotid stenosis. Conclusion: Pre-operative duplex carotid screening seems to be necessary in patients when there is hypertension, peripheral vascular disease, female gender, and advanced age.