Journal of

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Introduction: Hypoxemia can occur during upper gastrointestinal endoscopy with or without pharmacological sedation. Pulse oximetry saturation (SpO2) levels were assessed in patients attending for routine unsedated diagnostic upper gastrointestinal endoscopy to identify factors associated with oxygen desaturation. Methods: A total of 300 patients who underwent upper gastrointestinal endoscopy without sedation were monitored with continuous pulse oximetry. Factors related to the patient, the examination, and the monitoring data that could predict severe desaturation were evaluated. Results: Mild desaturation (SpO2 between 1-4%) was found in 143(47.7%) of the patients, while severe desaturation (SpO2≥5%) and hypoxemia occurred in 65 (21.7%) of patients, 40 (61.5%) of those had previous illnesses (p<0.001). The variables found to predict severe desaturation were basal SpO2 <95%, chronic obstructive pulmonary disease, anemia, age more than 60 years and coronary artery disease. Conclusion: The decrease in SpO2 is related to increase in age, basal SaO2 < 95%, respiratory disease, coronary artery disease, and anemia, .We recommend continuous monitoring of SpO2 in these high-risk patients undergoing upper gastrointestinal endoscopy.

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Malignant mesothelioma of the tunica vaginalis constitutes a very rare but often fatal malignancy of the male genitalia. This diagnosis should be suspected in patients exposed to asbestos and those presenting with clinical symptoms of either hydrocele or inguinal hernia. We report here a case of malignant mesothelioma of the tunica vaginalis. A 69-year-old man with a left hydrocele and inguinal mass was referred for left inguinal orchidectomy and hernioraphy. Histologic examination showed a malignant mesothelioma. Malignant mesothelioma of the tunica vaginalis testis is a very rare occupational neoplasm with highly aggressive biological behaviour. Treatment is difficult, and widespread local invasion and/or metastatic disease at presentation are associated with a poor prognosis.

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Introduction: Despite the popularity of needle biopsy for obtaining tissue samples in several solid organs, its use in thoracic lesions has been very restricted in some hospitals. This study intended to investigate the CT-Guided transthoracic core needle biopsy specimens in Yazd Shahid Sadoughi hospital during 2001- 2010. Methods: This is a retrospective cross- sectional study conducted on pathologic results of CT-Guided transthoracic core needle biopsy specimens in Shahid Sadoughi hospital from 2001-2010. Results: In our study, 89 thoracic CNB were studied between2001-2010 from patients that referred to Sadoughi hospital who involved 53 males and 36 females. 78 biopsies were from lung and 11 biopsies from Mediastin. In a total of 89 biopsies 71 biopsies (78.9%) supplied appropriate material for histopathological diagnosis. Results were classified into one of the following four groups: positive or suspicious for malignancy(19.1%), benign specific(34.8%), benign non-specific(25.8%) and non-diagnostic(20.2%). Conclusion: Based on multivariate analysis there was no significant correlation between age ,sex ,size of lesion and pathology results, but there was a significant correlation between the location of thoracic lesion in lung and pathology results (p-value=0.024). Application of automated system for biopsy and fluoroscopy CT for guidance of needle biopsy can elevate adequacy of core needle biopsy in thoracic lesion.

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Introduction: Schwannoma is an uncommon benign neoplasm which in is found in head and neck in 25-48% of the cases. This tumor arises from Schwann cells and nerve sheath and asymptomatic swelling is the chief complaint of this tumor. Although aspiration is performed for such cases, the nature of tumor can be defined only after histopathologic examination. In fact, Schwannoma diagnosis is difficult before the surgical procedure. Medical History: The case was a 24-year-old female who had a mass at the anterior of the left ear for three years. She did not have spontaneous pain. The lesion was mobile and painful in deep palpation. CT with contrast was performed for the patient which showed left parotid enlargement and a hypodense mass in the middle. Fine-needle aspiration biopsy (FNA) revealed pleomorphic adenoma. The patient underwent a superficial lobe parotidectomy. Microscopic examination showed parotid schwannoma with cystic changes. Conclusion: Parotid gland is an uncommon location for schwannoma. There are no pathognomonic visual findings for this lesion. Only 17.6% of the reported parotid schwannomas have been diagnosed before the surgical procedure. FNA is not a reliable procedure for tumor diagnosis, because in most of the cases it shows benign tumor of salivary gland i.e. pleomorphic adenoma. The nature of these tumors can be defined only after histopathologic examination. Since in histopathology of pleomorphic adenoma, myoepithelial cells were seen as schwannoma-like fusiform cells, immunohistochemistry was also performed to make sure of the diagnosis. In this method, CK and S100 markers in order to stain, which CK demonstrated negative result and S100 reported positive results, thus confirming the diagnosis of schwannoma.

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Introduction: vitamin K2 involves one of the vitamin K derivatives which is synthesized by intestinal bacteria. A great number of studies have demonstrated the presence of high concentration of vitamin K2 as well as its important functions in the brain. Vitamin K2 is capable to inhibit many inflammatory mediators in different diseases. Therefore, this study intended to investigate the effect of vitamin K2 at the level of spinal cord in inflammatory paw edema induced by formalin. Methods: In this research study, male Wistar rats (200-250g), except those of the control group, after recovery from cannulation surgery for intrathecal administration (i.t.), were classified into four groups including sham (DMSO), 2µg/10µl vitamin K2, 10µg/10µl vitamin K2 and 20µg/10µl vitamin K2. In each group, inflammatory edema volume caused by sub plantar injection of formalin (0.05 ml, 2.5%) was measured after one hour using plethysmometric method. Results: The study results indicated that I.t injection of vitamin K2 reduced formalin induced inflammatory paw edema significantly (P<0.01). In addition, in comparison with the other concentrations, the lowest concentration of vitamin K2 (2µg/10µl) demonstrated the highest decrease in inflammatory paw edema volume induced by formalin (P<0.05). Conclusion: Vitamin K2 can reduce the edema volume induced by formalin, probably by diminishing as well as inhibiting the activity of COX and synthesis of prostaglandins. Moreover, this effect on edema can be exerted via reducing free radicals such as ROS and NO followed by decreasing the release of inflammatory and pro-inflammatory mediators in the spinal cord and thus in the peripheral.

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Introduction: Head and neck squamous cell carcinoma is one of the most important causes of morbidity and mortality. It has several histologic subtypes, among which papillary squamous cell carcinoma (pscc) is a rare one, specifically in upper aerodigestive tract. It was first introduced in 1990, which proved to have poor prognosis. In this study, a 72-year old female was introduced with ethmoidal PSCC, right ptosis and proptosis from 2 years ago.

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Introduction: Malignant pleural effusion is recognized as the second most common cause of exudative pleural effusion. Thoracentesis and cytological examinations are regarded as simple procedures that can be performed easier than biopsy presenting less pain and danger. Hence, this study aimed to compare the results of malignant pleural fluidcytology and pathology of effusions in order to determine an appropriate method for malignant pleural effusion dignosis. Methods: The design of this study was a cross-sectional analytical survey of all pleural puncture samples (obtained from 1383-1393) which were diagnosed malignant via cytologic or pathologic analysis in the pathology department of Shahid Sadoughi hospital. After the required data were collected by a questionnaire, SPSS software( ver. 19) was applied via Chi- square and fisher’ s exact tests in order to analyze the study data. Results: Out of 61 malignant pleural effusion cases, 31 (50.8%) were males and 30 (49.2%) were females. 39 cases (63.9%) were reported to have positive cytology results and 56 cases were reported to have positive (91.8%) pleuralneedle biopsies. Biopsy and cytology (55.7% of cases) were matched in regard with malignancy diagnosis. However,within 27 cases this correspondence was not observed between cytology and pathology results. In general, 22 (36.1%) biopsies and 5 (8.2%) cytologies were reported to be positive . Conclusion: The study results revealed that pleural fluid cytology can be considened as a noninvasive and rapid diagnostic method in order to diagnose malignant pleural effusions. The diagnostic efficiency of this method can be improved via repeating pleural fluid cytology.

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