PURPOSE: To evaluate orbital blood flow velocities and optic nerve diameter with Doppler and gray-scale sonography in patients with acute unilateral optic neuritis (ON). METHODS: Orbital Doppler and gray-scale sonography was performed in 46 eyes of 23 patients aged 19- to 47-years with acute unilateral ON. ON was diagnosed by an ophthalmologist on the basis of clinical presentation, presence of decreased visual acuity and assessment of visual evoked potentials. The peak systolic velocity (PSV) and end-diastolic velocity (EDV), as well as the resistance index (RI) and pulsatile index (PI) of the ophthalmic artery (OA), central retinal artery (CRA), posterior ciliary arteries (PCAs) and optic nerve diameter were measured in both eyes. We compared results from affected and unaffected eyes using the paired t-test. The area under the receiver operating characteristic (ROC) curves was used to assess the diagnosis of ON based on measured blood flow parameters of the OA, CRA and PCAs and optic nerve diameter. RESULTS: The mean (standard deviation) optic nerve diameter in eyes with ON was 4.1 (0.8) mm, which was significantly larger than the 3.0 (0.4) mm diameter measured in unaffected control eyes (p < 0.001). There were no differences in average PSV, EDV, RI, or PI of the OA and CRA between affected and unaffected eyes (p > 0.05). The mean RI in the PCAs was slightly lower in the eyes with ON than in the contralateral eyes (0.60 vs. 0.64, p < 0.05). The area under the ROC curves indicated that optic nerve diameter was the best parameter for the diagnosis of ON. CONCLUSIONS: Optic nerve diameter was related to ON, but orbital blood flow parameters were not.
Adult ; Humans ; Middle Aged ; Ophthalmic Artery/*physiology/*ultrasonography ; Optic Nerve/*blood supply/*ultrasonography ; Optic Neuritis/*physiopathology/*ultrasonography ; Orbit/blood supply/ultrasonography ; Pulsatile Flow/physiology ; Regional Blood Flow/physiology ; Ultrasonography, Doppler, Color ; Vascular Resistance/physiology ; Young Adult

The authors report the case of a 63-year-old man who underwent an open adrenalectomy for a synchronous, malignant, metastatic left adrenal tumor and a total colectomy for T3N0M1 (stage 4) primary, malignant colon cancer. Two polypoid lesions, one measuring 40 mm × 30 mm × 30 mm and the other measuring 20 mm × 10 mm × 10 mm, were found in the ascending colon and rectosigmoid (RS) junction, respectively, and a synchronous, malignant, left adrenal gland lesion measuring 70 mm × 50 mm × 30 mm was incidentally found on abdominal computed tomography scan. Histological examination revealed a metastatic, necrotic adenocarcinoma of the left adrenal mass, an adenocarcinoma of the cecal mass, and an adenomatous polyp (tubulovillous type) of the smallest polypoid lesion in RS junction that had invaded deeply into the submucosal layer. The patient recovered uneventfully, and his condition is now stable, with no evidence of local recurrence or metastatic disease, 2 years after the surgery. To the best of our knowledge, only 25 cases of an adrenalectomy for treating metastatic adrenal gland tumors have been reported to date; physicians should be aware of the possibility of this event.
Adenocarcinoma ; Adenomatous Polyps ; Adrenal Gland Neoplasms ; Adrenal Glands ; Adrenalectomy ; Colectomy ; Colon* ; Colon, Ascending ; Colonic Neoplasms* ; Humans ; Middle Aged ; Recurrence

Objective: To investigate the effects of soy extract on pentylenetetrazol (PTZ)-induced seizures in ovariectomized (OVX) rats. Methods: Female Wistar rats were randomly divided into 4 groups (n=15 in each group) as follows: sham-operated, OVX, low-dose soy (LDS) and high-dose soy (HDS). The rats in each group were divided into two subgroups and received daily injection of a low dose of PTZ (40 mg/kg body weight, intraperitoneally, n=7 in each subgroup) for 14 d or a single injection of a high dose of PTZ (90 mg/kg body weight, intraperitoneally, n=8 in each subgroup). The rats of LDS and HDS groups were injected with 20 and 60 mg/kg body weight of soy extract intraperitoneally, respectively, just 30 min before each PTZ injection. The rats of the sham-operated and the OVX groups received saline instead of soy extract. After treatment, the rats were placed in a plexiglas cage and their behaviors were observed for 60 min. Results: The results of repeated injection of low dose of PTZ during 14 d showed that the seizure score of the rats of OVX group on days 3, 5, 8, 10, 11, 12, and 13 was lower than that of the sham-operated group (P<0.05 or P<0.01). However, the rats of both LDS and HDS groups had higher score compared with the OVX group on the mentioned days (P<0.05 or P<0.01). The results of a single injection of a high dose of PTZ showed a significant increase (P<0.01) in the generalized tonic-clonic seizure (GTCS), but not the minimal clonic seizure (MCS) in the OVX rats compared with the sham-operated rats. Treatment with both low and high doses of soy extract significantly decreased the GTCS and MCS latencies compared with the OVX group (P<0.01). Conclusion: Female hormones affect seizure severity induced by PTZ, and phytoestrogens of soy mimic this effects. However, more investigations need to be done in the future.

Objectives: The purpose of the current study was to determine the upper threshold number of cases for which pertussis infection would reach an outbreak level nationally in Iran. Methods: Data on suspected cases of pertussis from the 25th February 2012 to the 23rd March 2018 from the Center for Disease Control and Prevention in Iran was used. The national upper threshold level was estimated using the exponentially weighted moving average (EWMA) method and the Poisson regression method. Results: In total, 2,577 (33.6%) and 1,714 (22.3%) cases were reported in the Spring and Summer respectively. There were 1,417 (18.5%) and 1,971 (25.6%) cases reported in the Autumn and Winter, respectively. The overall upper threshold using the EWMA and the Poisson regression methods, was estimated as a daily occurrence of 8 (7.55) and 7.50 (4.48-11.06) suspected cases per 10,000,000 people, respectively. The daily seasonal thresholds estimated by the EWMA and the Poisson regression methods were 10, 7, 6, 8 cases and 10, 7, 7, 9 cases for the Spring, Summer, Autumn, and Winter, respectively. Conclusion The overall and seasonal estimated thresholds by the 2 methods were similar. Therefore, the estimated thresholds of 6-10 cases in a day, per 10,000,000 people could be used to detect pertussis outbreaks and epidemics by health policymakers.