Search

Background: Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and micro-architectural deterioration of bone tissue, leading to bone fragility and increased fracture risk. Since Panoramic image is a feasible and relatively routine imaging technique in dentistry; it could provide an opportunistic chance for screening osteoporosis. In this regard, numerous panoramic derived indices have been developed and suggested for osteoporosis screening. Jaw trabecular pattern is one of the main bone strength factors and trabecular bone pattern assessment is important factor in bone quality analysis. Texture analysis applied to trabecular bone images offers an ability to exploit the information present on conventional radiographs. Objective: The purpose of this study was to evaluate the relationship between Jaw trabecular pattern in panoramic image and osteoporosis based on image texture analyzing using local binary pattern. Material and Methods: An experiment is evaluated in this paper based on a real hand-captured database of panoramic radiograph images from osteoporosis and non-osteoporosis person in Namazi Hospital, Shiraz, Iran .An approach is proposed for osteoporosis diagnosis consisting of two steps. First, modified version of local binary patterns is used to extract discriminative features from jaw panoramic radiograph images. Then, classification is done using different classifiers. Results: Comparative results show that the proposed approach provides classification accuracy about 99.6%, which is higher than many state-of-the-art methods. Conclusion: High classification accuracy, low computational complexity, multiresolution and rotation invariant are among advantages of our proposed approach.

Background: Electromagnetic fields (EMF) with different intensities are widely used at home, offices and public places.Today, there is a growing global concern about the effects of human exposure to EMFs. Epilepsy is one of the most common chronic neurological diseases, affecting 50 million people of all ages worldwide. We aimed to investigate the effect of exposure to Wi-Fi radiation on epileptic behavior of rats. Methods: 147 male rats, weighing 200-250 g, were divided into seven groups; negative control (no intervention), sham 1(distilled water), positive control (Pentylentetrazol [PTZ]), intervention group 1 (PTZ + Wi-Fi “off”), sham 2 (distilled water + Wi-Fi “off”), sham 3 (distilled water + Wi-Fi “on”), and intervention group 2 (PTZ + Wi-Fi “on”). The rats were exposed to Wi-Fi for 2h at a distance of 30cm from a commercial Wi-Fi router. Convulsive behaviors of rats were monitored and scored based on the intensity and type by measuring latency/threshold time, number of convulsions, sum of scores and durations of seizure, and duration of score 6 seizure. Kruskal-Wallis and Mann-Whitney U-tests were used to analyze the data. Results: Convulsion was observed in interventions Group 4 and Group 7, and positive control. The mean number of events, and sum of scores were significantly different in intervention 2 than other two groups. However, the differences in mean threshold, mean sum of durations and “ time to show convulsion with score 6 ” were not statistically significant (P>0.05). Conclusion: Due to limitations of our study including the sample size, these findings should be interpreted with caution. In this study, exposure to 2.4 GHz Wi-Fi radiation showed significant beneficial effects on the epileptic behaviour of rats. More experiments are needed to verify if these exposures can be used as a therapeutic approach for amelioration of seizures in epilepsy.

The aim of this report is to present a new two-piece thyroid-neck phantom produced by the concurrent use of epoxy resin and poly(methyl methacrylate) (PMMA: plexiglass) soft tissue equivalent materials. Accordingly, mass attenuation coefficients of the epoxy resin and the plexiglass compounds were obtained from simulation (NIST XCOM 3.1) and measurements (practical dosimetry) and compared to those related to human soft tissue (ICRU 44). The thyroid-neck phantom and thyroid gland dimensions were derived from scientific references and the atlas of human anatomy, respectively. The thyroid phantom was designed by CATIA V5R16 software and produced by the epoxy resin compound by three-dimensional printer. Other organs were designed by ProNest software and made by the plexiglass sheets by CNC laser cutting machine. The mass attenuation coefficients for the epoxy resin (50 keV- 20 MeV) and the plexiglass (0-20 MeV) were comparable to human soft tissue (ICRU 44), all with standard relative deviation beneath 5%. In addition, the SPECT images indicated the similarity between human thyroid tissue and its phantom. In conclusion, this study proves the feasibility and reliability of epoxy resin application in the production of two-piece thyroid-neck phantom. This phantom can be applied in the calibration of gamma camera systems, dosimetry and gamma spectrometry in the nuclear medicine field.

A large body of evidence now indicates that the amount of mercury released from dental amalgam fillings can be significantly accelerated by exposure to radiofrequency electromagnetic fields (RF-EMFs) such as common mobile phones and magnetic resonance imaging (MRI). Studies performed on the increased microleakage of dental amalgam restorations after exposure to RF-EMFs have further supported these findings. Although the accelerated microleakage induced by RF-EMFs is clinically significant, the entire mechanisms of this phenomenon are not clearly understood. In this paper, we introduce “Triple M” effect, a new evidence-based theory which can explain the accelerated microleakage of dental amalgam fillings after exposure to different sources of electromagnetic radiation. Based on this theory, there are saliva-filled tiny spaces between amalgam and the tooth. Exposure of the oral cavity to RF-EMFs increases the energy of these small amounts of saliva. Due to the small mass of saliva in these tiny spaces, a small amount of energy will be required for heating. Moreover, reflection of the radiofrequency radiation on the inner walls of the tiny spaces causes interference which in turn produces some “hot spots” in these spaces. Finally, formation of gas bubbles in response to increased temperature and very rapid expansion of these bubbles will accelerate the microleakage of amalgam. Experiments that confirm the validity of this theory are discussed.

Background: A new treatment approach for most patients who have undergone early stage non-small-cell lung carcinoma (NSCLC) is wedge resection plus permanent implant brachytherapy. However, the specification of dose to medium at low energies especially in heterogeneous lung is unclear yet. Objective: The present study aims to modify source strength for different configurations of 125I and 103Pd seeds used in lung permanent implant brachytherapy. Methods: Different arrays of 125I and 103Pd seeds were simulated by MCNPX code in protocol-based water vs. actual 3D lung environments. Absorbed dose was, then, scored in both mediums. Dose differences between both environments were calculated and source strength was modified for the prescription point. In addition, lung-towater absorbed dose ratio was obtained and presented by precise equations. Results: Due to significant differences in prescription dose, source strength was modified 16%-19% and 37%-43% for different configurations of 125I and 103Pd seeds, respectively. In addition, depth-dependent dose differences were observed between the actual lung and protocol-based water mediums (dose difference as a function of depth). Conclusion: Modification of source strength is essential for different arrangements of 125I and 103Pd seeds in lung implantation. Modified source strength and presented equations are recommended to be considered in future studies based on lung brachytherapy.

Background: Numerical study of angulation effects of renal arteries on blood flow has been of great interest for many researchers. Objective: This paper aims at numerically determining the angulation effects of stenosed renal arteries on blood flow velocity and renal mass flow. Method: An anatomically realistic model of abdominal aorta and renal arteries is reconstructed from CT-scan images and used to conduct numerical simulation of pulsatile non-Newtonian blood flow incorporating fluid-structure interaction. The renal arteries in the realistic model have left and right branch angles of 53˚ and 45˚, respectively. Atrapezium shape stenosis is considered in the entrance of right renal artery. Two other branch angles, i.e. 90˚ and 135˚, are also considered for right renal artery to study the angulation effects. Results: Comparison between models with right renal branch angles of 45˚, 90˚ and 135˚ reveals that high curvature of streamlines in the entrance of the renal artery with the angle of 135˚ causes the flow velocity and renal mass flow to be less than those of 45˚and 90˚. Conclusion: It is concluded that large renal branch angles cause the arteries to be unable to deliver blood in the requisite amounts to kidney. Kidney responds to counteract low blood flow by activating the renin-angiotension system which leads to severe hypertension.

Kianoush Fathi Vajargah,1 Homayoun Sadeghi-Bazargani,2,3 Robab Mehdizadeh-Esfanjani,4 Daryoush Savadi-Oskouei,4 Mehdi Farhoudi41Department of Statistics, Islamic Azad University, Tehran, North Branch, 2Neuroscience Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran; 3Public Health Department, Karolinska Institute, Stockholm, Sweden; 4Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, IranAbstract: The objective of the present study was to assess the comparable applicability of orthogonal projections to latent structures (OPLS) statistical model vs traditional linear regression in order to investigate the role of trans cranial doppler (TCD) sonography in predicting ischemic stroke prognosis. The study was conducted on 116 ischemic stroke patients admitted to a specialty neurology ward. The Unified Neurological Stroke Scale was used once for clinical evaluation on the first week of admission and again six months later. All data was primarily analyzed using simple linear regression and later considered for multivariate analysis using PLS/OPLS models through the SIMCA P+12 statistical software package. The linear regression analysis results used for the identification of TCD predictors of stroke prognosis were confirmed through the OPLS modeling technique. Moreover, in comparison to linear regression, the OPLS model appeared to have higher sensitivity in detecting the predictors of ischemic stroke prognosis and detected several more predictors. Applying the OPLS model made it possible to use both single TCD measures/indicators and arbitrarily dichotomized measures of TCD single vessel involvement as well as the overall TCD result. In conclusion, the authors recommend PLS/OPLS methods as complementary rather than alternative to the available classical regression models such as linear regression.Keywords: Prognostic study, trans cranial doppler, partial least squares regression, orthogonal projections to latent structures, multicolinearity

Background: A new treatment approach for most patients who have undergone early stage non-small-cell lung carcinoma (NSCLC) is wedge resection plus permanent implant brachytherapy. However, the specification of dose to medium at low energies especially in heterogeneous lung is unclear yet. Objective: The present study aims to modify source strength for different configurations of 125I and 103Pd seeds used in lung permanent implant brachytherapy. Methods: Different arrays of 125I and 103Pd seeds were simulated by MCNPX code in protocol-based water vs. actual 3D lung environments. Absorbed dose was, then, scored in both mediums. Dose differences between both environments were calculated and source strength was modified for the prescription point. In addition, lung-towater absorbed dose ratio was obtained and presented by precise equations. Results: Due to significant differences in prescription dose, source strength was modified 16%-19% and 37%-43% for different configurations of 125I and 103Pd seeds, respectively. In addition, depth-dependent dose differences were observed between the actual lung and protocol-based water mediums (dose difference as a function of depth). Conclusion: Modification of source strength is essential for different arrangements of 125I and 103Pd seeds in lung implantation. Modified source strength and presented equations are recommended to be considered in future studies based on lung brachytherapy. [ABSTRACT FROM AUTHOR]

Surface plasmon resonance effect of gold nanostructures makes them good candidates for photothermal therapy (PTT) application. Herein, gold-ferrite nanocomposite (GFNC) was synthesized and characterized as a photothermal agent in PTT. The aim of this study was to investigate the effect of GFNC upon laser irradiation on treatment of cancer in mice bearing melanoma cancer. Thirty mice received 1.5 × 10(6) B16/F10 cells subcutaneously. After 1 week, the mice bearing solid tumor were divided into four groups: control group (without any treatment), laser group (received laser irradiation without GFNC injection), GFNC group (only received intratumorally GFNC), and GFNC + laser group (received intratumorally GFNC upon laser irradiation). In GFNC + laser group, 200 μL of fluid, 1.3 × 10(-7) mol L(-1) gold nanoparticles, was injected intratumorally and immediately the site of tumor was exposed to continuous wave diode laser beam (808 nm, 1.6 W cm(-2)) for 15 min. All mice but four were euthanized 24 h after treatment to compare the necrotic surface area histologically by using measuring graticule. Statistical analyses revealed significant differences in necrosis extent for GFNC + laser group, compared to other groups. Four subjects (control group and GFNC + laser group, two mice each) were kept for longitudinal study. Histological analyses and tumor volume measurements of the four subjects indicated that tumor in GFNC + laser group was controlled appropriately. It was concluded that combining an 808-nm laser at a power density of 1.6 W cm(-2) with GFNC has a destruction effect in melanoma cancer cells in an animal model. [ABSTRACT FROM AUTHOR]

Background: Nowadays, mothers are continuously exposed to different sources of electromagnetic fields before and even during pregnancy. It has recently been shown that exposure to mobile phone radiation during pregnancy may lead to adverse effects on the brain development in offspring and cause hyperactivity. Researchers have shown that behavioral problems in laboratory animals which have a similar appearance to ADHD are caused by intrauterine exposure to mobile phones. Objective: The purpose of this study was to investigate whether the maternal exposure to different sources of electromagnetic fields affect on the rate and severity of speech problems in their offspring. Methods: In this study, mothers of 35 healthy 3-5 year old children (control group) and 77 children and diagnosed with speech problems who had been referred to a speech treatment center in Shiraz, Iran were interviewed. These mothers were asked whether they had exposure to different sources of electromagnetic fields such as mobile phones, mobile base stations, Wi-Fi, cordless phones, laptops and power lines. Results: We found a significant association between either the call time (P=0.002) or history of mobile phone use (months used) and speech problems in the offspring (P=0.003). However, other exposures had no effect on the occurrence of speech problems. To the best of our knowledge, this is the first study to investigate a possible association between maternal exposure to electromagnetic field and speech problems in the offspring. Although a major limitation in our study is the relatively small sample size, this study indicates that the maternal exposure to common sources of electromagnetic fields such as mobile phones can affect the occurrence of speech problems in the offspring. [ABSTRACT FROM AUTHOR]

BCI is one of the most intriguing technologies among other HCI systems, mostly because of its capability of recording brain activities. Spelling BCIs, which help paralyzed people to maintain communication, are one of the striking topics in the field of BCI. In this scientific a spelling BCI system with high transfer rate and accuracy that uses SSVEP signals is proposed. In addition, we suggested that LED light sources can provide proper signals for speller BCIs and they can be used in future. [ABSTRACT FROM AUTHOR]

Background: Pre-exposure to radiofrequency radiations of mobile phones would significantly increase the survival rate of exposed animals compared to those exposed to a lethal dose of gamma radiation alone. Stimulation of the immune system is believed to be a key mechanism for the induction of this phenomenon, the so-called "adaptive response." The immune system protects organisms against infection with multiple lines of defense of increasing specificity. Objective: In this animal study, the effect of pre-exposure to radiofrequency on the survival adaptive response of a group of BALB/c mice which received intraperitoneal injections of Escherichia coli was investigated. Methods: Groups of BALB/c mice (exposure groups) were exposed to radiofrequency radiations emitted from a GSM mobile phone for 2, 4, 8 or 12 hours a day for 3 days. Other groups (sham exposed groups) were treated as exposure groups but the mobile phone was switched off during the experiment. On day 4, animals received intraperitoneal injections of E. coli. Survival of the animals was carefully monitored by an expert scientist. Results: 15 days after exposure to the bacteria, the survival rate of the animals exposed to mobile radiations for 12 h/day was significantly (p=0.021) higher than those which only exposed to the bacteria (no pre-exposure to radiofrequency). Conclusion: Pre-exposure of BALB/c mice to radiofrequency radiations emitted from a GSM mobile phone increases their resistance to E. coli infection. This finding may have important clinical implications in treating bacterial infections. [ABSTRACT FROM AUTHOR]

We construct the asymptotically fiat charged thin-shell wormholes of Lovelock gravity in seven dimensions by a cut-and-paste technique and apply the generalized junction conditions in order to calculate the energy-momentum tensor of these wormholes on the shell. We find that for negative second-order and positive third-order Lovelock coefficients, there are thin-shell wormholes that respect the weak energy condition. In this case, the amount of normal matter decreases as the third-order Lovelock coefficient increases. For positive second- and third-order Lovelock coefficients, the weak energy condition is violated and the amount of exotic matter decreases as the charge increases. Finally, we perform a linear stability analysis against a symmetry-preserving perturbation and find that the wormholes are stable, provided the derivative of surface pressure density with respect to surface energy density is negative and the throat radius is chosen suitably. [ABSTRACT FROM AUTHOR]

The author reflects on the complexities and importance of ethical issues facing editors of the "Journal of Biomedical Physics & Engineering."

The aim of this study was to investigate the effect of pre-irradiation with microwaves on the induction of radioadaptive response. In the 1st phase of the study, 110 male mice were divided into 8 groups. The animals in these groups were exposed/sham-exposed to microwave, low dose rate gamma or both for 5 days. On day six, the animals were exposed to a lethal dose (LD). In the 2nd phase, 30 male rats were divided into 2 groups of 15 animals. The 1st group received microwave exposure. The 2nd group (controls) received the same LD but there was no treatment before the LD. On day 5, all animals were whole-body irradiated with the LD. Statistically significant differences between the survival rate of the mice only exposed to lethal dose of gamma radiation before irradiation with a lethal dose of gamma radiation with those of the animals pre-exposed to either microwave (p=0.02), low dose rate gamma (p=0.001) or both of these physical adapting doses (p=0.003) were observed. Likewise, a statistically significant difference between survival rates of the rats in control and test groups was observed. Altogether, these experiments showed that exposure to microwave radiation may induce a significant survival adaptive response. [ABSTRACT FROM AUTHOR]

Background: Radiotherapy has become a part of therapeutic process of more than 50 percent of patients suffering from cancer. However, recent studies have shown that radiation therapy might affect the expression of adhesive molecule related genes such as E-cadherin and cause cancer cells to move and migrate. Besides, various studies have reported that the expression of E-cadherin changes differently after radiation treatment. There are several studies which showed the loss of E-cadherin function after radiation; however, this reduction has not been observed in others., Objective: This study aims to investigate the effect of different radiation doses of X-ray on changes that might occur in the expression of E-cadherin gene in colorectal cancer cell line HT-29., Material and Methods: In this experimental study, the cells cultured in flasks were irradiated with X- rays in different doses, including 0.1, 2.5, 5, and 10 Gy; then, the expression of E-cadherin gene was measured using real-time PCR., Results: The expression of E-cadherin did not change significantly in post-irradiated HT-29 cell line after different radiation doses of X-ray., Conclusion: The results showed that low, medium and high doses of X- radiation did not change the expression of E-cadherin gene in HT-29 cancer cells. However, it has been reported that radiation mostly downregulated the expression of E-cadherin and mediated metastasis formation and invasiveness in different cancer cell lines. Therefore, further studies need to be conducted to investigate the effects of radiation dose on the molecular pathways contributing to regulation of E-cadherin in HT-29 cell line., (Copyright: © Journal of Biomedical Physics and Engineering.)

Background: A new treatment approach for most patients who have undergone early stage non-small-cell lung carcinoma (NSCLC) is wedge resection plus permanent implant brachytherapy. However, the specification of dose to medium at low energies especially in heterogeneous lung is unclear yet., Objective: The present study aims to modify source strength for different configurations of 125I and 103Pd seeds used in lung permanent implant brachytherapy., Methods: Different arrays of 125 I and 103 Pd seeds were simulated by MCNPX code in protocol-based water vs. actual 3D lung environments. Absorbed dose was, then, scored in both mediums. Dose differences between both environments were calculated and source strength was modified for the prescription point. In addition, lung-to-water absorbed dose ratio was obtained and presented by precise equations., Results: Due to significant differences in prescription dose, source strength was modified 16%-19% and 37%-43% for different configurations of 125 I and 103 Pd seeds, respectively. In addition, depth-dependent dose differences were observed between the actual lung and protocol-based water mediums (dose difference as a function of depth)., Conclusion: Modification of source strength is essential for different arrangements of 125 I and 103 Pd seeds in lung implantation. Modified source strength and presented equations are recommended to be considered in future studies based on lung brachytherapy.

Application of superparamagnetic iron oxide nanoparticles (NPs) as a negative contrast agent in magnetic resonance imaging (MRI) has been of widespread interest. These particles can enhance contrast of images by altering the relaxation times of the water protons. In this study, dextrin-coated zinc substituted cobalt-ferrite (Zn0.5Co0.5Fe2O4) NPs were synthesized by a co-precipitation method, and the morphology, size, structure and magnetic properties of the NPs were investigated. These NPs had superparamagnetic behavior with an average size of 3.9 (±0.9, n=200)nm measured by transmission electron microscopy. Measurements on the relaxivities (r2 and r2(*)) of the NPs were performed in vitro by agarose phantom. In addition, after subcutaneous injection of the NPs into C540 cell line in C-57 inbred mice, the relaxivities were measured in vivo by a 1.5T MRI system. These NPs could effectively increase the image contrast in both T2-and T2(*)-weighted samples., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: Hypertension significantly increases the risk for chronic graft loss and accelerates the deterioration of transplanted kidney function. Aggressive control of blood pressure (BP) is recommended in the posttransplant period when maintenance levels of immunosuppressive drugs are achieved. The aim of this study was to investigate whether the improved control improved the graft survival., Methods: We compared transplant kidney function in two groups of hypertensive patients matched for age, gender, donor-recipient relation, primary disease, early posttransplant course, and immunosuppressant and hypertensive therapy during 3 years follow-up. The patients were divided into satisfactory and unsatisfactory controlled blood pressure. Group 1 consisted of 98 patients with satisfactory BP control (arterial pressure <160/90 mmHg) and group 2, 98 patients with unsatisfactory BP control., Results: The mean through levels of cyclosporine in whole blood were similar in both groups and did not exceed 185 ng/mL. A slow but significant increase in mean creatinine levels was observed among group 2 during 3 years follow-up, whereas, among group 1, graft function remained stable. Cardiovascular events were observed only in group 2: stroke in one patient and death because of heart failure in one patient. Factors which correlated with development of post transplant hypertension were age, gender, duration of disease before transplant, and underlying disease., Conclusion: Lowering BP, even several years posttransplantation, was associated with improved graft and patient survival in renal transplant recipients.

Cardiovascular disease is the leading cause of death following renal transplantation, accounting for 40% to 55% of all deaths. An analysis in our center showed a 15% mortality in a cohort of renal transplant recipients followed for an average of 10 years. Various contributing risk factors of cardiovascular diseases in transplant recipients such as tobacco use, hypertension, hyperlipidemia, hereditary risk, diabetes, physical inactivity, obesity, dialysis duration, hyperuricemia, proteinuria, hyperhomocysteinemia, hyperparathyroidism, anemia; C-reactive protein level, and immunosuppressive regimen as well as some rare risk factors, such as cytomegalovirus infection, were evaluated in a population of 1200 kidney transplant recipients. Also we introduced methods for early detection, monitoring, and follow-up of proven risk factors of cardiovascular disease.

Background: Cardiovascular disease is the most common cause of death after renal transplantation. Furthermore, acute coronary syndrome (ACS) attributable to coronary artery disease (CAD) accounts for the majority of deaths due to cardiovascular disease posttransplant. Although renal transplantation is the treatment of choice for end-stage renal disease, understanding the causes of graft and patient loss is exceedingly important to improve outcomes., Methods: This observational study included 1200 patients who underwent a kidney transplant between 1988 and 2003. The outcome was the occurrence of an ACS event within a maximum of 15 years after renal transplantation., Results: Of all 215 deaths, 28.3% were caused by complications of CAD, the most common cause of death at our center. On multivariate analysis, diabetes (P = .005), prior transplant (P = .047), body mass index (BMI) at the time of transplant (P = .01), cholesterol level (P = .012), and low-density lipoprotein (LDL) level (P = .007) during 3 years after transplant were associated with early ACS. In conclusion, diabetes, prior transplant, BMI, cholesterol, and LDL were significantly associated with early ACS highlighting the importance of improved screening and perioperative management.

In coping with the shortage of living-related and cadaveric donor groups for renal transplantation, and in the fear of organ marketing, spousal donors are considered an invaluable potential source. Survival rates have been reported to be as high as even some related groups. This study evaluated 1039 renal transplantations up to 2003. Patient survival rates in different donor groups were determined using the Kaplan-Meier method. The 3-year patient survival rates were 93% for kidneys from 61 spouses; 92% for kidneys from 433 living-related donors; 91% for kidneys from 427 living-unrelated (excluding spouses) donors; and 90.5% for 118 cadaveric kidneys. Such results were consistent with many other reports which consistently showed that spousal donors were at least as good as living-related donors, representing a reliable source in cases of organ shortage. The high survival rate of spousal donors is probably related to their strong emotional support.

Chronic renal allograft dysfunction is the most common cause of graft loss, for which there are multiple risk factors, including obesity before transplantation, which is believed to lower long-term renal allograft survival. One hundred eighty-two kidney transplant recipients were studied. Body mass index (BMI) at the date of transplantation was calculated. BMI values were classified into 4 categories: (1) patients with BMI <20, (2) BMI between 20 and <25, (3) BMI between 25 and <30, and (4) BMI > or =30. The minimum follow-up period in this study was 3 years after transplantation. The link between categorized BMI and the presence of renal allograft dysfunction and mortality within 3 years posttransplantation was investigated using independent sample t test. BMI at the date of transplantation showed statistically significant association with presence of renal allograft dysfunction and mortality within 3 years posttransplantation (P = .008, P = .01, respectively). BMI at the date of transplantation has a strong association with outcomes after renal transplantation. The extremes of very high and very low BMI are important risk factors for chronic renal allograft dysfunction; therefore, weight adjustment before kidney transplantation can be useful in improving the function of a transplanted kidney and increasing patient's survival.

The Shiraz Organ Transplant Center in southern Iran has been performing all liver transplantations in Iran and certain neighboring countries for 12 years. This study evaluated the 140 operations performed from April 1993 through November 2004. Sixty-one percent of the recipients were men and 39% were women. The average recipient age was 29.9 +/- 14.0 years. One hundred twenty-eight patients has a full-size cadaveric transplant. Most frequent causes of cirrhosis were cryptogenic and viral. An acute rejection episode occurred in 47.5% of cases, and two episodes in 8%. Most frequent short-term complications included respiratory, neurologic, and biliary problems. The 1-, 2-, and 3-year patient survival rates were 92%, 89%, and 85%, respectively. The experience that the Shiraz Organ Transplant Center has had with liver transplantation indicated success comparable to that noted in other reports. The calculated trend suggests that a goal of 100 transplantations for 2005 is within reach.

Posttransplantation diabetes mellitus (PTDM) is a well-recognized complication of renal transplantation. PTDM is reported to contribute to major infections and cardiovascular complications and leads to increased posttransplantation morbidity. The present study was conducted to evaluate the frequency of PTDM in our center, to identify the role of immunosuppressive therapy and other risk factors in the genesis of PTDM, and to assess the impact of PTDM on graft and patient survival. From December 1998 to December 2003 we followed-up 1200 renal transplant recipients, including 121 recipients with pretransplantation diabetes mellitus and 1079 recipients without diabetes. PTDM occurred in 203 patients (mean age, 35.4 +/- 5.9 years); 131 (64.5%) were male. Graft loss and mortality were significantly higher in patients with PTDM versus those without. The overall reported incidence of PTDM worldwide varies from 3.4% to 46%. The incidence in our center is 18.8%. We also found a significantly higher incidence of PTDM among patients receiving grafts from living-related donors. This may be related to the higher cumulative doses of immunosuppressive drugs administered (in part, due to the greater number of acute rejections) in these patients.

Biliary tract complications, which occur in 5.8% to 24.5% of adult liver transplant recipients, remain one of the most common problems following transplantation. The aim of this study was to determine the incidence of biliary complications and analyze methods of treatment. From 1993 to 2004, 14 cases (10%) among 140 patients who had undergone liver transplantation developed biliary complications, third to respiratory and neurologic complications. In addition to biliary leakage in six cases, obstruction/stenosis occurred in three cases. One case of biliary fistula and one vanishing bile duct syndrome were observed. There was no death or need for retransplantation; all cases were treated surgically without recurrence. Biliary complications remain an important problem in liver transplantation. Endoscopic and radiologic management are effective in the majority of cases. Surgical intervention is obligatory and safe in selected cases.