مهتاب رهبر

Reference values of blood urea nitrogen (BUN), serum creatinine (sCr) and BUN to creatinine ratio (BCR) in the different pediatric populations are not well-established yet. The aim of this study was to determine reference values of BUN, sC and BCR in healthy Iranian children. 

The study included 3268 children (1670 males and 1598 females) who were hospitalized at Ali-Asghar Childrenchr('39')s Hospital (Tehran, Iran) between April 2016 and May 2018. The subjects were stratified into three age groups: toddlers, developing children and adolescents. Demographic data, medical history and laboratory findings were extracted from medical records of the subjects. Statiscal analyses were peformed using SPSS at statistical significance of 0.05.

The mean (95th Percentile) level of BUN was 12.60 mg/dl (range: 6.8 to 20.5 mg/dl). The mean and 95th percentile of sCr was 0.77 mg/dl (range: 0.8 to 1.15 mg/dl). The mean and 95th percentile of BCR was 16 (range: 12.75 to 15.4). The BUN, sCr and BCR levels differed significantly between males and females (P<0.05). In both genders, the concentrations of BUN and sCr were significantly higher in older children (P<0.05). On the contrary, the BCR value decreased significantly with age in both males and females (P<0.05).

This study is the first to report the BUN, sCr, and BCR reference values among healthy Iranian children. These values can be used by clinicians for diagnostic and therapeutic purposes.

    CD163 is a cell surface glycoprotein as known as a hemoglobin/haptoglobin scavenger receptor. The Soluble form of CD163 attenuates macrophages immune response. The aim of this study is to describe the effect of CD 163 phagocytes on progression and joint destruction by osteoarthritis (OA). Twenty OA patients participated in this study. The mean age of patients was 68 ± 8 years (range 46 to 75 years) and the male to female le ratio was 1.5, with 10.6 ± 6.3 years mean duration of OA disease. Twenty synovial biopsies of OA patients and 10 healthy control (HC) specimens were analyzed for CD163 expression (using the immunohistochemistry method) with soluble CD163 (using the ELISA method) in synovial fluid (SF) as well as sCD163 in the serum of. The score of CD163 expression in the synovial intima (P < 0.01), the subintima (P < 0.01) and periarticular area (P < 0.02) increased in OA as compared with the healthy control group. Synovial fluid sCD163 and serum sCD163 levels increased in the OA sample population as compared with the healthy control group. Also, Synovial fluid and serum sCD163 positively associated with ESR and CRP (P < 0.02, P < 0.01and P < 0.06, P < 0.06 respectively). The mean concentration of SF sCD163 was about 2 times higher than in serum in OA patients (P < 0.01). There was no correlation between clinical findings of patients and SF leukocyte count the (P < 0.09). This study shows increased numbers of CD163 macrophages with an enhanced phagocytes infiltration within the degenerated synovium as well as the local production of serum and SF sCD163. Therefore, these cells could provide a future therapeutic strategy for osteoarthritis.  

Folliculotropic mycosis fungoides (FMF) is a variant of mycosis fungoides characterized by the presence of folliculotropic atypical Tcells infiltrates, often with sparing of the epidermis and preferential involvement of the head and neck. Since the original designation of folliculotropic mycosisfungoides (FMF) is a distinct entity, there has been an increasing appreciation of the broad clinical and histopathology spectrum, which can present in this disease..
In July 2013, a 37-year-old male from Tehran (Iran) who had complained of 9 months of progressive erythematous follicular patches and plaques on the trunk and comedones and acne like lesions on his forehead has been referred to us. The histopathology study showed perifollicular and intrafollicular lymphoid cells infiltration predominantly. There was no histopathology evidence of dermal mucin deposit (PAS negative) and alopeciaor syringotropism T cell infiltration. The immunohistochemical analysis was positive for CD3 and D4. The patients received different treatments based on the stage of their disease..
FMF should be considered in patients who present with alopecia, acne like lesions, cysts and comedones in older ages with a spectrum of histologic changes. We emphasize for any time it should be under-recognized..

Spitz Nevus is an infrequent acquired melanocytic nevus. There is still a challenge for dermatopathologists in dis- tinguishing spitz nevus from malignant melanoma particularly in adults since there is no immunohistochemistry or molecular markers which differentiate Spitz Nevus frommelanoma.

The aim of this study is to make clear what clinico-histopathological features of Spitz Nevus are in order to reduce malpractice due tomisdiagnosis.

In the present study, a series of twenty two patients have been reviewed who were diagnosed with Spitz Nevous based on proved histopathology features between the years 2009 - 2013. The patients were evaluated for demographic parameters like age, sex, clinical differential diagnosis, cutaneous location of tumor, tumor diameter, subtype, symmetry,maturation, upper cleft- ing of melanocytic nest, shoulder phenomena, epidermal hyperplasia, type, kamino body,mitotic rate , inflammatory infiltration, pagetoid spread and regression.

In our study, 45% of patientswere younger than 10 years old. The average age of patientswas 1411.37. Male to female ratio was 1.44. The commonest location was head and neck. Spitz nevus was the first clinical differential diagnosis in 20% of patients. The commonest variant type was conventional type and then polypoid and desmoplastic types. The mean size of nevi was 0.81  0.59mm. About 59% of nevi shows epithelioid cytologic features. Other histologic parameters fromthemost to the least frequency were symmetry (100%), maturation (100%), epidermal hyperplasia (77.3%), kamino body (68.2%), subtype (compound 68%), mitotic rate (63.6%), clefting (59%), inflammatory infiltration (54.5%), pagetoid spread (18.2%), shoulder (37.5%) and regression (9.1%).

We tried to hifhlight some clinical and histopathological features which are distinguishing Spitz nevus from other melanocytic nevi evenmalignantmelanoma.