seyedamir mousavian

Several reports have shown that radiotherapy treatment increases the risk of sarcoma. In this report, a 67-year-old female patient complained of chest wall pain and swelling in the previous mastectomy area. Twelve years ago, She had a history of mastectomy, after which she underwent five sessions of chemotherapy and 25 sessions of radiotherapy. In the examination, the immobile hard mass arising from the rib was evident. In the CT scan, there was involvement of three ribs in the front. The patient was a candidate for radical excision and reconstruction with Prolene mesh and was discharged three days after surgery with a good general condition. The final pathology of undifferentiated liposarcoma was reported as grade III. Awareness of the possibility of sarcoma caused by ionizing radiation along with long-term follow-up of patients treated with radiotherapy can lead to early diagnosis of these patients.

Septic arthritis of the sternoclavicular (SC) joint is an uncommon disease with some risk factors. Because of being rare and insidious, a diagnosis could probably be difficult, delayed, or even missed until complications occur, resulting in severe and life-threatening outcomes. It should be noted that early recognition and diagnosis, followed by immediate treatment, play an essential role in the patient’s prognosis. Septic arthritis of the SC joint is a relatively infrequent infection. Clinical symptoms are mostly sudden, and from days to months, the patients may have pain in the chest, shoulder, or neck, limited movement in the upper extremities, and fever.

We report a patient without predisposing factors who developed septic SC arthritis with infraclavicular abscess and was rapidly treated with partial clavicular resection

Diagnosis of septic arthritis in the SC region is often deferred. Early diagnosis allows more accessible medical or surgical treatment and a significant prognosis.

Methods of using natural ventilation in the architecture of the buildings have been studied. Architectural elements such as: the atrium, the ceiling light aperture, the courtyard, the staircase, dome roof, duct of the installations, and vertical channels of the building such as channel of the elevator are widely used in Iranian buildings. Feasibility of using these elements for natural ventilation has been studied taking into account the relevant standards. Significant results of the study are the sizes of the openings suitable for each case of ventilation.  For the ventilation based on vertical paths such as the installation duct or the atrium, the ratio of the path area to the opening to it should be 0.78 times of the hydraulic diameter of the path. The area of the opening of the room to outdoor should 1.5 times of the opening of the room to the path. For ventilation using the light ceiling aperture the area of the opening to outdoor is independent of building area and should be 1 m2.  In ventilation using duct and staircase the should be an opening on the doom roof with area equal to the area of the duct. 

Myasthenia gravis (MG) is an autoimmune disease affecting patients’ quality of life and necessitating long-term medical therapy. The efficacy of thymectomy for treatment of MG has been well established. Although several techniques have been used for thymectomy, there has been controversy over the best method with highest rate of improvement. Herein, we discuss our seven years of clinical experience with thoracoscopic thymectomy for MG.
We evaluated all patients who were operated on with preoperative diagnosis of non-thymomatous MG from 2007 to 2013 in Masih Daneshvari Hospital (Tehran, Iran). All patients underwent thoracoscopic thymectomy, and rates of remission and cumulative improvement were compared to those reported by other studies.
Thoracoscopic thymectomy was performed in 34 patients with MG. The rate of complete remission and cumulative improvement at the end of the third year was 44.1% and 85.3%, respectively. Patients who were operated early after the diagnosis showed higher improvement rate, although it was not statistically significant (P=0.065).
Thoracoscopic thymectomy is a safe procedure for treatment of MG with comparable results to other techniques. Thymectomy soon after the diagnosis may be associated with higher improvement rate.

One Lung Ventilation (OLV) is the preferred method of anesthesia in the vast majority of thoracic operations, especially thoracoscopic procedures. Although double lumen endotracheal tubes are usually used to conduct OLV during thoracic operations, in patients with permanent tracheostomy, because of short trachea, keeping these tubes safe in place is usually difficult. Thus, OLV in patients with permanent tracheostomy may be challenging or even impossible. Herein, we report a patient with permanent tracheostomy who underwent successful OLV and thoracoscopic lobectomy.

Hemophilia is a congenital disease resulting in deficiency of clotting factors. For this reason they have a constant need of clotting factors which makes them one of the largest consumers of blood products. Through this blood product use، many of these patients have become infected by hepatitis C virus (HCV). We have studied the seroprevalence of anti-HCV antibody and HCV infection in hemophilic patients refereeing to Iran Hemophilia Society center in Tehran. In a cross-sectional study we reviewed files of all hemophilic patients registered in Iran Hemophilia Society center in Tehran from 2003 to 2005. Subjects with available results of anti-HCV antibody were included. Among the 1170 files examined، 1095 contained data on HCV infection status. From these، 802 subjects (72. 3%) had anti-HCV antibodies. Genotype 1 was most common (60%) followed by genotype 3 (38%). Almost 10% of patients with anti-HCV antibodies had a negative HCV RNA by PCR. HCV is very common among hemophilic patients and considering the risk for the patients and their contacts it is necessary to screen all hemophiliacs for HCV and treat if indicated.