Human fibroblast-like synoviocyte isolation matter: a comparison between cell isolation from synovial tissue and synovial fluid from patients with rheumatoid arthritis.

OBJECTIVE: Cell culture technology has become a popular method in the field of cell biology, pharmacology, and medical researches. Primary cells represent the normal physiological condition of human cells. Fibroblasts are the most common native cells of connective tissue that play a crucial role in the entire pathogenesis of various disorders, such as rheumatoid arthritis (RA). Fibroblast-like synoviocytes (FLSs), which overlie the loose connective tissue of the synovial sublining, are known to be the central mediators of joint damage. The most routine approach for the isolation of FLS is an enzymatic digestion of synovial tissue. This experimental study is designed to introduce an easy, fast, and high-throughput method compared with enzymatic digestion for isolation of FLS. METHODS: The synovial tissue and synovial fluid (SF) samples were collected from eight patients with RA who underwent routine knee replacement surgery. Synovial tissue was incubated with collagenase VIII enzyme, while SF was washed with a similar volume of phosphate-buffered saline. The cells were further subcultured and stored based on the standard protocols. The purity of isolated synoviocytes was confirmed using flow cytometry analysis. RESULTS: Isolation of FLS from SF was more successful with a faster rate, 3-5 days after culture. The morphological assessment and flow cytometry analysis confirmed the purity of SF-derived cells in passage 4. CONCLUSIONS: SF could be a more accessible source of FLS than synovial tissue. Obtaining primary FLS from SF is a simple, fast, and cost-effective way to have a large-scale cell during a short time.

Comparison of gastrointestinal symptoms at daily 10 mg versus weekly 70 mg Alendronate prescription in 195 osteoporotic cases.

BACKGROUND: Osteoporosis is defined as a reduction of bone density or the presence of a fragility fracture. One class of new antiosteoporotic drugs is the bisphosphonates. Oral bisphosphonates seems to induce serious gastrointestinal (GI) side effects in some patients. The aim of the study is to comparison the GI symptoms of Alendronate daily 10mg versus weekly 70mg administration in osteoporotic patients during 8 weeks. MATERIALS AND METHODS: This is a clinical trial study that was conducted in the department of Internal Medicine, Shohada Ashayer Hospital, Khorramabad, Iran, 2002-2007. 195 osteoporotic patients selected for this study. They separated in three groups (first group: Placebo for eight weeks, 2 nd group 70 mg Alendronate at single dose per weeks for eight weeks and 3 rd group 10 mg Alendronate per day for 8 weeks). Then GI symptoms were detected for each person at different groups. STATISTICAL ANALYSIS: The Data was analyzed with Chi-square test and ANOVA. RESULTS: comparison of mean of complications between groups shows that the patients in placebo group had lesser complications (P < 0.001). Comparison of each symptom between patients in 2 nd and 3 rd groups shows that only eructation had lesser frequency in first group of patients and other complications had not significant difference during 8 weeks of treatment. CONCLUSION: there is significant differences in GI symptoms between placebo and Alendronate but between Alendronate in doses of 10mg per day and 70 mg per week had not significant difference. Using of Alendronate must be cautiously because of producing severe GI disorders.

Analysis of patients with post-chemotherapy arthralgia and arthritis in breast cancer.

OBJECTIVE: Evaluate the characteristics of arthropathy and musculoskeletal pain after chemotherapy in patients with breast cancer. MATERIALS AND METHODS: In this study, we evaluate the characteristics of 15 patients with joint symptoms after receiving chemotherapy for breast cancer. Demographic information including sex, age, time of rheumatologic findings after starting of chemotherapy, and time of improvement after starting of medication, and laboratory findings detected for each patient. RESULTS: Patients comprised 15 women with mean age 43.4 ± 10.6 years that received classic chemotherapy for breast cancer according to stage of disease including cyclophosphamide, and tamoxifen. Joint symptoms usually began about 6 months after the first session of chemotherapy. Patients had an average of 2 tender joints and 1 hour of morning stiffness. None of patients were positive for anti-nuclear antibody, and just 1 patient was positive for rheumatoid factor. Non-steroidal anti-inflammatory drugs, disease modifying anti-rheumatic drugs (DMARD), corticosteroids, and venlafaxine were prescribed. 5 patients did not show an improvement and were also given low dose oral corticosteroids. Follow-up was available for all patients. 13 patients showed favorable responses, characterized by a significant decrease (more than 50%) in morning stiffness, pain, and tender joint counts after a mean of 3 months' treatment. 9 patients had complete resolution of symptoms and stopped all medications. CONCLUSION: Chemotherapy-related arthropathy is not rare, and the prognosis is fairly good with early treatment using NSAID, DMARD, and corticosteroids.

Clinical finding and outcome in suicidal attempt due to intravenous injection of kerosene.

The aim of this study was to describe the clinical findings and outcome in suicidal attempted due to intravenous injection of kerosene. This case series study was conducted in the Department of Internal Medicine, Shohada Ashayer Hospital, Khorramabad, Iran during 8 years. Ten IV drug addicts who intravenously injected themselves with Kerosene were collected. All patients admitted in ICU, completely monitored for cardiopulmonary status and consulted with pulmonologist, cardiologist, neurologist, anesthesiologist and dermatologist. Therapeutic decision including intubation, antibiotics therapy, and oxygen, correction of water and electrolyte disturbances was applied according patients condition. The data were analyzed with fisher-exact test. Nine (90%) patients were male, 1(10%) was female. All cases were attempted suicides and IV drug abusers. Mean age was 20.3 +/- 2 years. The patients' mean arrival time to the hospital after poisoning was 1.1 h. Death of 5(50%) patients was related to the higher doses (>5 mL) of intravenous injection of kerosene, the most clinical findings were related to pulmonary involvement with pulmonary edema and subsequent cardiac and neurological complications and phlebitis due to IV injection. Intravenous kerosene injection causes major injury to the lungs, the organ bearing the first capillary bed encountered. Other complications including cardiac and neurological seems to be related to severe hypoxia and other metabolic disturbances due to lung injury. The amounts of kerosene were major determinants of lethality. Early and aggressive supportive care might be conducive to a favorable outcome with minimal residual pulmonary squeal at least in patients with injection of less than 5 mL of kerosene.