Allogenic peripheral stem cell transplantation from HLA-matched related donors for adult sickle cell disease: remarkable outcomes from a single-center trial.

Adult patients with sickle cell disease (SCD) are highly susceptible to stem cell transplant complications, including drug toxicity, graft versus host disease (GVHD), and graft rejection due to SCD-related tissue damage, endothelial activation, and inflammation. The scarcity of compatible stem cells for transplantation further limits treatment options, with only 43 cases of adult allogeneic peripheral blood stem cell transplantation (allo-PSCT) from human leukocyte antigen (HLA)-identical sibling donors reported in the international registry for the period 1986-2013. Herein we report remarkable outcomes in a cohort of adult SCD patients who underwent allo-PSCT using a fludarabine (Flu), busulfan (Bu), and anti-T-cell lymphocyte globulin (ATG)-based conditioning regimen in combination with very low dose total body irradiation (TBI), followed by post-transplant cyclophosphamide (Cy) and sirolimus as GVHD prophylaxis. We performed a single-center, retrospective study consisting of 20 consecutive patients (mean age 33.4 years) who underwent allo-PSCT from HLA-matched related donors with a conditioning regimen of Flu 150/Bu 3.2/Cy 29/ATG 30 (Fresenius)/TBI 200 between September 2013 and September 2017. Data were validated by an independent data audit group of the affiliated JACIE-accredited transplantation center. All patients experienced a sustained donor cell engraftment. Full donor chimerism (total cell) occurred within 180 days in all patients. Mean duration of follow-up was 13.8 months (range: 0.3-50 months), with 12 (60%) patients completing 12 months. No non-relapse mortality or graft rejection occurred. Successful treatment was achieved without the presence of graft loss, grade III-IV acute GVHD, extensive chronic GVHD, or other major complications. Allo-PSCT in combination with Flu 150/Bu 3.2/Cy 29/ATG 30(Fresenius)/TBI 200- Cy/Sirolimus therapy yielded encouraging outcomes with no mortality and low incidence of GVHD. Further controlled studies will be necessary to compare transplant protocols and long-term outcomes.

Plasma thrombin-activatable fibrinolysis inhibitor (TAFI) antigen levels in diabetic foot ulcers.

Plasma TAFI may participate in arterial thrombosis in cardiovascular diseases (CVD) and may be involved in the mechanism of vascular endothelial damage in diabetic patients. The aim of this study was to investigate the association of plasma TAFI antigen level in the development of diabetic foot ulcer in Type 2 diabetes. The TAFI antigen levels were determined in 50 patients with diabetic foot ulcers and 34 patients without diabetic foot ulcers and 25 healthy individuals. We measured TAFIa/ai antigen in plasma samples with a commercially available ELISA Kit. Diabetic foot ulcer group and diabetic group were similar in terms of mean age and sex distribution. Diabetes duration, retinopathy, neuropathy, macrovascular disease and infection were related to diabetic foot ulcers. HbA1c, HDL-cholesterol and Folic Acid levels were decreased in the diabetic foot ulcer group. TAFI levels were 99.44 ± 55.94% in control group, 135.21 ± 61.05% in diabetic foot ulcer group, 136.75 ± 59.38% in diabetic group and was statistically different (P < 0.05). But no difference was seen in TAFI levels between the diabetic foot ulcer group and diabetic group (P > 0.05). No significant difference in plasma TAFI levels were seen between diabetic foot ulcer stages. TAFI antigen levels are increased in Type 2 diabetic patients, but are not related to diabetic foot ulcer development.

The knowledge, approach and function of pediatricians in prevention of caries in Tehran.

The Study was carried out an 160 Pediatricians in Tehran to find out the knowledge, approach and functioning of the pediatricians as related to the awareness regarding prevention of dental Caries. It was observed that 14.4% of the pediatricians had good dental awareness, 48.1% had moderate awareness and 37.5% had weak awareness.

Ultrastructure of the seminiferous tubules in human testes before and after varicocelectomy.

Ultrastructure of the membrana propria and the seminiferous epithelium was studied in infertile human testis both before and 3-6 months after varicocelectomy. The frequent alterations, observed before and after the operation, were extremely thickened membrana propria, deep invaginations, multilamination and knob-like formation of basal laminae and formation of multinucleated spermatids, which were all considered as the common response of the testis to different noxious agents. Although the cells of the seminiferous epithelium were clearly affected by varicocele before varicocelectomy, many areas exhibited normal features after the operation. Furthermore, multinucleated cells, sharing common features of Sertoli cell and spermatogonium, were observed, as well as presence of well-developed annulate lamellae in the Sertoli cells, exhibiting centrioles in the vicinity of their nuclei after varicocelectomy. These multiple ultrastructural observations indicate that Sertoli cell division takes place. This study suggests that if the observation period of the tissue samples after varicocelectomy is long enough, the reversible changes of the tubular cells would be seen much more frequently.

The effect of toluene on the rat ovary: an ultrastructural study.

In this study, eighteen Wistar female albino rats were used to observe the ultrastructural effects of toluene on the rat ovaries. The animals were divided into experimental and control groups. The experimental group was exposed to 3,000 ppm toluene/m3 for 7 days and 8 h/day. At the end of the experiment the main ultrastructural findings related to the oocytes of the antral follicles of the experimental group were: abundant vacuoles, lytic areas, degenerative mitochondria in the ooplasm and blunt microvilli on the surface. Furthermore, the granulosa cells revealed prominent degenerative changes such as pyknotic nuclei, mitochondrial alterations and dilatation of the endoplasmic reticulum (ER) cisternae. It was interesting to note tht the ultrastructure of primordial follicles was almost similar in both experimental and control groups. All these findings suggested that, although toluene did not affect the primordial follicles, the growing follicles showed degenerative changes attributable to the inhalation of a toxic agent such as toluene.