Human autologous serum as a substitute for fetal bovine serum in human schwann cell culture

Nowadays, cell -based and tissue engineered products have opened new horizons in treatment of incurable nervous system disorders. The number of studies on the role of Schwann cells [SC] in treating nervous disorders is higher than other cell types. Different protocols have been suggested for isolation and expansion of SC which most of them have used multiple growth factors, mitogens and fetal bovine sera [FBS] in culture medium. Because of potential hazards of animal-derived reagents, this study was designed to evaluate the effect of replacing FBS with human autologous serum [HAS] on SC's yield and culture parameters. Samples from 10 peripheral nerve biopsies were retrieved and processed under aseptic condition. The isolated cells cultured in FBS [1st group] or autologous serum [2nd group]. After primary culture the cells were seeded at 10000 cell/cm[2] in a 12 wells cell culture plate for each group. At 100% confluency, the cell culture parameters [count, viability, purity and culture duration] of 2 groups were compared using paired t-test. The average donors' age was 35.80 [SD=13.35] and except for 1 sample the others cultured successfully. In first group, the averages of cell purity, viability and culture duration were 97% [SD=1.32], 97/33% [SD=1.22] and 11.77 [SD=2.58] days respectively. This parameters were 97.33% [SD=1.00], 97.55% [SD=1.33] and 10.33 days [SD=1.65] in second group. The difference of cell count, purity and viability were not significant between 2 groups [P>0.05]. The cells of second group reached to 100% confluency in shorter period of time [P=0.03]. The results of this study showed that autologous serum can be a good substitute for FBS in human SC culture. This can reduce the costs and improve the safety of cell product for clinical application

EEG abnormalities in clinically diagnosed brain death organ donors in Iranian tissue bank

Brain death is defined as the permanent, irreversible and concurrent loss of all brain and brain stem functions. Brain death diagnosis is based on clinical criteria and it is not routine to use paraclinical studies. In some countries, electroencephalogram [EEG] is performed in all patients for the determination of brain death while there is some skepticism in relying on EEG as a confirmatory test for brain death diagnosis. In this study, we assessed the validity of EEG and its abnormalities in brain death diagnosis. In this retrospective study, we used 153 EEGs from medical records of 89 brain death patients in organ procurement unit of the Iranian Tissue Bank admitted during 2002-2008. We extracted and analyzed information including EEGs, which were examined by a neurologist for waves, artifacts and EEG abnormalities. The mean age of the patients was 27.2 +/- 12.7 years. The most common cause of brain death was multiple traumas due to accident [65%]. The most prevalent artifact was electrical transformer. 125 EEGs [82%] were isoelectric [ECS] and seven EEGs [5%] were depictive of some cerebral activity which upon repeat EEGs, they showed ECS patterns too. There was no relationship between cause of brain death and cerebral activity in EEGs of the patients. In this study, we could confirm ECS patterns in all brain death patients whose status had earlier been diagnosed clinically. Considering the results of this study, it seems sensible to perform EEG as a final confirmatory test as an assurance to the patients' families.

[Cost-effectiveness of homograft heart valve replacement surgery: an introductory study]

The clinical effectiveness of heart valve replacement surgery has been well documented. Mechanical and homograft valves are used routinely for replacement of damaged heart valves. Homograft valves are produced in our country but we import the mechanical valves. To our knowledge the cost-effectiveness of homograft valve has not been assessed. The objective of the present study was to compare the cost-effectiveness of homograft valve replacement with mechanical valve replacement surgery. Samples were selected from 200 patients that underwent homograft and mechanical heart valve replacement surgery in Imam-Khomeini hospital [2000 - 2005]. In each group we enrolled 30 patients. Quality of life was measured using the SF-36 health survey and efficacy was measured in QALYs. For each group we calculated the price of heart valve and hospitalization charges. Finally the cost-effectiveness of each treatment modalities were summarized as costs per QALYs gained. Forty males and 20 females participated in the study. The mean score of quality of life was 66.06 [SD= 9.22] in homograft group and 57.85 [SD= 11.30] in mechanical group [P< 0.05]. The mean QALYs gained in homograft group was 0.67 more than mechanical group. The incremental cost-effectiveness ratio [ICER] revealed a cost savings of 9,604,440 IRRials for each quality-adjusted life year gained in homograft group. Despite limitation of this introductory study, we concluded that homograft valve replacement was more effective and less expensive than mechanical valve. These findings can encourage healthcare managers and policy makers to support the production of homograft valves and allocate more recourse for developing such activities