Human bone marrow-derived mesenchymal stem cell: a source for cell-based therapy

The ability of mesenchymal stem cells [MSCs] to differentiate into many cell types, and modulate immune responses, makes them an attractive therapeutic tool for cell transplantation and tissue engineering. This project was designed for isolation, culture, and characterization of human marrow-derived MSCs based on the immunophenotypic markers and the differentiation potential. Bone marrow of healthy donors was aspirated from the iliac crest. Mononuclear cells were layered over the Ficoll-Paque density-gradient and plated in tissue cultures dish. The adherent cells expanded rapidly and maintained with periodic passages until a relatively homogeneous population was established. The identification of adherent cells and the immune-surface markers was performed by flow cytometric analysis at the third passage. The in vitro differentiation of MSCs into osteoblast and adipo-cytes was also achieved. The MSCs were CDllb [CR3], CD45, CD34, CD31 [PCAM-1], CD40, CD80 [B7-1], and HLA-class II negative because antigen expression was less than 5%, while they showed a high expression of CD90, and CD73. The differentiation of osteoblasts, is determined by deposition of a mineralized extracellular matrix in the culture plates that can be detected with Alizarin Red. Adipocytes were easily identified by their morphology and staining with Oil Red. MSCs can be isolated and expanded from most healthy donors, providing for a source of cell-based therapy

Hemoglobin D [Hb D Punjab/ Los Angeles and Hb D Iran] and Co-Inheritance with Alpha- and Beta- Thalassemia in southern Iran

Hemoglobin-D [Hb D] is an uncommon structural hemoglobin variant, which is reported to be prevalent in north western India. There are only a few small series, of this entity in the literature. We report the largest single center experience on this entity from Iran. Between November 2002 and December 2010 as a result of screening premaritally for betathalassemia in Shiraz, Fars Province, Southern Iran, column chromatography, Hb electrophoresis, solubility test, and/or high performance liquid chromatography [HPLC], direct sequencing and restriction analysis were used for hemoglobinopathies and structural Hb variants. The data of 220 subjects with Hb D variants are analyzed in this report. These comprised of 180 carries of Hb D; 92 cases of Hb D Punjab/Los Angeles [beta 121[Glutamic acid -> Glutamine]] and 88 subjects with Hb D Iran [beta 22 [Glu- > Gln]], 3 homozygous cases for Hb D, 17 subjects with betathalassemia- Hb D, 12 with Hb D- alpha- thalassemia- 1, 3 homozygous Hb D- alpha thalassemia- 1 trait, one with Hb D Punjab - sickle cell anemia, and two with Hb D Iran/sickle cell anemia. The carriers of Hb D and homozygous cases for Hb D were not anemic and had normal red blood cell morphology, as they are not usually detected. If Hb D was inherited in combination with thalassemia, the subjects had mild anemia and in some of them, the spleen was palpable [1-2 cm]. Co-inheritance of alpha thalassemia and Hb D resulted in the slightly higher Hb level and lower Hb D level as compared to Hb D/ betathalassemia cases [Hb D 24-37% vs 57-88%]. Co inheritance of Hb D and sickle cell results was moderate to severe hemolytic anemia

Expansion of human marrow derived mesenchymal stem cells and their transdifferentiation potential

The ability of mesenchymal stem cells [MSCs] to differentiate into other cell types makes these cells an attractive therapeutic tool for cell transplantation. In order to provide a source of human MSCs for autologus cell-based therapy, we have expanded MSCs from the bone marrow and analyzed the biological identities and transdifferentiation potential. The bone marrow of healthy donors was aspirated from the iliac crest. The adjacent cells expanded rapidly and maintained with periodic passages until a relatively homogeneous population was established. The identification of these cells was carried out by differentiation potential into the osteocytes and adipocytes. Transdifferentiation of human MSCs into hepatocyte-like cells was undertaken in response to a specific culture condition. The differentiation of MSCs into osteoblast is determined by deposition of a mineralized extracellular matrix. Adipocytes are identified by their morphology and staining. Hepatic cells were demonstrated in vitro functions characteristic of liver cells. We have defined conditions under which human MSCs can be isolated and expanded from human bone marrow. These cells can be amplified about 10[8]-fold in 6 weeks, and are capable of transdifferentiation into the cells of another developmental lineage

prevalence and clinical significance of anticardiolipin antibody in acute myeloblastic leukemia

Antiphospholipid antibodies, including lupus anticoagulants and anticardiolipin [aCL] antibodies are associated with a wide variety of disorders including malignancies. The aim of this study was to investigate the prevalence and prognostic significance of aCL antibodies in Iranian patients with acute myeloblastic leukemia [AML]. Forty-one patients with AML [27 men and 14 women, mean age 34.9 +/- 16.7 years] were included in this study. aCL IgG and aCL IgM antibodies were evaluated in patients before induction chemotherapy. All patients were followed up for chemotherapy response. Antibodies [IgG, IgM or both] were found in 26 of 41 patients [63.4%], of whom 19 [46.3%] had a low titer, 6 [14.6%] a moderate titer and 1 [2.4%] a high antibody titer. No correlation was found between complete remission or relapse and aCL antibodies positivity. aCL antibody titers are slightly to moderately elevated in patients with hematologic malignancies, and these antibodies do not correlate with disease prognosis

[ effect of missing data in growth curves]

Background and Objective: Applying the growth curve is the most powerful way for monitoring the growth in children and through this method it would be possible to recognize in time the deviation from the natural growth pattern in children. Falling the data and missing values are general problems in analyzing the growth longitudinal data. Therefore, it is important that by computing the missing values, the data should be completed and directed towards the proper path for analysis

Methods: This 2 year longitudinal study was done on 317 infants [153 boys and 164 girls] in Shiraz during 1996. The information related to growth [Weight, height, round the head, round the arm, and round the chest] at the birth time were collected and 11 visits from the infants' living houses were done. In order to influence the missing values on the growth charts, 4 methods [Ignoring the missing values, general and individual models of growth curve and multiple imputation] were considered to study. Mean, 3[rd], 50[th], 97[th] centiles of raw and smooth weight were computed in boys and the smooth growth charts of their weight were determined and compared based on the four methods

Findings: There was no noticeable difference in the boys' mean weight at age under study according to growth curve methods and multiple imputation while missing values were ignored. However, the smooth growth charts showed that applying the individual growth curve model [Second level] and multiple imputation causes the noticeable difference between the values of 3[rd], 97[th] centiles and the traditional analysis [Ignoring missing values]

Conclusion: Regarding the existence of missing values in growth longitudinal studies, ignoring the missing values for analyzing is not acceptable. Applying the growth curve model method could be considered important in making desirable the analysis and the proper growth path

Islamic medical jurisprudence part II: the responses of Islamic law to medical dilemmas

Judicial decisions [Fatawa] of some of the most learned juridical authorities in the Imamate [Shiite] community [maraja' al-taqlid] of present time on medical issues are examined in this paper. They will provide the reader with the responses of the Islamic jurisprudence to the most involved medical dilemmas. The paper mainly focuses on the rational viewpoints of the Islamic law on permission of family planning and birth control, strict ban of abortion especially when the embryo is four months and above in normal conditions, and legitimacy of artificial insemination by the husband- Judicial prescription of cadaver and organ donation and transplantation are also discussed in some detail. The religious rite of circumcision and its impact on the health of man is duly elaborated and the principles of medical examination explained. The principle of priority of saving human life prevails all forbidden rulings set out for observing human sanctity in ordinary cases. Also, the principle of necessity when no definitive ruling is available on a given issue, has been an important source for religious prescription in all matters pertaining to the welfare of the Muslim society

Ethical issues in medical statistics

Medical statistics [biostatistics], as a vital essential part of modem life, does raise some fundamental ethical issues. Surprisingly, this aspect seems to have been totally ignored by books on medical ethics. This paper discusses how the statistical aspects affect the ethics. The relation between biostatistics and medical research is explored. All stages of a medical research exercise are vulnerable to statistical mismanagement which might lead to misuse of patients by exposing them to unjustified risk and inconvenience; the misuse of resources including the researchers' time, which could be better employed on more valuable activities; and the consequences of publishing misleading results, which may include carrying out unnecessary further work. These are specific and highly undesirable outcomes. Failure to guard against these is surely as unethical as using experimental methods that offend against moral principles, such as failing to obtain full informed consent from subjects. Raising statistical standards of medical researches and publications serves as a safeguard to observe the element of ethics. This can be achieved by widespread teaching of medical statistics at all levels, involvement of biostatisticians as active participants of any medical researches and ethical committees. Ethical issues in medical statistics require wider and more open debate. Those involved in medical research need to involve the whole medical profession. Indeed, moral philosophers, theologians, and other professional groups have an important contribution to make

Islamic medical jurisprudence part I: general aspects and principles

Islamic medical jurisprudence, which is the subject concerned with the application of Islamic laws to the area of medicine, has never been discussed as an independent field of jurisprudence, although several selected topics, especially those concerning food and beverages, sexuality, death, wounds and injuries, and doctor-patient relations have been more discussed than others. The results of an investigation on the Islamic medical jurisprudence characterized on the basis of practicing Ijtihad are presented. A survey on the Imamate [Shiite] jurisprudence was conducted through the works of prominent Shiite jurists from 4th- 10th century to the present time. The concept and methodology of practising Ijtihad is clarified and the authoritative sources of the Islamic law: The Qur'an, the Sunna, the Ijma' [consensus], and the' Aql [reasoning] are discussed. The paper further highlights the value of human life in Islam holding reference to the topics discussed in the Imamate works which proves the existence of a body of medical jurisprudence that enjoys comprehensiveness, penetration, and flexibility. In addition, the specifications of the Islamic medical jurisprudence characterized by the organic connection between the reasoning and divine law, negation of foreign dominance, observation of public benefit, actualization of public responsibility, existence of flexible overriding rules, and the discretionary authority of the jurist are elaborated. The Shiite jurists'views to medical issues prove that pragmatism prevails and the aim is to seek a compromise between Islamic heritage and the achievements of modern medicine, as long as basic Islamic dogma is not violated