Tehran University Medical Journal

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Migraine as one of the most common types of headaches with high intensity and prevalence, affects life significantly. This study was devised to determine the effects of migraine on economic status and life quality of Iranian surffcres.
"Pain database questionnaire", prepared by the International Association for the Study of Pain (IASP) in the year 1995, was translated to Farsi. Then we modified it regaiding cultural, geographical and social characteristics of Iran. 65 patients (55 women and 10 men) were recruited form neurology clinic consultants. Those patients who met the International Headache Society. (IHS) criteria for migraine, were interviewed using IASP questionnaire. Pain effects on sleep, marital life, social, recreational and sexual activities, quality and quantity of drug consumption as well as using paraclinic procedures were considered.
Significant decrease in sleep duration was seen during pain (7.4 ± 1.9 h) compared to pain-free conditions (6 ± 3.7 h) (P < 0.001). The effects of pain on marital life, social, recrealtional and sexual activities during pain were compared with pain-free conditions based on a zero to ten ranking schedule,. Wilcoxone test showed statistically significant (P < 0.02) differences.
We concluded that the economic effect of migraine and its impact on patients' quality of life are significant and should be considered in health planning and disease management

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A retrospective study was conducted to investigate about breast cancer in Tehran from 1985 to 1995. All breast pathological records at five General District and Teaching Hospitals (18 general surgical wards) were reviewed and data were extracted. Overall, 3085 records were found (7291 female and 294 male). The final diagnosis was made for 2436 female records including 903 breast cancer (37.1%), 1430 benign breast disease (58.7%), 45 breast skin disease (1.8%) and 58 normal pathological report (2.4%). The dominant group age for breast cancer in women was age group of 40-49 years. The most frequent pathological stage was stage III. Breast cancer was also seen in 2.3 percent of women of 25 year old or younger. The diagnosis was also made for 278 men showing 32 breast cancer (11.5%), 23 benign breast disease (86%), 3 breast skin disease (1.1%) and 4 normal pathological report (1.4%). The results suggest that 3.5 percent of the overall breast cancer were men's, all having over 40 years of age with 60 years or older as the most frequent age. The most frequent pathological stage was stage III. The findings have some implications for public health professionals in terms of breast cancer screening in Iran.

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One of the useful function of melatonin is its protective effect against endogenous oxidants. The object of this investigation was to study the protective effect of melatonin on stress-induced gastric lesions.
Results: Our results show that pretreatment of animals with melatonin decrease the stress-induced gastric lesions dose dependently.
L-NAME, a nitric oxide synthesis inhibitor, potentiat the stress-induce gastric lesions and melatonin produced gastro-protective effect against concurrent stress and L-NAME-induced gastric lesions.
Conclusion: Our results indicate that melatonin may produce its gastro-protective effect Via increasing level of nitric oxide.

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Background: Intra-rater agreement in observing and decision making in diagnosis of any disease is of great importance.This investigation is to observe and read ultrasound pictures of ovarian cysts and distinguish its category for any radiologist. Distinguishability is one of the related entities in this matter and radiologists&apos ability in correct diagnosis is of great concern. In this study, we evaluated radiologist’s distinguishability of ordered categories of ovarian cyst diseases (benign, borderline and malignant) in ultrasonography. To do this, we measured intra-rater agreement of radiologists by Weighted Kappa coefficient, and then by the help of “square scores association model” and “agreement plus square scores association model” we evaluated their distinguishability in diagnosis of the severity of the ovarian cyst’s diseases.

Methods: In this analytical cross-sectional study, two radiologists and three radiology residents assessed ultrasounds of 40 patients separately and independently in two periods (with the interval of one week). Patients selected from those who were referred to Mirza Koochak Khan Hospital in January 2005. Ultrasounds were performed by an expert radiologist and by a single apparatus.

Result: Data from radiologists was evaluated by “square scores association model” due to their superior results of distinguishability. Mean of Weighted Kappa coefficient was 0.81 and intra-rater agreement was 0.99 for our radiologists, but due to weaker results of our residents, we used “agreement plus square scores association model” for analyzing and mean of Weighted Kappa coefficient was 0.65 and intra-rater agreement was 0.97 for them.

Conclusion: Although radiologists had a better function than their residents, all of them showed appropriate distinguishability and intra-rater agreement in diagnosis and categorizing of the ovarian cyst’s disease. To distinguish benign category from borderline was more difficult than to distinguish malignant category from borderline and radiologists showed better results in this than their residents did.

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Background: Dialysis access procedures and complications are important causes of morbidity and hospitalization for chronic hemodialysis patients. Ideally, any patient undergoing hemodialysis should receive an autogenous fistula that can be accessed throughout the patient's life. In patients with primarily unsuitable or secondarily surgically-exhausted veins, a prosthetic graft can be performed. Several recently published studies report the outcome of prosthetic grafts. The conclusions of these studies differ dramatically. The aim of this prospective study was to determine the patency, infection and thrombosis rates using Poly-tetrafluoroethylene (PTFE) in grafts for vascular access in hemodialysis patients.
Methods: During this three-year prospective study, 84 patients underwent placement of vascular access graft at the Vascular Surgery Department of Sina Trauma and Surgery Research Center in Tehran. Demographics, complications, and subsequent treatment were recorded. Primary patency rates were estimated using the Kaplan-Meier method. Logrank tests were used to evaluate the statistical differences in survival distribution.
Results: The mean patient age was 55 years (±12 years). Hypertension, diabetes and smoking were considered to be risk factors for atherosclerosis in 45, 26 and 19 cases, respectively. The patients were followed up for at least 24 months. The primary patency rates were 78%, 63.3% and 54.9% at 6, 12 and 18 months, respectively. There were 39 (46.4%) access failures, which were related to infection in five cases (6%), thrombosis in 30 cases (35.7%) and bleeding in two cases (2.4%). The patency rate in patients without hypertension and with hypertension were 62.2% and 29.7%, respectively (P<0.03). Patency rates for upper extremity and lower extremity grafts were 60% and 26%, respectively (P<0.05).
Conclusion: A PTFE vascular graft seems to be an appropriate vascular access and is a promising alternative when upper extremity arteriovenous fistulas cannot be constructed. Additionally, good care and educating patients can further decrease the rate of complication and morbidity, thereby resulting in a better patency rate.

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Background: Plant-origin foods are among the most important sources of food allergic reactions. An increase in the incidence of sesame seed allergy among children and adults has been reported in recent years. The aim of this preliminary study was to investigate the prevalence, importance and clinical manifestations of sesame allergy among Iranian patients.

Methods: In a cross-sectional survey, 250 patients with suspected IgE-mediated food allergies completed a questionnaire and underwent skin prick tests with sesame extract as well as cross-reacting foods (walnut, soya and peanut). Total IgE and sesame-specific IgE levels were measured. Patients with positive skin test reactions and/or IgE specific for sesame without clinical symptoms were considered sensitive to sesame. The patients who also had clinical symptoms with sesame consumption were diagnosed as allergic to sesame.

Results: Of the 250 patients enrolled in this study, 129 were male and 121 female, with a mean age of 11.7 years. The most common food allergens were cow's milk, egg, curry, tomato and sesame. Sesame sensitivity was found in 35 patients (14.1%). Only five patients (2%) had sesame allergy. Sesame-sensitive patients had a significantly higher frequency of positive prick test to cross-reacting foods when compared to non-sensitized patients (p=0.00). The type of symptom was independent of gender and age of the patients, but urticaria and dermatitis-eczema were significantly more frequent in sensitized patients (p=0.008).

Conclusions: This is the first study addressing the prevalence of sesame seed allergy in Iranian population. We found sesame to be a common and important cause of food allergy. The panel of foods recommended for use in diagnostic allergy tests should be adjusted.

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Background: Although postoperative chemoradiotherapy should be considered for all patients at high risk for recurrence of adenocarcinoma of the stomach, curative surgery occurs in less than 50% of nonmetastatic gastric cancers. A regimen of docetaxel, cisplatin and infusional fluorouracil improves survival of patients with incurable locally-advanced gastric adenocarcinoma. So we assessed the perioperative regimen of docetaxel, cisplatin and infusions 5FU (TCF) and postoperative chemoradiotherapy to improve outcomes in patients with potentially resectable gastric adenocarcinoma.

Methods: Between March 2005 and March 2008, we 100 enrolled patients with stage II to IV (M0) adenocarcinoma of the stomach who had not been treated previously. Treatment consisted of three preoperative and one postoperative cycles of TCF followed by chemoradiotherapy. The primary end point was overall survival. The secondary end points were progression-free survival and toxicity of treatment.

Results: A total of 100 patients participated, 83 of whom received neoadjuvant and 17 received adjuvant chemotherapy. Seventy-five patients underwent at least D₀ gastrectomy. After chemotherapy, tumor stages were significantly lower than before beginning the protocol. Out of 100 patients, 44 had stage IV before chemotherapy versus 15 after the treatment. Three patients showed complete pathologic response. The median survival time was 25 months.

Conclusion: Docetaxel, cisplatin and 5FU combination chemotherapy is an active preoperative treatment in locally advanced gastric cancer. Perioperative chemoradio-therapy should be considered as an option to lengthen patient survival.

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Background: Anterior Cruciate Ligament (ACL) is one of the main knee stabilizing ligaments. Because of high incidence of ACL tearing especially in young athletes its reconstruction is very important. The aim of this study was to evaluate short-term results of anterior cruciate ligament ruptures using four strand hamstring auto graft and Bone patellar tendon autograph.

Methods: The study group included 96 patients (3 female and 93 male) with ACL teared who had been referred to our center in 5 years period (2002-2007). The subject which were Accessed in this study included meniscal injury concomitant chondral injury, determine the most common cause of ACL tearing, comparision of IKDC and lysholm score in all patients before and after surgery, and limitation of rang of motion of knee post operation.

Results: Involvement was in the right knee in 38 patients and in the left knee in 58 patients. Mean age of patients was 27.6 years (19-48). Mean surgical delay was 18 month (1-77). The most common cause of tear was playing soccer. Meniscal injury was in 78 patients. (Medial meniscus in 63 patients, lateral meniscus in 29 patients) Concommitent chondral injury was in 54 patients (56.25%). 68% of patients returned to preoperative functions sport activity. There was no limitation in extension and there was 6 patients limitation in flexion about 20º. In last visit of patients IKDS in class A and B was 96.

Conclusion: It is seem that arthroscopic reconstruction of ACL is a safe and good method in treatment of Knee stability. Use of IKDC and lysholm score for comparision of patients before and after surgery is helpful. The operation should be done early after injury. Reconstruction of ACL in older patients in the abscense of DJD is effective.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Knee arthrosis is one of the most common and debilitating diseases in the advanced ages. Regarding the fact that knee arthroplsty is the definitive and ultimate treatment for this disease, we survey the short term result of this modality.
Methods: In this survey 34 patients with knee arthrosis who have been admitted in Dr ali shariati university hospital, Tehran, Iran in a five years period (2001-2006) and have undergone knee arthroplasty. The relationship between, gender and the operation results were evaluated using the system of knee society knee score before and after the operation, causes of arthrosis, prosthesis to be used and the complications of the surgery.
Results: patients included 20 females and 14 males with the mean age of 67.37±5.25 year and the age specterum (51-78). In 15 patients the operation was done only in right knee, in 5 patients in the left knee and in 14 patients both knees were operated. The mean of functional score of the operated knee reached from 32.68±4.14 before operation (26-45) to 68.67±6.45 after that (59-82) and the mean of knee score reached from 30.6±3.8 before operation (22-39) to 86.4±6.34 after operation (73-92).
Conclusion: Regarding significant improvement in the functional score and the knee score and the low complication rate of knee arthroplasty it is recommended that in case of indication this operation be done as soon as possible because late attendance increases complications.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Gastric cancer is the second most common cancer and known as the second cause of death due to cancers worldwide. Adenocarcinoma is the most fatal cancer in Iran and a patient with this kind of cancer, has a lower lifetime than others. In this research, the survival of patients with gastric carcinoma who were registered at Taleghani Hospital, were studied.
Methods:  291 patients with Gastric carcinoma who had received care, chemotherapy or chemoradiotherapy, at Taleghani Hospital in Tehran from 2002 to 2007 were studied as a historical cohort. Their survival rates and its relationship with 12 risk factors were assessed.
Results:  Of the 291 patients with Gastric carcinoma, 70.1 percent were men and others (29.9%) were women. The mean age of men was 62.26 years and of women was 59.32 years at the time of diagnosis. Most of patients (93.91%) were advanced stage and metastasis. The Cox proportional hazards model showed that age at diagnosis, tumor stage and histology type with survival time had significant relationships (p=0.039, p=0.042 and p=0.032 respectively).
Conclusion: The five-year survival rate and median lifetime of gastric cancer patients who underwent chemotherapy or chemoradiotherapy are very low and seems that one of the important reasons for this situation is delayed diagnosis. The scheme of public education about the early warning signs of the disease and diagnosis and administration of periodic examinations is unavoidable.

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Background: In kidney transplantation decision about the proper kidney donation is different between surgeons, but simple vasculature anatomy and a kidney without abnormalities are the most important reasons of choosing a kidney. Therefore    complete assessment of renal vessels of a live donor with noninvasive techniques is a necessity for nephrectomy. For delineation of the kidney vasculature anomalies and urinary system abnormalities, Multi-Detector CT seems to be excellent method for evaluation.
Methods: In this study 59 live donors were assessed with Multi-Detector CT Angiography. After injection of contrast media, we acquired images with 0.6 mm slice thickness. Processing and three dimentional reconstructions were done and the accessory arteries, early branching of main renal artery, the number of main renal vessels and the ureters were assessed. Findings were compared with the nephrectomy results.
Results: In Multi-Detector CT Angiography the prevalence of accessory renal artery was 3/4% with 98% accuracy, early branching of main renal artery was 8/4% with 100% accuracy. Multiplicity of renal veins was seen in 8/4% of donors with 98% accuracy. Duplicated ureter was not seen in any of the donors.

Conclusions: The accuracy of CT Angiography is 95% for depicting accessory renal artery and multiple renal artery and 100% for early branching. These results were comparable with findings in conventional angiography. Studies showed this method  more valuable than M.R. Angiography and digital subtraction angiography. It is less invasive and can be named as the gold standard method in the diagnosis of anomalies of vessels & collecting system in live donors. 

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Although the short-term results of kidney transplantation have improved greatly during the past decades, the long-term results have not improved according. Graft loss due to chronic allograft dysfunction (CAD) is a major concern in renal transplant recipients (RTRs). There is little data about disease progression in this patient population. In this paper, we investigated history of kidney function as the pattern, waiting time and rate of pass from intermediate stages in RTR with CAD.

Methods: In a single-center retrospective study, 214 RTRs with CAD investigated at the Urmia University Hospital urmia, Iran from 1997 to 2005. Kidney function at each visit assessed with GFR. We apply NKF and K/DOQI classification of chronic kidney disease (CKD) staging system to determine pattern of disease progression per stage in this group of patients.
Results: The pure death-censored graft loss was 26% with mean waiting time 81.7 months. 100% of RTRs passed from stage I to II in mean waiting time 26.3 months. The probability of prognostic factors transition from stage II to III was 88.9% with mean waiting time 25.5 months, transition from III to IV was 55.7% with mean waiting time of 24.9 months and transition for stage 4 to IV was 53.5% with mean waiting time of 18.2 months. In overall rate of transition from stage i to j in patients with stage III at the beginning of the study (time of start CAD's process) was faster than others.
Conclusions: This study revealed, that kidney function in first years after transplantation is one of the most important II to III of survival probability per stage and death-censored graft loss. Therefore care of RTRs in first year could potentially increase long-term kidney survival.

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Background: Scorpion envenomation is considered as one of the Public Health problems in some countries in the world including Iran. Annually, approximately 30,000 scorpion stings happen in Iran from which 12% belongs to Hemiscorpius lepturus (special small closely spaced, bead-shaped jointed tail, similar in the shape to a cows tail, and is locally called ‘‘gaodim'' (Gao, cow dim, tail)) with 95% mortality. The main treatment is antiserum therapy which is produced in horse and is the only way to neutralize the venom. Due to the anaphylactic shock of the horse antiserum in some of the stung patients other source of antiserum is recommended. In this study the ability of produced camel antiserum in neutralizing the scorpion venom of Hemiscorpius lepturus was performed in Balb/c model.

Methods: Camel is an animal model that genetically is compatible with human genome utilized in this research to produce antiserum against scorpion venom. Two camels were used for immunization with the venom of Hemiscorpius lepturus. ELISA method was used to confirm the immunity. Antiserum was produced and used for neutralizing test. The precipitated antiserum with saturated ammonium sulfate (SAS) was also used to perform the neutralizing test in mice.

Results: The results indicated that the amount of 200 µl of antiserum and 400 µl of SAS antiserum were able to neutralize the amount of 1 LD100 of the venom and the survived the mice from death.

Conclusion: The result indicated that camel antiserum against scorpion venom is capable to neutralize the crude venom in mice model. Due to the safety of camel serum in human, it is suggested that the produced antiserum in camel can be substitute with the traditional horse antiserum in scorpion stung patients.

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Background: A correlation between coronary artery disease (CAD) and atherosclerosis of peripheral arteries and the determination of noninvasive indexes for its existence and extent have been sought by many researchers. Some studies report that the intima-media thickness (IMT) of peripheral arteries could play this role. This study evaluated the correlation between the IMTs of common carotid and common femoral arteries and the degree of atherosclerosis in aortic arch and to evaluate the severity of CAD in candidates of coronary artery bypass grafting (CABG).

Methods: In a cross-sectional analytic-descriptive study, The severity of CAD, the grade of atherosclerosis of the aortic arch, and the IMTs of the common carotid and common femoral arteries were determined.

Results: There was a significant weak positive correlation between the IMT of common carotid artery (ρ = 0.193, p = 0.039) and common femoral artery (ρ = 0.206, p = 0.028) with the number of involved carotid vessels the mean of these two parameters was not significantly different between the three CAD groups. There was not any significant relation between the IMTs of common carotid and common femoral arteries with the severity of atherosclerosis in the aortic arch too. There was not any significant relation between the presences of atherosclerotic plaque in the common carotid or the common femoral arteries with the severity of CAD. The severe atherosclerosis of the aortic arch was significantly higher in patients with three vessel disease.

Conclusion: According to our results, the IMTs of common carotid and/or common femoral arteries may increase with the severity of CAD however, these parameters are not a surrogate for predicting the CAD severity.

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Background: One of the most common orthopedic complaints is direct or indirect trauma to the knee with torn anterior cruciate ligament (ACL). Reconstruction of the torn ACL is emphatically offered in active individuals as by this operation, we prevent osteoarthritis, knee instability and injury to the meniscus. There are numerous methods for graft fixation in the femoral tunnel in ACL reconstruction. If the graft proves to be stable after the operation, patients would not complain of giving way knee joints. In this clinical trial, we compared transfemoral pinning with endobutton fixation of hamstring graft in arthroscopic ACL reconstruction by examining knee stability and use of other relevant functional tests. Methods: Fourteen Patients who had undergone arthroscopic ACL reconstruction in Shariati Hospital during the years 2008-2009 and were being followed up were evaluated at least 15 months post-operatively by physical examination and the use of an arthrometer made by the Faculty of Mechanics of Sharif Technical University. Results: The results showed that two out of seven patients in which their ACL had been reconstructed by hamstring graft fixation by endobutton technique, and in one out of seven patients who had undergone ACL reconstruction by hamstring graft fixation through transfemoral pinning, Lachmann test (in 25 position) was greater than 5 mm but there were not any complaints of giving way knee joints. Conclusion: The clinical results of ACL reconstruction by transfemoral pinning technique seems to be superior to the reconstruction by endobutton technique.

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Background: Studies indicate that obestatin, an anti-hunger peptide, plays an important role in energy balance, GH secretion, and body weight. It has been physiologically shown that obestatin apposes the function of Ghrelin. The purpose of the present study was to investigate the effects of a single session of aerobic exercise in trained women (a 1.5-mile run) on the expression of obestatin gene found in lymphocytes.

Methods: 16 trained female participants (4±1 years of training experience) were voluntarily selected from Khorasan province in Iran and were randomly divided into two groups: the control and aerobic exercise groups. The participants in the aerobic group were asked to run for 1.5 miles with a fixed speed (70 VO2 max) while the controls were passively present in the exercise environment. Following an overnight fast, blood samples (10 ml from the antecubital vein) were collected before and immediately after the exercise from all the participants. Obestatin expression was investigated after separating the lymphocytes by centrifuge and using semi-quantitative RT-PCR.

Results: There was a rise in obestatin gene expression in the case group after one session of aerobic training versus the control group but the changes were not statistically significant.

Conclusion: The results indicated that a single aerobic exercise could not significantly increase the expression of obestatin. Perhaps the type, duration and intensity of the applied protocol in this study did not have a cumulative effect on this gene although these results are in harmony with the results of other studies in this regard.

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Background: Anterior cruciate ligament (ACL) reconstruction is a first choice treatment for ACL-deficient knees, and arthroscopic single-bundle reconstruction has been widely accepted around the world in this regard. Although, such single-bundle reconstructions result in sufficient knee stability in most cases, but some patients have not been satisfied with postsurgical results in both short-term and long term clinical studies. One of the reasons for these unsatisfactory results could be related to the fact that normal function of the native ACL has not been restored by the traditional ACL reconstruction which uses only a single-bundle graft. The natural ACL consists of a 3-dimensional structure with multibundle fascicles, which can be anatomically divided into 2 main bundles, the anteromedial (AM) and the posterolateral (PL) bundles named for the orientation of their tibial insertions. The purpose of the present study was to compare double-bundle and single-bundle ACL reconstruction.
Methods: Twenty-two patients with anterior cruciate ligament tear who were candidates for ACL reconstruction were enrolled in the study undertaken in Shariati Hospital from 2009 to 2010. Fourteen patients underwent single-bundle and 8 patients double-bundle ACL reconstruction. The patients were evaluated by arthrometer and physical examination in postoperation follow up visit at least 9 months after the operations.
Results: Four out of 14 patients with single-bundle reconstruction had knee joint translation greater than 5 mm but nobody had knee translation more than 5 mm in the double-bundle reconstruction group.
Conclusion: Double-bundle ACL reconstruction seems to be more stable than single-bundle ACL reconstruction.

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Background: Cancer is a multistep process that develops very rapidly after its onset. Previous studies have confirmed antitumor effects of curcumin (1,7-bis (4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5-dione diferuloylmethane) that can potentially prevent colon cancer development with low side-effects. Different methods have been performed to increase the efficiency and effectiveness of curcumin among which dendrosome, a nanoparticle created by Sarbolouki et al. was used in this study. The present study was undertaken to evaluate the effects of dendrosomal curcumin on rat colon cancer.

Methods: In this study which was performed in Cancer Research Center of Tehran University of Medical Sciences in 2010 year, forty rats were equally divided into control, curcumin and curcumin-dendrosome groups. Animals received azoxymethane (15 mg/kg s.c.), a carcinogen, once a week for two weeks. Curcumin (0.2%) and curcumin-dendrosome were administered to the respective animals 2 weeks before the first and 14 weeks after the last azoxymethane injections. Eventually, colorectal specimens from tumoral and adjacent non-tumoral mucosal tissues were fixed in 10% formaldehyde, and passaged and embedded in paraffin. Histopathological and immunohistochemical studies were performed on the specimens.

Results: The mean number of lesions, nuclear/cytoplasmic ratio, epithelial stratification, loss of nuclear polarity, goblet depletion, structural abnormality and beta-catenin expression were higher in the control group compared to curcumin and curcumin-dendrosome groups. These parameters had significantly decreased in the dendrosomal curcumin group (P<0.05).

Conclusion: The present study shows that dendrosome can be used as a suitable nanoparticle to increase curcumin efficiency in the prevention or treatment of colon cancer.

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Background: Currently, autologous and allogeneic adipose tissues represent a ubiqui-tous source of material for fat reconstructive therapies. However, these approaches are limited, and often accompanied by a 40-60% reduction in graft volume following transplantation, limited proliferative capacity of mature adipocytes for ex vivo expansion, and extensive adipocyte damage encountered when harvested with conventional liposuction techniques. Recently, cell-based approaches utilizing adipogenic progenitor cells for fat tissue engineering have been developed and were reported to promote both short-term in vivo adipogenesis and to repair defect sites. The aim of this study was to isolate stem cells from fat tissue than examine the growth of stem cells by invitro tests. Methods: For human adipose stem cell isolation (hASC), subcutaneous adipose tissue sites were obtained from female subjects undergoing elective procedures. Tissues were washed 3-4 times in phosphate buffered saline (PBS) and suspended in an equal volume of PBS supplemented with 1% FCS and 0.1% collagenase type I. The tissue was placed in an agitated water bath at 37 1C. The supernatant containing mature adipocytes, was aspirated. Portions of the SVF were suspended in DMEM medium. hASCs were selected based on their ability to adhere to tissue culture plastic and subsequently expanded to 75-90% confluence. Adipose stem cells were isolated and cultured on DMEM. To assess mesenchymal origin of stem cells we used flow-cytomery technique as well as differentiation to osteocyte and chondrocyte lines. Results: The nature of the mesenchymal cells was confirmed by flow -cytometry tech-niques, based on the expression of CD90, CD105, CD166, and lack of expression of hematopoietic markers of CD34, CD31, and CD45. The successful differentiation of our stem cells to osteocyte, chondrocyte had been showed by specific Alizarin-Red and Toluidine-blue staining of cells. Conclusion: Although we have not the results of in vivo tests to support in vivo adipo-genesis either alone or in combination with natural or synthetic matrix, the results showed that stem cells isolation from adipose tissue was successful, and we provided an environment for differentiation of stem cells.