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Objective: Local cryotherapy is used to relieve pain and inflammation in injuries and inflammatory conditions. Whole-body cryotherapy is an extreme method administered at -110 degrees C for 2 to 3 minutes. The aim of the study was to compare the effect of cryotherapies on pain and inflammation in patients with rheumatoid arthritis (RA)., Methods: Sixty patients with active seropositive RA were recruited in a randomised controlled single-blinded study to receive whole-body cryotherapy at -110 degrees C, whole-body cryotherapy at -60 degrees C, application of local cold air at -30 degrees C and the use of cold packs locally. In the final analysis, the last 2 groups were pooled. The patients had 2-3 cryotherapy sessions daily for one week plus conventional physiotherapy. Clinical and laboratory variables and patient's and physician's global assessments were used to assess the outcome. Disease activity was calculated by DAS., Results: Pain decreased in all treatment groups, most markedly in the whole-body cryotherapy (-110 degrees C) group. DAS decreased slightly with no statistically significant differences between the groups. No serious or permanent adverse effects were detected. Six of 40 patients (15%) discontinued the whole-body cryotherapy., Conclusion: Pain seemed to decrease more in patients in the whole-body cryotherapy at -110 degrees C than during other cryotherapies, but there were no significant differences in the disease activity between the groups. However, cryotherapy at -110 degrees C is expensive and available only in special centres and may have minor adverse effects. Based on our results, whole-body cryotherapy at -110 degrees C is not superior to local cryotherapy commonly used in RA patients for pain relief and as an adjunct to physiotherapy.

The expression of laminin alpha1, alpha2, beta1, beta2 and gamma1 subunits and proalpha1(I), proalpha1(III), alpha1(IV), alpha1(VI), alpha2(VI) and alpha3(VI) collagen chains was studied by Northern hybridizations, RNase protection assays and indirect immunofluorescence (IIF) labellings in cell cultures initiated from sciatic nerves of 14-27-wk-old human fetuses. The cultures represented mixed populations of Schwann cells, perineurial cells and fibroblasts, as estimated by morphology and S 100 protein immunolabellings. The mRNAs for certain basement membrane (BM) components, laminin beta1 and gamma1 chains and collagen alpha1(IV) chain, were readily detectable by Northern analyses in all cultures. In contrast, laminin alpha1, alpha2 and beta2 chain mRNAs were expressed at markedly lower levels. The expression of laminin alpha1 chain was detectable only by RNase protection assay. RNase protection analysis also demonstrated that the expression of laminin alpha2 chain increased with the developmental stage of the nerve used as the source for cell cultures. The expression of laminin beta2 chain was detected only at the protein level by IIF which demonstrated a faint immunosignal in a small subpopulation of cells. The mRNAs for type I, III and VI collagens were readily detectable in the cultures by Northern hybridizations. In summary, the extracellular matrix genes expressed in fetal human peripheral nerves and corresponding cell cultures display marked similarities. Cell cultures characterized here may prove useful in analyses elucidating potential roles of selected growth factors and cytokines in the induction of e.g. laminin alpha1 and beta2 chain expression by cells of developing peripheral nerves.