Traditional adipose tissue transplantation has unpredictable viability and poor absorption rates. Recent studies have reported that treatment with platelet-rich plasma (PRP), adipose-derived stem cells (ASCs), and stromal vascular fraction (SVF) are related to increased survival of grafted adipose tissue. This study was the first simultaneous comparison of graft survival in combination with PRP, ASCs, and SVF. Adipose tissues were mixed with each other, injected subcutaneously into the back of nude mice, and evaluated at 4, 8, and 12 weeks. Human adipocytes were grossly maintained in the ASCs and SVF mixtures. Survival of the adipose tissues with PRP was observed at 4 weeks and with SVF at 8 and 12 weeks. At 12 weeks, volume reduction in the ASCs and SVF mixtures were 36.9% and 32.1%, respectively, which were significantly different from that of the control group without adjuvant treatment, 51.0%. Neovascular structures were rarely observed in any of the groups. Our results suggest that the technique of adding ASCs or SVF to transplanted adipose tissue might be more effective than the conventional grafting method. An autologous adipose tissue graft in combination with ASCs or SVF may potentially contribute to stabilization of engraftment.
Adipocytes/*transplantation ; Adipose Tissue/cytology/*transplantation ; Adult ; Animals ; Female ; *Graft Survival ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; *Platelet-Rich Plasma ; Stem Cells ; Stromal Cells/*transplantation ; Transplantation, Heterologous

From June 1990 to December 1998, 792 kidney transplantations were performed at Asan Medical Center. 436 cases(55M) were from living-related donors, 139 cases(17.6%) were from living-unrelated donors and 217 cases(27.4%) were from cadaveric donors. The results of the trasnplantation were analyzed according to the various factors known to influence the outcome of transplantation. In living transplants, the overall patients survival rate was 98.2% at 1 year and 95.8% at 5 years, the corres-ponding allograft survival rate was 96.9 and 86.1N. In cadaveric transplants, the overall patients survival rate was 94.3% at 1 year and 94.3% at 5 years, the corresponding allograft survival rate was was 90.296 and 84.8%. In living transplants, donor age(>50yrs), recipient age(>50yrs), ABO compatability, pretrans-plant blood transfusion, diabetic history had no effect on allograft survival rate. But HLA DR cornpa-tability, serum creatinine(2.5mg/dL) at discharge and rejection history had effect on allograft survival(p<0.05). In living-related transplants, 5 year allograft survival rate was 100% at HLA identical group and 86% at HLA haplomatched group. But the statistical significance was not found(p=0.052). In cadaveric transplants, donor age(>50yrs), recipient age(>50yrs), ABO compatability, HLA DR match, diabetic history, pretransplant transfusion had no effect on allograft survival. But serum creatinine at discharge(>2.5mg/dL) and posttransplant rejection had effect on allograft survival.
Allografts ; Blood Transfusion ; Cadaver ; Chungcheongnam-do* ; Creatinine ; Humans ; Kidney Transplantation ; Survival Rate ; Tissue Donors

Split cord malformations (SCMs) usually present in childhood, and are rarely reported in adults. And also, a cervicothoracic SCM associated with tethered cord syndrome has very rarely been reported in the literature. We report a case of SCM associated with tethered cord and spina bifida in an adult. This report describes the case of a 34-year-old woman who presented for evaluation of neck pain, back pain, and intermittent paraparesis of several months duration. The MRI and CT showed a SCM at the cervicothoracic level and a fibrous septum at the thoracic level. She underwent surgery for the SCM and tethered cord syndrome, and was followed for 7 years. Patient presented complete recovery in the follow-up. The authors discuss this unusual lesion and describe the anatomical relationship of the level of cord duplication and fibrous septum.
Adult* ; Back Pain ; Female ; Follow-Up Studies ; General Surgery ; Humans ; Neck Pain ; Neural Tube Defects* ; Paraparesis ; Spinal Dysraphism

PURPOSE: Adipose-derived stromal cells (ASCs) are readily harvested from lipoaspirated tissue or subcutaneous adipose tissue fragments. The stromal vascular fraction (SVF) is a heterogeneous set of cell populations that surround and support adipose tissue, which includes the stromal cells, ASCs, that have the ability to differentiate into cells of several lineages and contains cells from the microvasculature. The mechanisms that drive the ASCs into the osteoblast lineage are still not clear, but the process has been more extensively studied in bone marrow stromal cells. The purpose of this study was to investigate the osteogenic capacity of adipose derived SVF cells and evaluate bone formation following implantation of SVF cells into the bone defect of human phalanx. METHODS: Case 1 a 43-year-old male was wounded while using a press machine. After first operation, segmental bone defects of the left 3rd and 4th middle phalanx occurred. At first we injected the SVF cells combined with demineralized bone matrix (DBM) to defected 4th middle phalangeal bone lesion. We used P (L/DL)LA [Poly (70L-lactide-co-30DL-lactide) Co Polymer P (L/DL)LA] as a scaffold. Next, we implanted the SVF cells combined with DBM to repair left 3rd middle phalangeal bone defect in sequence. Case 2 was a 25-year-old man with crushing hand injury. Three months after the previous surgery, we implanted the SVF cells combined with DBM to restore right 3rd middle phalangeal bone defect by syringe injection. Radiographic images were taken at follow-up hospital visits and evaluated radiographically by means of computerized analysis of digital images. RESULTS: The phalangeal bone defect was treated with autologous SVF cells isolated and applied in a single operative procedure in combination with DBM. The SVF cells were supported in place with mechanical fixation with a resorbable macroporous sheets acting as a soft tissue barrier. The radiographic appearance of the defect revealed a restoration to average bone density and stable position of pharyngeal bone. Densitometric evaluations for digital X-ray revealed improved bone densities in two cases with pharyngeal bone defects, that is, 65.2% for 4th finger of the case 1, 60.5% for 3rd finger of the case 1 and 60.1% for the case 2. CONCLUSION: This study demonstrated that adipose derived stromal vascular fraction cells have osteogenic potential in two clinical case studies. Thus, these reports show that cells from the SVF cells have potential in many areas of clinical cell therapy and regenerative medicine, albeit a lot of work is yet to be done.
Adipose Tissue ; Adult ; Bone Density ; Bone Matrix ; Durapatite ; Fingers ; Follow-Up Studies ; Hand Injuries ; Humans ; Hypogonadism ; Male ; Mesenchymal Stromal Cells ; Microvessels ; Mitochondrial Diseases ; Ophthalmoplegia ; Osteoblasts ; Osteogenesis ; Polymers ; Regenerative Medicine ; Stromal Cells ; Subcutaneous Fat ; Surgical Procedures, Operative ; Syringes ; Tissue Therapy

BACKGROUND: Hepatocellular carcinoma (HCC) is a representative inflammation-associated cancer and known to be the most frequent tumors. HCC may also induce important pro- and anti-tumor immune reactions. However, the underlying mechanisms are unsatisfactorily identified. We investigated the protective effect of boiled and freeze-dried mature silkworm larval powder (BMSP) on diethylnitrosamine (DEN)-induced hepatotoxicity in mice. METHODS: Mice were fed with diet containing BMSP (0.1, 1, and 10 g/kg) for two weeks and DEN (100 mg/kg, intraperitoneally) was injected 18 hours before the end of this experiment. Liver toxicity was determined in serum and histopathological examination was assessed in the liver tissues. Infiltration of immune cells and expressions of inflammatory cytokines and chemokines were also examined. RESULTS: Pretreatment with BMSP reduced necrotic and histopathological changes induced by DEN in the liver. Measurement of serum biochemical indicators, the levels of alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase, showed that pretreatment with BMSP also decreased DEN-induced hepatotoxicity. In addition, BMSP inhibited the macrophage and CD31 infiltration in a dose-dependent manner. The expressions of interleukin-1β, IFN-γ and chemokines for T cell activation were decreased in BMSP pretreatment groups. CONCLUSIONS: BMSP may have a protective effect against acute liver injury by inhibiting necrosis and inflammatory response in DEN-treated mice.
Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Aspartate Aminotransferases ; Bombyx* ; Carcinoma, Hepatocellular ; Chemokines ; Cytokines ; Diet ; Diethylnitrosamine ; Liver ; Macrophages ; Mice* ; Necrosis

PURPOSE: Due to their comorbidities, dialysis patients have many chances to undergo radiologic procedures using iodinated contrast media. We aimed to assess time-sequenced blood oxidative stress level after contrast exposure in hemodialysis (HD) patients compared to those in the non-dialysis population. MATERIALS AND METHODS: We included 21 anuric HD patients [HD-coronary angiography (CAG) group] and 23 persons with normal renal function (nonHD-CAG group) scheduled for CAG, and assessed 4 oxidative stress markers [advanced oxidation protein products (AOPP); catalase; 8-hydroxydeoxyguanosine; and malondialdehyde] before and after CAG, and subsequently up to 28 days. RESULTS: In the nonHD-CAG group, only AOPP increased immediately after CAG and returned to baseline within one day. However, in the HD-CAG group, all four oxidative stress markers were significantly increased starting one day after CAG, and remained elevated longer than those in the nonHD-CAG group. Especially, AOPP level remained elevated for a month after contrast exposure. CONCLUSION: Our study showed that iodinated contrast media induces severe and prolonged oxidative stress in HD patients.
Aged ; Contrast Media/*adverse effects ; Female ; Humans ; Male ; Middle Aged ; Oxidative Stress/*drug effects ; Renal Dialysis/*adverse effects

BACKGROUND: In the Korean National Health Insurance Corporation (KNHIC), payment for inhaled anesthetics are made according to the simulated dose and not the consumed dose. We compare the consumption of inhaled anesthetics according to fresh gas flow (FGF) and anesthetic circuits to compare the consumption of anesthetics and the guidelines for KNHIC payments. METHODS: 161 patients were randomized into six groups who received isoflurane using a closed circuit (group I-C), a semi-closed circuit with FGF 3 L/min (group I-3), or 4 L/min (group I-4), as for the sevoflurane group (group S-C, S-3, and S-4). Mean arterial pressure (MAP) and heart rate (HR) were maintained within +/- 20% of baseline. Minimum alveolar concentration (MAC) and consumption of inhaled anesthetics were recorded by a new anesthetic machine. RESULTS: There were no significant differences among the groups for MAP, HR, and MAC. During anesthesia maintenance, the mean consumption per 15 minutes of inhaled anesthetics was significantly lower in group I-C (1.0 +/- 0.3 ml) than in group I-3 (3.5 +/- 0.7 ml) and than group I-4 (4.9 +/- 0.9 ml) and similar to the sevoflurane groups (group S-C [1.3 +/- 0.4 ml] vs group S-3 [5.3 +/- 1.0 ml] vs group S-4 [6.9 +/- 1.3 ml], respectively; P < 0.05). CONCLUSIONS: In sevoflurane groups, inhaled anesthetics were consumed more than in isoflurane groups. The KNHIC payment guidelines were close to the actual consumption of inhaled anesthetics under using a semi-closed circuit with FGF 3 L/min in sevoflurane and FGF 4 L/min in isoflurane.
Anesthesia ; Anesthetics ; Arterial Pressure ; Heart Rate ; Humans ; Insurance, Health ; Isoflurane ; Methyl Ethers ; National Health Programs

PURPOSE: There have been some reports that DAX-1 (Dosage-sensitive sex reversal, Adrenal hypoplasia critical region, on chromosome X, gene 1) can modify the estrogen receptor-beta and the progesterone and androgen receptors. Therefore, the aims of this work were to evaluate the expression pattern of DAX-1 in human breast cancer and its relationship to the steroid hormone receptors and other prognostic factors. METHODS: A retrospective analysis was performed using the clinical records of 161 patients diagnosed with invasive breast cancer, and who underwent surgical treatment and hormonal therapy between 1994 and 2004. We evaluated the presence and distribution of DAX-1 expressions in breast cancers using immunohistochemical staining. RESULTS: DAX-1 was expressed in 57 (35.4%) of the 161 cases. Also, the DAX-1 expression showed significant correlations with the size and nodal metastasis. In the androgen receptor positive cases (85 cases), the DAX-1 positive cases were statistically younger than the DAX-1 negative cases. In the progesterone receptor positive cases (81 cases), a statistical significance was noted between the DAX-1 expression and nodal metastasis. CONCLUSION: We conclude that DAX-1 can modulate the steroid hormone receptors including the progesterone and androgen receptors, in breast cancer. It could also be assumed that the influence of DAX-1 on the prognosis of breast cancer is different according to the kind of steroid hormonal receptor expressed.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Neoplasm Metastasis ; Progesterone ; Prognosis ; Receptors, Androgen ; Receptors, Progesterone ; Retrospective Studies

PURPOSE: There have been some reports that DAX-1 (Dosage-sensitive sex reversal, Adrenal hypoplasia critical region, on chromosome X, gene 1) can modify the estrogen receptor-beta and the progesterone and androgen receptors. Therefore, the aims of this work were to evaluate the expression pattern of DAX-1 in human breast cancer and its relationship to the steroid hormone receptors and other prognostic factors. METHODS: A retrospective analysis was performed using the clinical records of 161 patients diagnosed with invasive breast cancer, and who underwent surgical treatment and hormonal therapy between 1994 and 2004. We evaluated the presence and distribution of DAX-1 expressions in breast cancers using immunohistochemical staining. RESULTS: DAX-1 was expressed in 57 (35.4%) of the 161 cases. Also, the DAX-1 expression showed significant correlations with the size and nodal metastasis. In the androgen receptor positive cases (85 cases), the DAX-1 positive cases were statistically younger than the DAX-1 negative cases. In the progesterone receptor positive cases (81 cases), a statistical significance was noted between the DAX-1 expression and nodal metastasis. CONCLUSION: We conclude that DAX-1 can modulate the steroid hormone receptors including the progesterone and androgen receptors, in breast cancer. It could also be assumed that the influence of DAX-1 on the prognosis of breast cancer is different according to the kind of steroid hormonal receptor expressed.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Neoplasm Metastasis ; Progesterone ; Prognosis ; Receptors, Androgen ; Receptors, Progesterone ; Retrospective Studies

Malignant melanoma arising in the uterine endometrium is extremely rare. Only 12 cases of malignant melanoma of the uterine endometrium have been previously reported to date. All of them were metastatic cases. The most common presenting symptom was abnormal uterine bleeding. We report a case of primary malignant melanoma arising from the uterine endometrium. A 63-year-old multigravid woman presented with uterine bleeding. The pathologic review of an endometrial curettage specimen suggested an undifferentiated malignant tumor. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection were performed. Final pathologic examination revealed malignant melanoma. Immunohistochemical studies demonstrated reactivity of tumor cells for HMB-45 and S-100 protein. She had no previous history of malignancy. Whole body PET scan was performed in an effort to find the primary site of malignant melanoma and showed no demonstrable abnormal FDG uptake suggesting malignancy elsewhere. This case is the first report of primary malignant melanoma involving uterine endometrium in Korea.
Curettage ; Endometrial Neoplasms ; Endometrium* ; Female ; Humans ; Hysterectomy ; Korea ; Lymph Node Excision ; Melanoma* ; Middle Aged ; Positron-Emission Tomography ; S100 Proteins ; Uterine Hemorrhage