To induce bone formation at ectopic site by tissue engineering and gene therapy, we transplanted collagen sponges containing rhBMP-7 transduced HEK 293 cells in the hypodermis of nude mice. Bone formation was investigated by histological and electron microscopic method at 3, 6, and 9 weeks after transplantation. At 9 weeks after transplantation, eosinophilic bony tissue was observed in the implanted collagen sponge and was confirmed as bone tissue by Von Kossa stain. In the transmission electron microscopic observation, the cells in newly formed bone tissue had eccentrically located nucleus and well developed rough endoplasmic reticulum (rER). Therefore, the cells were evaluated as osteoblasts. Those results suggest that it is possible to form a bone tissue in the ectopic site by transplantation of rhBMP-7 transduced HEK 293 cells. This will be contributed to push more advanced gene therapy for bone formation. However, the HEK 293 cell is unable to apply to the clinical gene therapy. Therefore it is worth to find more compatible cells for clinical application. In addition, collagen sponge is considered as an excellent scaffold and/or carrier for gene therapy and a good biomaterial for tissue engineering.
Animals ; Bone and Bones ; Bone Morphogenetic Protein 7 ; Collagen ; Endoplasmic Reticulum, Rough ; Eosinophils ; Genetic Therapy ; HEK293 Cells* ; Mice ; Mice, Nude* ; Osteoblasts ; Osteogenesis* ; Porifera ; Subcutaneous Tissue ; Tissue Engineering

To induce bone formation at ectopic site by tissue engineering and gene therapy, we transplanted collagen sponges containing rhBMP-7 transduced HEK 293 cells in the hypodermis of nude mice. Bone formation was investigated by histological and electron microscopic method at 3, 6, and 9 weeks after transplantation. At 9 weeks after transplantation, eosinophilic bony tissue was observed in the implanted collagen sponge and was confirmed as bone tissue by Von Kossa stain. In the transmission electron microscopic observation, the cells in newly formed bone tissue had eccentrically located nucleus and well developed rough endoplasmic reticulum (rER). Therefore, the cells were evaluated as osteoblasts. Those results suggest that it is possible to form a bone tissue in the ectopic site by transplantation of rhBMP-7 transduced HEK 293 cells. This will be contributed to push more advanced gene therapy for bone formation. However, the HEK 293 cell is unable to apply to the clinical gene therapy. Therefore it is worth to find more compatible cells for clinical application. In addition, collagen sponge is considered as an excellent scaffold and/or carrier for gene therapy and a good biomaterial for tissue engineering.
Animals ; Bone and Bones ; Bone Morphogenetic Protein 7 ; Collagen ; Endoplasmic Reticulum, Rough ; Eosinophils ; Genetic Therapy ; HEK293 Cells* ; Mice ; Mice, Nude* ; Osteoblasts ; Osteogenesis* ; Porifera ; Subcutaneous Tissue ; Tissue Engineering

PURPOSE: The purpose of this study was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differential diagnosis of various intracranial cystic lesions. MATERIALS AND METHODS: This study included 19 patients (13 males, 6 females) with a mean age of 42.5 years. The final histopathological diagnoses for 14 patients were pyogenic brain abscess (n=3), glioblastoma (n=3), ependymoma (n=1), anaplastic astrocytoma (n=1), pilocytic astrocytoma (n=1), hemangioblastoma (n=2), arachnoid cyst (n=1), epidermoid (n=1) and schwannoma (n=1). The other cases of metastasis (n=4) and arachnoid cyst (n=2) were diagnosed on the basis of clinical, laboratory and imaging data. DWI imaging studies were performed with a 1.5 T MR system. A single shot spin echo EPI pulse sequence was applied. B values were set at 0 and 1000 sec/mm2. The apparent diffusion coefficient (ADC) were calculated from the ADC map of 10 different cystic brain lesions. Conventional MR imaging included T2WI, T1WI, FLAIR and contrast enhanced T1WI. We analyzed the location, nature, signal intensity on DWI, and the enhancement pattern of the lesions. RESULTS: All of the 3 cases of brain abscess, 1 of 4 cases of metastasis and 1 case of epidermoid showed hyperintensity on DWI. The mean ADC value of brain abscess (2 cases) was less than 1.15 (0.13x10-3 mm2/s). The mean ADC values of the other cystic lesions (8 cases) were variable, ranging from 2.840.66 to 3.100.16 (10-3 mm2/sec). CONCLUSION: DWI and ADC values were useful in the differential diagnosis of various intracranial cystic lesions, but some metastatic tumors may mimic a brain abscess on DWI. Therefore, a clinical correlation is mandatory.
Arachnoid ; Astrocytoma ; Brain ; Brain Abscess ; Diagnosis ; Diagnosis, Differential* ; Diffusion* ; Ependymoma ; Glioblastoma ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis ; Neurilemmoma

BACKGROUND AND PURPOSE: Restless legs syndrome (RLS) is a sleep disorder that frequently occurs in dialysis patients, which disturbs the sleep and reduces the quality of life. The aim of this study was to determine the risk factors for RLS in dialysis patients. METHODS: Patients who visited any of four outpatient dialysis clinics between September 2005 and May 2006 were included in this study. The diagnosis of RLS and the severity assessment were made using the criteria described by the International Restless Legs Syndrome Study Group. We collected basic demographic data, clinical information, and laboratory findings, and then analyzed their association with various aspects of RLS using univariate and multivariate analyses. RESULTS: RLS was present in 46 (28.0%) of 164 dialysis patients. We found no significant risk factor for inducing RLS. The predialysis serum blood urea nitrogen (BUN) level in the dialysis patients with RLS was significantly correlated with RLS symptom severity. CONCLUSIONS: Predialysis BUN is related to RLS symptom severity. Further studies on the underlying mechanism are needed.
Blood Urea Nitrogen ; Dialysis ; Humans ; Multivariate Analysis ; Outpatients ; Quality of Life ; Renal Dialysis ; Restless Legs Syndrome ; Risk Factors

The most commonly associated anomalies in patients with extrahepatic biliary atresia are cardiovascular, digestive and splenic defects. Of the cardiovascular anomalies, there are very few reports of biliary atresia with cardiomyopathy. We report the first case of a child with extrahepatic biliary atresia and restrictive cardiomyopathy. The patient was a 13-month-old boy diagnosed with extrahepatic biliary atresia at the age of 2 months, when he underwent laparotomy for definite diagnosis.Hepatic portoenterostomy was performed after confirmative cholangiogram. Recently, he developed severe cough and dyspnea, and his respiratory symptoms worsened. Chest radiograph showed cardiomegaly. Two- dimensional echocardiography showed marked biatrial enlargement. On M- mode echocardiogram, a slight increase in left ventricular dimension was seen in early diastole with a relatively good left ventricular function. Mitral inflow Doppler tracing showed an increased E-velocity (1.1 m/sec) with decreased deceleration time (75 m/sec), and increased E/A ratio (0.33). He was diagnosed as having restrictive cardiomyopathy with characteristic echocardiographic features.
Bile Ducts, Extrahepatic/*abnormalities ; Biliary Atresia/*complications/physiopathology/radiography/ultrasonography ; Cardiomyopathy, Restrictive/*complications/physiopathology/radiography/ultrasonography ; Human ; Infant ; Lung/radiography ; Male ; Radiography, Thoracic

Gastroparesis is a disorder of gastric motility that results in delayed gastric emptying. Up to 58% of patients with diabetes mellitus may have diabetic gastroparesis, a syndrome characterized by nausea, vomiting, early satiety, and bloating. The pathophysiology of this disorder is not completely understood, but it is believed to include fundic dysaccommodation, a decrease in gastroduodenal pressure gradient and antral hypomotility. In addition to antral and fundic dysfunction, patients with diabetes may typically have pyloric dysfunction or spasm. Treatment consists of a change in diet to small volume, frequent meals and the use of the prokinetic agents. This case report describes the four patients with severe diabetic gastroparesis whose symptoms persisted despite of dietary changes and the use of prokinetic agents in high doses. All of them were treated with pyloric injection of botulinum toxin and three had significant symptomatic and scintigraphic improvement.
Botulinum Toxins* ; Diabetes Mellitus ; Diet ; Gastric Emptying ; Gastroparesis* ; Humans ; Meals ; Nausea ; Pylorus ; Spasm ; Vomiting

Leiomyomas are very common tumors in the uterus and related adjacent structures but rare in the retroperitoneal space. Retroperitoneal leiomyomas are extremely rare and have a good prognosis. Long-term follow-up reveals no metastasis but small potential for local recurrences cannot be ruled out. We report a 44-years-old woman with retroperitoneal leiomyomas who had undergone total abdominal hysterectomy and left salpingooophorectomy 8 years ago due to uterine leiomyomas. Laparotomy was performed, and mass excision was successful.
Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Laparotomy ; Leiomyoma* ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retroperitoneal Space ; Uterus

PURPOSE: To assess the frequency, location, associated MR findings, and clinical symptoms of the high levellumbar disc herniation(HLDH). MATERIALS AND METHODS: A total of 1076 patients with lumbar disc herniation wereretrospectively reviewed. MR images of 41 of these with HLDH(T12-L1, L1-2, L2-3) were analysed in terms offrequency, location, and associated MR findings, and correlated with clinical symptoms of HLDH. RESULTS: Theprevalence of HLDH was 3.8%(41/1076). HLDH was located at T12-L1 level in four patients(10%), at L1-2 level in14(34%), at L2-3 level in 21(51%), and at both L1-2 and L2-3 levels in two. The age of patients ranged from 20 to72 years (mean, 44), and there were 26 men and 16 women. In 11(27%), whose mean age was 32 years, isolated discherniation was limited to these high lumbar segments. The remaining 30 patients had HLDH associated with variableinvolvement of the lower lumbar segments. Associated lesions were as follow : lower level disc herniation(14patients, 34%); apophyseal ring fracture(8 patients, 19%); Schmorl's node and spondylolisthesis (each 6patients, each 14%); spondylolysis(3 patients, 7%); and retrolisthesis(2 patients, 5%). In 20 patients(49%) withHLDH(n=41), there was a previous history. CONCLUSION: Patients with HLDH showed a relatively high incidence ofassociated coexisting abnormalities such as lower lumbar disc herniation, apophyseal ring fracture, Schmorl'snode, spondylolysis, and retrolisthesis. In about half of all patients with HLDH there was a previous history oftrauma. The mean age of patients with isolated HLDH was lower; clinical symptoms of the condition were relativelynonspecific and their incidence was low.
Female ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Male ; Spondylolisthesis ; Spondylolysis

The purpose of our study was to evaluate the dietary intake of kidney transplant recipients (KTRs) and assess oral intake related nutrition problems. Fifty patients who had undergone kidney transplantation were included: 24 males, 26 females. The mean age was 46.8 +/- 11.2 years, height was 161.3 +/- 8.3 cm, and body weight was 60.5 +/- 8.7 kg. We conducted nutrition education based on the diet guideline for KTRs (energy 32 kcal/kg of ideal body weight [IBW], protein 1.3 g/kg of IBW) and neutropenic diet guideline before discharge. Dietary intake of the patients at 1 month after transplantation was investigated by 3-day food records. Body weight and laboratory values for nutritional status and graft function were also collected. Body weight was significantly decreased from admission to discharge. Body weight from discharge to 1 month and 3 months after transplantation was increased but was not significant. Biochemical measurements were generally improved but the number of patients with hypophosphatemia increased. The daily dietary intake of energy and protein was adequate (33.1 kcal/kg, 1.5 g/kg, respectively). However, the dietary intake of calcium, folate, and vitamin C did not meet the Korean Recommended Nutrient Intake of vitamins and minerals (86.8%, 62.4%, and 88.0%, respectively). Patients with low intake of calcium, folate, and vitamin C presented low intake in milk and dairy products, vegetables, and fruits, and these foods were related to restricted food items in neutropenic diet. More attention should be paid on improving quality of diet, and reconsideration of present neutropenic diet guideline is necessary. These results can be used to establish evidence-based medical nutrition therapy guideline for KTRs.
Ascorbic Acid ; Body Weight ; Calcium ; Dairy Products ; Diet ; Education ; Female ; Folic Acid ; Fruit ; Humans ; Hypophosphatemia ; Ideal Body Weight ; Kidney Transplantation ; Kidney* ; Male ; Milk ; Minerals ; Nutrition Therapy ; Nutritional Status ; Transplantation* ; Transplants ; Vegetables ; Vitamins

PURPOSE: Previously, acute rejection (AR) episode in the elderly recipients was reported to be lower compared to that of young recipients. However, the relationship between the recipients age, incidence of AR, and graft survival has not been reevaluated recently. METHODS: Four hundred thirty-one recipients who had the first kidney transplantation were recruited, and we performed a retrospective study evaluating the incidence of AR, infectious episodes in one year, and graft and patient survival rates at 1 and 5 years. We divided recipients into 2 groups (age< 50, n=340 and age=50, n=91) and compared the outcomes. RESULTS: The incidence of AR was 18.8% in the younger group and 24.2% in the elderly group (p=NS). The incidence of infectious episodes was 24.7% in the younger group and 24.2% in the elderly group (p=NS). Five-year graft survival in the elderly was not significantly different from that in the younger group (90.8% vs. 91.8%). However, the patient survival at five year was different between the younger and the elderly groups (99.1% and 92.2%, respectively, p<0.05). CONCLUSION: Our findings suggest that recipients age would not influence the incidence of AR and graft survival. Therefore, the immunosuppression should be applied according to the conditions of recipients, not to recipients age.
Aged ; Graft Rejection ; Graft Survival ; Humans ; Immunosuppression ; Incidence ; Kidney ; Kidney Transplantation ; Rejection (Psychology) ; Retrospective Studies ; Survival Rate ; Transplants