PURPOSE: To examine the fate of muscle-derived stem cells (MDSC) after injection into different host conditions and provide an insight for their mechanism of action. MATERIALS AND METHODS: MDSCs differentiated in vitro towards the endothelial lineage and transfected with lentivirus tagged with green fluorescent protein (GFP) were injected into two animal models mimicking vascular diseases: hindlimb ischemia and carotid injury models. Injected cells were tracked at the site of injection and in remote organs by harvesting the respective tissues at different time intervals and performing immunofluorescent histological analyses. Stem cell survival was quantified at the site of injection for up to 4 weeks. RESULTS: MDSCs were successfully tagged with fluorescent material GFP and showed successful implantation into the respective injection sites. These cells showed a higher affinity to implant in blood vessel walls as shown by double fluorescent co-stain with CD31. Quantification of stem cell survival showed a time-dependent decrease from day 3 to 4 weeks (survival rate normalized against day 3 was 72.0% at 1 week, 26.8% at 2 weeks and 2.4% at 4 weeks). Stem cells were also fo und in distant organs, especially the kidneys and liver, which survived up to 4 weeks. CONCLUSION: MDSCs were successfully tracked in different vascular disease models, and their fate was assessed in terms of cell survival and distribution. Better understanding of the donor cell properties, including their interaction with the host conditions and their mechanism of action, are needed to enhance cell survival and achieve improved outcomes.
Adult Stem Cells ; Animals ; Blood Vessels ; Cell Survival ; Hindlimb ; Humans ; Ischemia ; Kidney ; Lentivirus ; Liver ; Models, Animal ; Stem Cell Niche ; Stem Cells* ; Tissue Donors ; Vascular Diseases

No abstract available.

No abstract available.

Aortic aneurysm is a common and life-threatening disease that can cause death from rupture. Current therapeutic options are limited to surgical or endovascular procedures because no pharmacological approaches have been proven to decrease the chance of expansion or rupture. The best approach to the management of aortic aneurysm would be the understanding and prevention of the processes involved in disease occurrence, progression, and rupture. There is a need for animal models that can reproduce the pathophysiological features of human aortic aneurysm, and several such models have been studied. This review will emphasize recent advances in animal models used in the determination of mechanisms and treatments of aortic aneurysms.
Aneurysm ; Aorta ; Aortic Aneurysm* ; Endovascular Procedures ; Humans ; Models, Animal* ; Rupture

Because of various current problems and issues which are low health insurance medical fee of National Health Insurance Corporation, extreme competition with very large general hospitals, new supply of more than of 3,000 new doctors, many medical practitioner's offices who are suffering management difficulties are increasing. In order to investigate their current overall management situations, we made this study through statistical extraction procedures with the sample population of the medical practitioners which are registered in Korean Medical Association and subsequently we made the study with 1,031 selected cases. The average number of patients is 53.6 patients per day. 44.4% of the medical practitioners' offices are working at night and legal holidays and 8.5% are working at Sunday. Average working hours is 50.1 hours per week, which greatly exceeds 40 hours per week that is regulated in the Labor Standards Act. According to the management performance analysis of those medical clinics through profit and loss statements, average total annual sales revenue in 2010 fiscal year was 444,167,867 KRW, the expenses were 314,217,081 KRW and the earnings before taxes was 129,940,786 KRW. The average net profit (earnings before taxes) of the director of the medical practitioners' offices was 122,337,868 KRW per year and 10,194,822 KRW per month. According to the study results, we have found that we need to increase doctor's bill for outpatient, and establishment and its improvement of medical service delivery systems and classification standards of medical services for first and succeeding outpatients. Considering overall results of the study, readjustment of outpatients' treatment fees and reestablishment of more efficient medical service delivery systems which require the first medical service is to be provided properly should be realized in order to improve the management performance of the medical practitioners' offices.
Commerce ; Fees and Charges ; Fees, Medical ; Holidays ; Hospitals, General ; Humans ; Insurance, Health ; Korea ; National Health Programs ; Outpatients ; Stress, Psychological ; Taxes

Greater than its influence on the medical practitioner's individual ability is the National Health Insurance System's influence on the management of medical practitioners' offices in Korea. However, despite the important effect health insurance exerts on the income of medical clinics, recently, the financial difficulties of medical clinics have often become an issue, and financial difficulty has been aggravated as much as a solution has been sought. The current state of the overall management of medical clinics was investigated to understand the factors influencing the sales and expenses in their management. A questionnaire was completed by 1,009 physicians registered in the Korean Medical Association who were participating in a statistical extraction course. As a result of the study, the factors influencing the total revenue and total expenditures of medical clinics, such as increases in the total number of doctors, increasing numbers of outpatients, the size of the medical office, medical disputes, and clinical specialties (based on the first medical treatment) showed statistical significance. In conclusion, in order to improve medical clinic management, a health insurance medical fee should be more reasonably fixed, a medical transfer system should be reestablished, and a cooperative strategy should be created for medical clinics and general hospitals in order to attract patients. As a result, low cost and highly efficient medical services could be provided and the satisfaction of patients improved.
Commerce ; Dissent and Disputes ; Fees, Medical ; Health Expenditures ; Hospitals, General ; Humans ; Insurance ; Insurance, Health ; Korea ; National Health Programs ; Outpatients ; Physicians, Primary Care ; Primary Health Care ; Surveys and Questionnaires

PURPOSE: To determine whether there is a discrepancy between the medical professions perception of what patients should know and that of the patients themselves, we studied patients need to be informed about different aspects of epilepsy and compared findings with medical personnels perceptions of the issue. METHODS: Our study population consisted of 39 patients with epilepsy from the inpatient epilepsy unit, and 51patients from the outpatients clinic of the S. University Hospital between July and November 1997. However, the patients who declined to participate or who were not able to understand the directions and content of the questionnaire were excluded. The medical personnel participated in this study were 56 residents or nurses who were working in either Neurology or Neuro surgery Units. The questionnaire consisted of 6 categories with a total of 79 questions. The responses were indicated on a 5point Likert scale with 5 indicating the highest need . The data were analyzed with descriptive statistics, students t-tests, and chi-square. RESULTS: Of the 90 patients and 56 medical personnel studied, the need for lifestyle information such as smoking, drinking, sleep, driving, employment, and marriage was significantly higher from medical personnel than that of the patients(p=0.00). Regarding medical knowledge about epilepsy, the patients group had higher scores in the need for information on the structure of the brain (p=0.00), whereas medical personnel had higher scores on the symptoms of epilepsy. There was no correlation between the length of epilepsy and the need for information on every item on the questionnaire. The patients had higher rank regarding diet, although it was not significantly different from the medical personnel. Regarding antiepileptic drugs and what to do when there is an attack, medical personnel scored higher. The items on which the patients group scored higher than 4.5 were the possibility of inheritance, the factors that might reduce the number of attacks, the period of usage of AED, and the food they have to avoid or the food they have to take to reduce seizure attacks. CONCLUSIONS: Our study indicates that the patients group requires higher educational need in the structure of the brain, diet, and surgical treatment, but less in lifestyles and what to do when there is an attack. The educational program for the patients with epilepsy should emphasize medical knowledge with regard to brain anatomy, what to eat and what to avoid, and details of surgical treatment.
Anticonvulsants ; Brain ; Diet ; Drinking ; Employment ; Epilepsy* ; Humans ; Inpatients ; Life Style ; Marriage ; Neurology ; Outpatients ; Surveys and Questionnaires ; Seizures ; Smoke ; Smoking ; Wills

Juvenile rheumatoid arthritis (JRA), an autoimmune disease, was characterized by chronic synovitis and associated with various extra-articular manifestations. Abnormal hematologic findings have been reported in all form of JRA, especially anemia due to chronic disease or iron deficiency. Dysplastic changes were rarely noted in the peripheral blood and bone marrow. We experienced a 15-year-old female patient with pauciarticular JRA who have pancytopenia in peripheral blood and a number of dysplastic changes in bone marrow, and present the case here with brief review of literatures.
Adolescent ; Anemia ; Arthritis ; Arthritis, Juvenile* ; Autoimmune Diseases ; Bone Marrow ; Chronic Disease ; Female ; Humans ; Iron ; Pancytopenia ; Synovitis

OBJECTIVE: The cardiovascular system maintains homeostasis through a series of adaptive responses to physiological requirements. However, little is known about the adaptation of fetal cardiac function to gravity, according to gestational age. In the present study, we aimed to evaluate the adaptive responses of cardiac function to postural changes, using Tei index measurements. METHODS: Fetal echocardiography and Doppler examination were performed on 114 women with vertex singleton pregnancies at 19 to 40 weeks' gestation. Participants were placed in an upright seated position, and the Tei index for fetal left ventricular cardiac function was measured. The women were then moved into a supine position and the Tei index was re-measured. RESULTS: The mean Tei index when measured in an upright seated position was significantly lower than that measured in a supine positioning for all fetuses (0.528±0.103 vs. 0.555±0.106, P=0.014, respectively). This difference was also noted in fetuses with a gestational age of 28–40 weeks (0.539±0.107 vs. 0.574±0.102, P=0.011, respectively). However, there was no difference in the Tei index between an upright seated and a supine position among fetuses with a gestational age of <28 weeks (0.505±0.091 vs. 0.516±0.103, P=0.571, respectively). CONCLUSION: Postural changes from an upright seated to a supine position result in an increased Tei index after a gestational age of 28 weeks. This appears to reflect maturation in the adaptive responses of the fetal cardiovascular system to postural changes.
Cardiovascular System ; Echocardiography ; Female ; Fetus ; Gestational Age* ; Gravitation ; Homeostasis ; Humans ; Posture ; Pregnancy ; Supine Position

BACKGROUND: Central fat mass (CFM) correlates with insulin resistance and increases the risk of type 2 diabetes and cardiovascular complications; however, peripheral fat mass (PFM) is associated with insulin sensitivity. The aim of this study was to investigate the relation of absolute and relative regional adiposity to insulin resistance index and adipokines in type 2 diabetes. METHODS: Total of 83 overweighted-Korean women with type 2 diabetes were enrolled, and rate constants for plasma glucose disappearance (KITT) and serum adipokines, such as retinol binding protein-4 (RBP4), leptin, and adiponectin, were measured. Using dual X-ray absorptiometry, trunk fat mass (in kilograms) was defined as CFM, sum of fat mass on the lower extremities (in kilograms) as PFM, and sum of CFM and PFM as total fat mass (TFM). PFM/TFM ratio, CFM/TFM ratio, and PFM/CFM ratio were defined as relative adiposity. RESULTS: Median age was 55.9 years, mean body mass index 27.2 kg/m2, and mean HbA1c level 7.12+/-0.84%. KITT was positively associated with PMF/TFM ratio, PMF/CFM ratio, and negatively with CFM/TFM ratio, but was not associated with TFM, PFM, or CFM. RBP4 levels also had a significant relationship with PMF/TFM ratio and PMF/CFM ratio. Adiponectin, leptin, and apolipoprotein A levels were related to absolute adiposity, while only adiponectin to relative adiposity. In correlation analysis, KITT in type 2 diabetes was positively related with HbA1c, fasting glucose, RBP4, and free fatty acid. CONCLUSION: These results suggest that increased relative amount of peripheral fat mass may aggravate insulin resistance in type 2 diabetes.
Absorptiometry, Photon ; Adipokines ; Adiponectin ; Adiposity ; Apolipoproteins ; Body Mass Index ; Fasting ; Female ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Leptin ; Lower Extremity ; Plasma ; Vitamin A