Osteoarthritis (OA) is the most common type of arthritis and causes a significant deterioration in patients’ quality of life. The high prevalence of OA as well as the current lack of disease-modifying drugs led to a rise in regenerative medicine efforts. The hope is that this will provide a treatment modality with the ability to alter the course of OA via structural modifications of damaged articular cartilage (AC). Regenerative therapy in OA starts with the concept that administered cells may engraft to a lesion site and differentiate into chondrocytes. However, recent studies show that cells, particularly when injected in suspension, rapidly undergo apoptosis after exerting a transient paracrine effect. If the injected stem cells do not lead to structural improvements of a diseased joint, the high cost of cell therapy for OA cannot be justified, particularly when compared with other injection therapeutics such as corticosteroids and hyaluronic acid. Long-term survival of implanted cells that offer prolonged paracrine effects or possible engraftment is essential for a successful cell therapy that will offer durable structural improvements. In this perspective review, the history and current status of regenerative therapy in OA are summarized along with the conceptual strategy and future directionsfor a successful regenerative therapy that can provide structural modifications in OA.

Tendons are structures that connect muscles to the bones in our body and transmit the force generated by contraction of the muscles to the bones. Ligaments are structures that connect bones to bones, with histological properties similar to tendons. In tendon and ligament tissue, there are very small amounts of cells similar to mesenchymal stem cells (MSCs) called tendon stem/progenitor cells (TSPCs), or tenogenic stem cells. While the role of specific growth factors and transcription factors is well established in the osteogenic and chondrogenic differentiation of stem cells, a consensus has not been established for tenogenic differentiation. Injuries to tendons and ligaments are very common, but natural healing is very slow and inefficient due to limited vascularization. Currently, there is no adequate method for restoring extensive tendon or ligament defects. Procedures addressing the unmet need for regeneration of these tissues are needed. In this review, the current knowledge, as well as the authors’ ideas and perspective on stem cell and regenerative medicine for tendon and ligament defects are presented.

OBJECTIVE: Uterine sarcomas are rare and characterized by rapid clinical progression and poor prognosis. The manegement of uterine sarcoma has been challenged. The purpose of this study was to investigate the clinicopathologic findings and outcome of patients with uterine sarcoma METHODS: From Sep. 1990 to July. 1999, 8 patients with histologically proven uterine sarcoma at department of obstetrics and gynecology of Chonbuk University Hospital were evaluated for their clinical profiles and survival retrospectively RESULTS: The age of patients with uterine sarcoma ranged 31 to 60, and the mean age was 46 years. The most common pathologic type of uterine sarcoma was leiomyosarcoma. The common presenting symptom were irregular uterine bleeding, hypermenorrhea and lower abdominal palpable mass. The patients with uterine sarcoma were treated by surgery, post-operative radiotherapy and adjuvant chemotherapy. The mean follow up duration was 34.1 months. The 2 year survival rate was 50%. Distant metastasis were reveled at two patients, and the sites are lung and brain. CONCLUSIONS: Uterine sarcomas are aggressive tumor with a poor prognosis. The Major treatment is surgery and the effect of chemotherapy and radiotherapy were undetermined.
Brain ; Chemotherapy, Adjuvant ; Drug Therapy ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Jeollabuk-do ; Leiomyosarcoma ; Lung ; Menorrhagia ; Neoplasm Metastasis ; Obstetrics ; Prognosis ; Radiotherapy ; Retrospective Studies ; Sarcoma* ; Survival Rate ; Uterine Hemorrhage

The hip is a true ball and socket joint. The hip joint is held in place with ligaments, tendons, and muscles. It is surrounded by a series of bursae which are fluid filled sacs designed to cushion the area. Hip pain may arise from the joint itself, the femur, the pelvic bone, the pelvis, blood vessels and nerves near the hip joint, and even the abdomen. It is important to differentiate true hip pain from other types of pain in the hip region. True hip pain is felt towards the front, in the groin region. It may radiate down the front of the thigh. Physical examination can point to the correct diagnosis. The skilled physician will evaluate range of motion as well as those factors which reproduce the pain. The diagnosis of hip disease usually requires the use of radiologic imaging. The imaging studies include plain films, arthrography, computed tomography (CT) scanning, ultrasound, nuclear imaging, and magnetic resonance imaging (MRI).
Abdomen ; Arthrography ; Blood Vessels ; Femur ; Groin ; Hip ; Hip Joint ; Hypogonadism ; Joints ; Ligaments ; Magnetic Resonance Imaging ; Mitochondrial Diseases ; Muscles ; Ophthalmoplegia ; Pelvic Bones ; Pelvis ; Physical Examination ; Range of Motion, Articular ; Tendons ; Thigh

Direct reprogramming/direct conversion/transdifferentiation is a process that induces conversion between completely different matured (differentiated) cells in higher organisms. Unlike the process of reprogramming of differentiated cells into induced pluripotent stem cells (iPSCs) and re-differentiation into the desired cell types, differentiated cells undergo the conversion into another type of differentiated cells without going through the iPSCs state. Osteoarthritis (OA) is the most common type of arthritis that causes a significant deterioration in patients’ quality of life. The high prevalence of OA as well as the current lack of disease-modifying drugs has led to a rise in regenerative strategy for OA treatment. Regenerative therapy in OA started with the concept of engraftment of the administered cells within the cartilage lesion and differentiation to chondrocytes after the engraftment. However, recent studies show that cells, particularly when injected in suspension, rapidly undergo apoptosis after exerting a transient paracrine effect. In this perspective review, the general overview and current status of direct conversion are introduced along with the conceptual strategy and future directions for possible application of regenerative therapy using stem cells in OA. In vivo direct conversion may open a new stage of regenerative medicine for OA treatment. Recent advances in in vivo gene transfer and smart biomaterials can bring the concept into reality in near future. Direct conversion can be a new type of treatment technology that has the potential to overcome the limitations of current cell therapy.

Direct reprogramming/direct conversion/transdifferentiation is a process that induces conversion between completely different matured (differentiated) cells in higher organisms. Unlike the process of reprogramming of differentiated cells into induced pluripotent stem cells (iPSCs) and re-differentiation into the desired cell types, differentiated cells undergo the conversion into another type of differentiated cells without going through the iPSCs state. Osteoarthritis (OA) is the most common type of arthritis that causes a significant deterioration in patients’ quality of life. The high prevalence of OA as well as the current lack of disease-modifying drugs has led to a rise in regenerative strategy for OA treatment. Regenerative therapy in OA started with the concept of engraftment of the administered cells within the cartilage lesion and differentiation to chondrocytes after the engraftment. However, recent studies show that cells, particularly when injected in suspension, rapidly undergo apoptosis after exerting a transient paracrine effect. In this perspective review, the general overview and current status of direct conversion are introduced along with the conceptual strategy and future directions for possible application of regenerative therapy using stem cells in OA. In vivo direct conversion may open a new stage of regenerative medicine for OA treatment. Recent advances in in vivo gene transfer and smart biomaterials can bring the concept into reality in near future. Direct conversion can be a new type of treatment technology that has the potential to overcome the limitations of current cell therapy.

PURPOSE: To evaluate the usefulness and diagnostic accuracy of turbo spin-echo(TSE) proton-density andT2-weighted images of meniscal tears of the knee. MATERIALS AND METHODS: We retrospectively evaluated thesensitivity, specificity, and accuracy of TSE proton density and T2-weighted images of meniscal tears confirmedarthroscopically or surgically in 47 patients(98 menisci). The routine TSE parameters used in all patients werethe dual echo sequence with sagittal proton density and T2-weighed images(4000/16, 90/5/2 [TR/effectiveTE/ETL/NEX]), and fat-suppressed coronal proton density and T2-weighted images. The chi-square test was used forstatistical analysis. RESULTS: The sensitivity, specificity, and accuracy of TSE proton density images for thedetection of meniscal tears were 93.9%, 93.8%, and 93.9%, respectively, in the medial meniscus, and 92.9%, 91.4%,and 91.8% in the lateral. On T2-weighted images the corresponding figures were 87.9%, 93.8%, and 89.8%,respectively, in the medial meniscus, and 64.3%, 91.4%, and 83.7 % in the lateral. CONCLUSION: With regard tosensitivity and accuracy, TSE proton density images of meniscal tears were superior to TSE T2-weighted images.
Humans ; Knee* ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Protons ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND: Severe acute lung injury(ALI), also known as the adult respiratory distress syndrome(ARDS), is a heterogenous nature of dynamic and explosive clinical synrome that exacts a mortality of approximately 50%. Endotoxin(ETX) is an abundant component of the outer membrane of gram-negative bacteria capable of inducing severe lung injury in gram-negative sepsis and gram-negative bacterial pneumonia, which are among the most common predisposing causes of ARDS. The influx of PMNs into airway tissue is a pathological hallmark of LPS-induced lung injury. And th3re is a substantial evidence suggesting that cytokines are important mediators of lung injury in gram-negative sepsis. However, the kinetics of phagocytes and cytokines by an exact time sequence and their respective pathogenic importance remain to be elucidated. This study was performed to investigate the role of phagocytes and proinflammatory cytokines in ETX-induced ALl through a time course of changes in the concentration of protein, TNFa and IL-6, and counts of total and its differential cells in BALF. The consecutive histologic findings were also evaluated. METHOD: The experimental animals, healthy male Sprague-Dawley, weighted 200+/-50g, were divided into controland ALI-group. ALI was induced by an intravenous administration of ETX, 5mg/kg. Above mentioned all parameters were examined at 0(control), 3, 6, 24, 72 h after administration of ETX. TNFa and IL-6 conc. in BALE were measured by a bioassay. RESULTS: The protein concentration and total leukocyte count(TC) in BALF was significantly increased at 3h compared to controls(p<0.05). The protein conc. was significantly elavated during observation period, but TC was significantly decreased at 72h(p<0.05 vs. 24h). There was a close relationship between TC and protein cone. in BALF(r = 0.65, p <0.001). The PMN and monocyte count was well correlated with TC in BALF, and the correlation of PMN(r=0.97, p<0.001) appeared to be more meaningful than that of monoeyte(r = 0.61, p<0.001). There was also a significant correlation between protein cone. and PMN or monocyte count in BALF(PMN vs. monocyte r = 0.55, p<0.005 vs. r = 0.64, p<0.001). The count of monocyte was significantly elavated during observation period though a meaningful reduction of PMN count in BALF at 72h, this observation suggested that monocyte may, at least, partipate in the process of lung injury steadly. In this sudy, there was no relationship between IL-6 and TNFt conc., and TNFa but not IL-6 was correlated with TC(r 0.61, p <0.05) and monocyte(r = 0.67, p<0.05) in BALF only at 3, 6h after ETX introduced. In particular, the IL-6 cone. increased earlier and rapidly peaked than TNFz cone. in BALF. In histologic findings, the cell counts of lung slices were increased from 3 to 72h(p<0.001 vs. NC). Alveolar wallthickness was increased from 6 to 24h(p<0.001 vs. NC). There was a significant correlation between the cell counts of lung slices and alveolar wall-thickness(r= 0.61, p<0.001). This result suggested that the cellular infiltrations might be followed by the alterations of interstitium, and the edematous change of alveolar wall might be most rapidly recovered to its normal condition in the process of repair. CONCLUSION: We concluded that although the role of PMIN is partly certain in ETX-induced ALI, it is somewhat inadequate to its known major impact on ALL Alveolar macrophage and/or non-immune cells such as pulmonary endothelial or epithelial cells, may be more importantly contributed to the initiation and perpetual progression of ETX-induced ALI. The IL-6 in ETX-induced ALI was independent to TNFa, measured by a bioassay in BALF. The early rise in IL-6 in BALF implies multiple origins of the IL-6.
Acute Lung Injury* ; Administration, Intravenous ; Adult ; Animals ; Biological Assay ; Cell Count ; Cytokines ; Epithelial Cells ; Gram-Negative Bacteria ; Humans ; Interleukin-6 ; Kinetics ; Leukocytes ; Lung ; Lung Injury ; Macrophages, Alveolar ; Male ; Membranes ; Monocytes ; Mortality ; Phagocytes* ; Pneumonia, Bacterial ; Rats, Sprague-Dawley ; Sepsis

PURPOSE: Few data exist regarding cardiopulmonary resuscitation (CPR) education status in relationship to characteristics of socio-economic status and health and medical conditions in Korea. The purpose of this study is to describe the characteristics associated with the CPR educated populationand to develop and analyze a simple predictive model of the CPR education status. METHODS: Based on a health survey of Incheon Metropolitan City adults (5,114), differences between a CPR-educated group (n=220) and a CPR non-educated group (n=4,894) were analyzed and a logistic regression analysis of the two groups was performed to evaluate socio-economic status-gender, age, marital status, education level, number of family members, and monthly household income-and health-medical conditions-disease, accidental history, EMS (emergency medical service) experience, and health status. RESULTS: The participation rate in CPR education in Korea is only 4.3% which is vastly lower than in other developed countries, and there are statistically significant differences between the CPR-educated and CPR not-educated in gender (0.000), age (0.000), marital status (0.000), education level (0.000), and diseases (0.003). Similarly, gender (OR: 0.247, 0.000), age (OR: 0.964, 0.000), marital status (OR: 0.463, 0.000), education level (OR: 1.797, 0.000), numbers of family members (OR: 1.231, 0.004), and health status (OR: 0.894, 0.009) are statistically significant predictors of participation in CPR education. CONCLUSION: Monthly household income, accident history, and EMS experience are not statistically significant factors for participation in CPR education in Korea. It may be necessary to determine the optimal fees of CPR education based on social characteristics and economic conditions, Certain subgroups of lay persons such as high-risk patients and family members need targeted outreach programs.
Adult ; Cardiopulmonary Resuscitation* ; Developed Countries ; Education* ; Emergency Medical Services ; Family Characteristics ; Fees and Charges ; Health Surveys ; Humans ; Incheon ; Korea ; Logistic Models ; Marital Status ; Sociology

OBJECTIVE: To investigate the clinical effect of stellate ganglion block in patients with secondary lymphedema after breast cancer treatment. METHOD: In a prospective clinical trial, the consecutive stellate ganglion block (SGB) was performed every two weeks to 10 patients (Mean age 46.0+/-9.4 (yr)) who was diagnosed as of secondary lymphedema after breast cancer treatment. The parameters were the circumstance of arm and the thickness of skin and subcutaneous tissue of the affected arm measured by ultrasonography. We measured these parameters with baseline value before SGB treatment and repeated the evaluation after each SGB treatment. And the subjective data of satisfaction, softness and improvement were obtained by questionnaires. RESULTS: 10 patients were treated with stellate ganglion block. The mean circumferences of upper arm and forearm after three consecutive SGB treatments reduced significantly: upper arm from 31.39 cm to 29.72, forearm from 25.14 cm to 23.64 cm (p <0.05). And the thickness of subcutaneous tissue of upper arm significantly decreased under no- compression measuring technique after three SGB treatments (p <0.05). The compliance of superficial tissue showed significant change with serial procedure. Almost all of the patients had a satisfaction and feeling of softness in their affected arm after treatments. CONCLUSION: The cervical stellate-ganglion block reduced the circumstance and the thickness of arm with lymphedema and satisfied almost lymphedema patients. So this treatment presents a favorable outcome to the breast cancer-related lymphedema patient clinically.
Arm ; Breast ; Breast Neoplasms ; Compliance ; Forearm ; Humans ; Lymphedema ; Pilot Projects ; Prospective Studies ; Skin ; Stellate Ganglion ; Subcutaneous Tissue