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

BACKGROUND: Acute tumor lysis syndrome(TLS) has been defined as the metabolic abnormalities that occur after rapid tumor breakdown. In this study, we have evaluated the types or degrees of metabolic abnormalities and clinical characteristics in patients with non-Hodgkin's lymphoma(NHL) who developed TLS. METHODS: Patients were considered to have 'laboratory TLS(LTLS)' if any two of the following metabolic abnormalities occurred spontaneously or within 4 days of treatment: hyperphosphatemia, hyperkalemia, hyperuricemia, azotemia, and hypocalcemia. 'Clinical TLS(CTLS)' was defined as LTLS plus one of the following: a serum potassium level greater than 6.0mEq/L, a creatinine level greater than 2.5mg/dL, a calcium level less than 6.0mg/dL, the development of a life-threatening arrhythmia, or sudden death. RESULTS: Of 111 cases with NHL, TLS occurred in 16(14.4%), LTLS in 11(9.9%), and CTLS in 5(4.5%). There was a significant difference of gender, histologic type, clinical stage, performance status, extranodal involvement, serum lactate dehydrogenase(LDH), LDH index, beta2-microglobulin, uric acid, and blood urea nitrogen(BUN) level in the TLS versus control group. In multiple regression analysis, TLS occurred more frequently in patients with pre-treatment azotemia, aggressive histologic type, and elevated serum LDH level(p< 0.05, respectively). Pre-treatment and post-treatment TLS occurred in 8 cases(50%) respectively. The common metabolic abnormalities included hyperphosphatemia(87.5%), azotemia(81.3%), and hypocalcemia(75%). Of 11 cases with conservative care, 8 cases recovered within several days, but 3 cases died with multi-organ failure from disease progression. All 5 cases after hemodialysis for TLS recovered without any significant complications. CONCLUSION: The current study suggests that all patients with high-grade lymphomas and pre-treatment azotemia or a high serum LDH level be carefully monitored for at least 4 days after chemotherapy.
Arrhythmias, Cardiac ; Azotemia ; Calcium ; Creatinine ; Death, Sudden ; Disease Progression ; Drug Therapy ; Humans ; Hyperkalemia ; Hyperphosphatemia ; Hyperuricemia ; Hypocalcemia ; Lactic Acid ; Lymphoma, Non-Hodgkin* ; Potassium ; Renal Dialysis ; Tumor Lysis Syndrome* ; Urea ; Uric Acid

No abstract available.
Graves Disease* ; Immunoblastic Lymphadenopathy*

OBJECTIVES: To quantitate apoptosis and Fas antigen expression of T lymphocytes by activation in aplastic anemia (AA) and compare with that of normal controls and completely-recovered AA, and to investigate the apoptotic sensitivity to anti-fas antibody of activated T lymphocytes in AA. METHODS: We studied the expression of Fas antigen on fresh T lymphocytes of twenty patients with AA [13 newly diagnosed, 7 recorvered AA after immunosuppressive therapy (IST)], and investigated the activation-induced cell death (AICD) and Fas expression by activation [interleukin-2 (200 U/ml) and phytohemagglutinin (50 micrograms/ml)] in 5 newly-diagnosed AA, 5 normal controls and 5 AA in complete response (CR). Apoptotic sensitivity to anti-Fas antibody was assessed by the time-course kinetics of induction of cell death by anti-Fas antibody (500 ng/ml). RESULTS: There was no significant difference of Fas antigen expression on freshly-isolated T lymphocytes among newly-diagnosed severe AA, normal control s and patients with AA in CR after IST. In normal controls, T lymphocytes death was greatly increased at 3 days of activation, and Fas antigen expression on T lymphocytes was increased above baseline at day 1 of activation. In contrast, in newly-diagnosed AA, T lymphocytes showed delayed cell death, which correlated with a slowed increase of Fas antigen expression by activation. Also, anti-Fa s antibody sensitivity of activated T lymphocytes was decreased in newly-diagnosed AA. In completely recovered AA, these abnormal AICD and Fas antigen expressions by activation were recovered to normal range. CONCLUSIONS: Abnormal AICD plays a role in the immune pathophysiology of AA, and defective Fas system is involved in this process.
Anemia, Aplastic/pathology ; Anemia, Aplastic/immunology* ; Antigens, CD95/blood ; Apoptosis ; Case-Control Studies ; Human ; In Vitro ; Lymphocyte Transformation ; T-Lymphocytes/pathology* ; T-Lymphocytes/immunology* ; Time Factors

PURPOSE: It is very important to differentiate breast cancer from benign mass. There are many reports to evaluate the differential diagnosis under the several diagnostic tools. We evaluated the usefulness of mammography and Tc-99m MIBI scintimammography in the differential diagnosis of breast mass and correlated with pathologic findings. MATERIALS AND METHODS: This study included 80 patients (age: 24-72, mean: 48.4) who underwent mammography and Tc-99m MIBI scintimammography for breast masses. Scintimammographies (anterior-posterior and lateral projections) were acquired in 10 minutes and 2 hours after intravenous injection of Tc-99m MIBI. Four specialists in diagnostic radiology and nuclear medicine evaluated the findings of breast masses under the mammography and Tc-99m MIBI scintimammography, and calculated the tumor to background (T/B) ratio. The pathologic results were obtained and we statistically analyzed the correlations between pathologic results and imaging findings under the mammography and Tc-99m MIBI scintimammography by chi-square and correlation test. RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value of mammography for detection of breast cancer were 87.5%, 56.3%, 75.0%, and 75.0% respectively. 45 cases of 80 patients were suspicious for breast cancer under the Tc-99m MIBI scintimammography. 41 cases of 45 patients were confirmed as breast cancer and the remaining 4 cases were confirmed as benign masses. The sensitivity, specificity, positive predictive value and negative predictive value of Tc-99m MIBI scintimammography for detection of breast cancer were 85.4%, 87.5%, 91.1%, and 80.8% respectively. The sensitivity of scintimammography was lower than that of mammography for detection of breast cancer, however the specificity, positive predictive value, and negative predictive value were higher. In the benign mass, the mean T/B ratio in 10 minutes was 1.409 +/- 0.30, and that in 2 hours was 1.267 +/- 0.42. The maximal T/B ratio of benign mass in 10 minutes was 1.604 +/- 0.42, and that in 2 hours was 1.476 +/- 0.50. In the malignant mass, the mean T/B ratio in 10 minutes was 2.220 +/- 1.07, and that in 2 hours was 1.842 +/- 0.75. The maximal T/B ratio of malignant mass was 2.993 +/- 1.94, and that in 2 hours was 2.480 +/- 1.34. And the T/B ratio under the early and delayed images were meaningful. CONCLUSION: The scintimammography is useful diagnostic tool to differentiate breast cancer from benign mass, although the sensitivity of mammography for detection of breast mass is high. Especially, the use of the T/B ratio is helpful to diagnose breast cancer.
Breast Neoplasms* ; Breast* ; Diagnosis, Differential* ; Humans ; Injections, Intravenous ; Mammography* ; Nuclear Medicine ; Sensitivity and Specificity ; Specialization

Schwannomas are benign nerve sheath tumors that originate from any anatomical site. Most schwannomas occur in the head, neck or limbs, but rarely occur in the retroperitoneal space. Furthermore, the schwannoma originating from the vagus nerve of retroperitoneal space is much rare. We experienced a case of retroperitoneal schwannoma of the vagus nerve. A 34-year-old male was refered to our hospital for the evaluation of abdominal mass on ultrasonography. Endoscopic examination revealed submucosal tumor-like lesion on high body of the stomach. Computed tomography (CT) revealed that the stomach was compressed by a solid tumor in the retroperitoneum. On exploratory laparotomy, this mass turned out to be a baseball sized mass in the retroperitoneal space. The mass was excised in an encapsulated state. Histological examination with immunohistochemical stains revealed a schwannoma of the vagus nerve.
Adult ; Cranial Nerve Neoplasms/*diagnosis ; English Abstract ; Humans ; Male ; Neurilemmoma/*diagnosis ; Retroperitoneal Space ; *Vagus Nerve ; Vagus Nerve Diseases/*diagnosis

Anastomotic leakage following rectal resection is a serious and fearful complication, and may cause presacral abscess and/or peritonitis. To our knowledge, massive hematochezia secondary to presacral abscess caused by anastomotic leakage has not yet been reported in the literature. We observed this rare and life-threatening complication in three patients who were successfully treated with a simple but effective transanal gauze packing technique.
Abscess* ; Anastomotic Leak* ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Peritonitis

BACKGROUND: The traditional approach for reduction of frontal sinus fractures is coronal incision. Inherent complications of the coronal approach include long scar, hair loss, and long operation time. We describe a simple approach for the reduction of frontal sinus anterior wall fractures using a suprabrow incision that is commonly used for brow lift. METHODS: From March 2007 to October 2016, the authors identified patients with anterior wall frontal sinus fractures treated by open reduction through a suprabrow incision. Only cases with photographic/radiographic documentation and a minimum follow-up of 6 months were included. The incision line was designed to be at the upper margin of the eyebrow. Medical records and radiographic data were retrospectively reviewed. Surgical outcomes, cosmetic results, and complication were assessed. The patient scale of the patient and observer scar assessment scale was used to assess patient satisfaction for incisional scar at the 6-month follow-up. RESULTS: Thirty-one patients underwent fracture reduction through a suprabrow approach during the study period, with a mean follow-up of 41 months. No patients showed any recurrent displacement, eyebrow asymmetry, or infection during follow-up. Thirteen patients reported their forehead paresthesia postoperatively, and 12 of them had preoperative symptom. One patient complained of incisional scar and underwent scar revision. All patients were satisfied with their eyebrow and forehead contour. CONCLUSION: The suprabrow approach allowed for an accurate reduction of the fractures in the anterior wall frontal sinus by providing direct visualization of the fracture. This transcutaneous approach can effectively restore forehead contour with acceptable postoperative complications and patient satisfaction.
Cicatrix ; Eyebrows ; Follow-Up Studies ; Forehead ; Frontal Sinus* ; Hair ; Humans ; Medical Records ; Minimally Invasive Surgical Procedures ; Paresthesia ; Patient Satisfaction ; Postoperative Complications ; Retrospective Studies ; Skull Fractures

STUDY DESIGN: In-vitro experimental study. OBJECTIVES: To determine the proteoglycan synthesis of the rabbit nucleus pulposus cells in various concentration of extracellular collagen type I and II under the stimulation of TGF-beta1. SUMMARY OF LITERATURE REVIEW: Therapeutic effect of growth factor and gene therapy can be altered by composition of extracellular matrix. However, the effect of extracellular collagen types I and II on synthetic activity of intervertebral disc cells is not thoroughly studied before. MATERIALS AND METHODS: The nucleus pulposus cells were isolated and cultured from 10 skeletally mature rabbits. Cultures were trypsinized and incorporated into alginate beads with different concentration of extracellular collagen type I and II (0.5%, 1.0% and 1.5%). Those cultures with TGF-beta1 (10 ng/ml) served stimulated condition of matrix synthesis. Newly synthesized proteoglycans were assessed by 35 S-sulfate incorporation using chromatography on Sephadex G-25 in PD-10 columns. Scintillation count was normalized with DNA content by Hoechst dye method. RESULTS: In basal condition, difference in proteoglycan synthesis in given concentration of extracellular collagen type I and II were statistically insignificant. In stimulated condition with TGF-beta1, difference in proteoglycan synthesis in given concentration of extracellular collagen type I and II was also statistically insignificant. However, cultures in stimulated condition with TGF-beta1 showed increased amount of newly synthesized proteoglycans compared to those of basal condition regardless of the concentration of extracellular collagen type I and II (p < 0.05). CONCLUSION: Anabolic response of rabbit nucleus pulposus cells is relatively insensitive to extracellular matrix composition, which facilitates application of gene therapy in various conditions of disc degeneration.
Chromatography ; Collagen Type I ; Collagen* ; DNA ; Extracellular Matrix* ; Genetic Therapy ; Intervertebral Disc Degeneration ; Intervertebral Disc* ; Proteoglycans ; Rabbits ; Transforming Growth Factor beta1 ; Trypsin

Primary malignant lymphoma is very rare and represents less than 1.5% of all intracranial neoplasms. The authors have experienced a case of primary malignant lymphoma of the brain in a 66 year-old woman who presented with presistent headache, nausea and generalized weakness. Brain CT scan demonstrated typical deep seated tumor masses in the right temporal and left frontal lobes with strong contrast enhancement. We obtained a good result after surgery followed by radiation and chemotherapy and report our case with review of the articles.
Aged ; Brain Neoplasms ; Brain* ; Drug Therapy ; Female ; Frontal Lobe ; Headache ; Humans ; Lymphoma* ; Nausea ; Tomography, X-Ray Computed