OBJECTIVE: To investigate the effect of intravenous infusion of peripheral blood mononuclear cells (mPBMC) mobilized by granulocyte-colony stimulating factor (G-CSF) on upper extremity function in children with cerebral palsy (CP). METHODS: Fifty-seven children with CP were enrolled. Ten patients were excluded due to follow-up loss. In total, 47 patients (30 males and 17 females) were analyzed. All patients' parents provided signed consent before the start of the study. After administration of G-CSF for 5 days, mPBMC was collected and cryopreserved. Patients were randomized into two groups 1 month later. Twenty-two patients were administered mPBMC and 25 patients received normal saline as placebo. Six months later, the two groups were switched, and administered mPBMC and placebo, respectively. Quality of Upper Extremity Skills Test (QUEST) and the Manual Ability Classification System (MACS) were used to evaluate upper motor function. RESULTS: All subdomain and total scores of QUEST were significantly improved after mPBMC and placebo infusion, without significant differences between mPBMC and placebo groups. A month after G-CSF, all subdomain and total scores of QUEST were improved. The level of MACS remained unchanged in both mPBMC and placebo groups. CONCLUSION: In this study, intravenously infused mPBMC showed no significant effect on upper extremity function in children with CP, as compared to placebo. The effect of mPBMC was likely masked by the effect of G-CSF, which was used in both groups and/or G-CSF itself might have other neurotrophic potentials in children with CP.
Cerebral Palsy* ; Child* ; Classification ; Follow-Up Studies ; Granulocyte Colony-Stimulating Factor ; Humans ; Infusions, Intravenous* ; Male ; Masks ; Parents ; Peripheral Blood Stem Cell Transplantation ; Upper Extremity*

OBJECTIVE: To determine whether there was a difference in balance, proprioception, and skeletal muscle mass among patients who undergo hip fracture surgery relative to and elective total hip replacement (THR). METHODS: Thirty-one THR patients were enrolled. The patients were categorized into two groups: fracture group (n=15) and non-fracture group (n=16). Berg Balance Scale (BBS) was used to balance the proprioception of the hip joint while a joint position sense (JPS) test was used to evaluate it. Skeletal muscle mass was measured by bioelectrical impedance analysis and expressed as a skeletal muscle mass index (SMI). Quality of life (QOL) was also assessed using a 36-item short form health survey (SF-36). All tests were assessed at 3 months after the surgery. An independent t-test was used to compare the fracture group and non-fracture group. Spearman correlation was used to identify the correlation of each variable. RESULTS: In an independent t-test, the BBS score of patients undergoing elective surgery was higher than the BBS score of patients undergoing hip fracture surgery. There was a significant correlation between the BBS and JPS score after a THR. SMI also correlated with the score of BBS. CONCLUSION: It seems that THR patients undergoing surgery for a hip fracture might have more trouble balancing than elective THR patients. Therefore THR patients undergoing hip fracture surgery might need more care during rehabilitation.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Electric Impedance ; Health Surveys ; Hip ; Hip Joint ; Humans ; Joints ; Muscle, Skeletal* ; Pilot Projects* ; Postural Balance ; Proprioception* ; Quality of Life ; Rehabilitation

BACKGROUND/AIMS: With the growing volume of screening colonoscopies, the incidence of rectal carcinoids and the number of endoscopic resections for rectal carcinoids are also increasing. However, the prognosis including recurrence and metachronous lesions after endoscopic resection is unclear. METHODS: The medical records of 255 patients who had undergone endoscopic resection for rectal carcinoids between October 1999 and April 2010 were retrospectively reviewed. RESULTS: The number of males was 150 (58.8%), and the mean age was 54.1 years (range, 27-85 years). Mean tumor size was 6.9 mm. In total, 162 cases (63.5%) were treated with endoscopic mucosal resection and 93 (36.5%) were treated with endoscopic submucosal dissection. Although endoscopic complete resections were achieved in all cases, the histological examination showed 47 cases with a positive resection margin (18.4%) and three with lymphovascular invasion (1.2%). In the 54 patients with a free resection margin, who were followed for more than 12 months, abdominopelvic computed tomography and endoscopy did not show recurrence after a median of 30.5 and 36 months, respectively. Three patients with lymphovascular invasion did not show recurrence during follow-up period of 13, 30, and 37 months, respectively. Metachronous rectal carcinoids were detected in four patients at 23, 58, 61, and 89 months, respectively, after initial endoscopic resection, leading to a second endoscopic treatment. CONCLUSIONS: Small rectal carcinoids completely resected grossly and pathologically without lymphovascular invasion appear to have low probability of short-term recurrence. However, considering the slow growth rate of carcinoids, long-term follow-up for recurrence and metachronous carcinoids is required.
Carcinoid Tumor ; Colonoscopy ; Endoscopy ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mass Screening ; Medical Records ; Prognosis ; Rectum ; Recurrence ; Retrospective Studies

We experienced the case of infected mesh with subsequent infective cellulitis of obturator foramen after a TOT procedure. We reported our case of a 47-year-old woman who presented with persistent vaginal discharge, pain and motion limitation of left leg after having a TOT placed for stress incontinence. Inflammation around obturator foramen was demonstrated on computed tomography (CT) scan. We performed total excision of the mesh material. She ultimately had an uneventful postoperative course and no recurrence of incontinence after follow-up 1 month.
Cellulitis* ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Leg ; Middle Aged ; Recurrence ; Suburethral Slings* ; Vaginal Discharge

PURPOSE: Urodynamic study (UDS) is widely used to evaluate voiding dysfunction, however, it is invasive and bothersome for patients because it requires catheterization into the urethra and anus. We assessed patients' anxiety and pain levels caused by UDS. MATERIALS AND METHODS: A total of 60 female patients who were undergoing UDS were included in the study on a prospective basis. Anxiety level was taken prior to the procedure and pain level was taken immediately after the procedure by visual analogue scale (VAS). Just after the procedures, they were asked if they were willing to undergo the same procedure and if they could recommend the procedure to another people if medically indicated. 60 patients were divided into 2 groups: urodynamic urethral catheters (9Fr, PVC, n=30) were used in group I and Foley catheters (10Fr, Silicon, n=30) were used in group II. RESULTS: The mean age of both groups were 45.5+/-5.3 (group I)and 45.5+/-3.8 (group II)years old. The anxiety and pain levels were relatively high, but there was no significant difference between both groups in pain level. Anxiety level prior to UDS was correlated with pain level (r=0.492, p<0.001). 42 out of 60 patients (70.0%) answered they were willing to undergo UDS if they were asked again and 37 patients (61.7%) answered they could recommend the procedure to another people. 21 patients (35.0%) were menopausal women and they showed higher anxiety level compared to non-menopausal women. CONCLUSION: Female patients felt anxiety before UDS and pain immediately after UDS, especially in menopausal women, and the more anxious they were, the more painful they felt. Therefore, we need to provide sufficient explanation with regard to the procedure for patients prior to UDS to diminish patients' anxiety and pain.
Anal Canal ; Anxiety* ; Catheterization ; Catheters ; Female ; Humans ; Prospective Studies ; Silicones ; Urethra ; Urinary Catheters ; Urodynamics*

Hemangiomas result from proliferation of immature capillary vessels. This disorder in the genitourinary tract is a rare lesion. We experienced one case of a 31 years old man suffered from cavernous hemangioma of the penis shaft with painful erection. He was treated successfully with surgical excision. Herein, we report our experience and a critical review of the literature.
Capillaries ; Caves ; Hemangioma ; Hemangioma, Cavernous ; Male ; Penis

PURPOSE: We wanted to present the feasibility and safety of hand-assisted laparoscopic donor nephrectomy(HALDN) for treating patients with multiple renal arteries. MATERIALS AND METHODS: Between February 2000 and July 2006, 252 patients underwent HALDN. The results for the patients with a single renal artery (n=187)(Group I) and those patients with multiple renal arteries(n=65) (Group II) were compared in terms of the donor and recipient outcomes. A retrospective chart review was performed and statistical analysis included Student's t-test, the chi square test and Kaplan-Meier survival probability analysis. RESULTS: HALDN was technically successful in 251 patients(1 patient had to be converted to open donor nephrectomy). The operative times were increased in group II, but the differences between the groups were not statistically significant. The warm ischemic times were significantly longer in group II. The intraoperative blood loss, postoperative hospital stay and complication rate in the donor group were not associated with the number of renal arteries. The recipients' renal function and overall graft survival were similar between groups I and II. CONCLUSIONS: In our single-center study, the presence of renal artery multiplicity when performing HALDN does not have a significant impact on the outcomes of the renal donors or recipients.

PURPOSE: We wanted to present the feasibility and safety of hand-assisted laparoscopic donor nephrectomy(HALDN) for treating patients with multiple renal arteries. MATERIALS AND METHODS: Between February 2000 and July 2006, 252 patients underwent HALDN. The results for the patients with a single renal artery (n=187)(Group I) and those patients with multiple renal arteries(n=65) (Group II) were compared in terms of the donor and recipient outcomes. A retrospective chart review was performed and statistical analysis included Student's t-test, the chi square test and Kaplan-Meier survival probability analysis. RESULTS: HALDN was technically successful in 251 patients(1 patient had to be converted to open donor nephrectomy). The operative times were increased in group II, but the differences between the groups were not statistically significant. The warm ischemic times were significantly longer in group II. The intraoperative blood loss, postoperative hospital stay and complication rate in the donor group were not associated with the number of renal arteries. The recipients' renal function and overall graft survival were similar between groups I and II. CONCLUSIONS: In our single-center study, the presence of renal artery multiplicity when performing HALDN does not have a significant impact on the outcomes of the renal donors or recipients.

Genistein is a naturally occurring isoflavone that has been identified predominantly in soybean. It has been found that genistein can inhibit the growth of various cancer cell lines. Melanoma continues to increase in incidence in many parts of the world and remains among the top six cancers as a cause of death and morbidity. Understanding and overcoming resistance mechanism(s) of melanoma to apoptosis would therefore facilitate identification of new therapeutic targets and development of new treatments. This study was undertaken to investigate whether genistein induced apoptosis on human melanoma cells (G361). Genistein had a significant dose- and time-dependent inhibitory effect on the viability of G361 cells. The death of cells was further demonstrated to be due to apoptosis characterized by chromatin condensation and apoptotic bodies by hoechst staining, and DNA electrophoresis. p53 levels were not altered by genistein treatment. Genistein treatment induced caspase-3 cleavage and activation. Poly (ADP-ribose)-polymerase (PARP) and DNA fragmentation factor 45 (DFF45), which are caspase-3 substrates, were cleaved during genistein-induced apoptosis. It was found that the caspase-6 substrate lamin A was cleaved, whose cleavage has been reported to be necessary for complete condensation of DNA during apoptosis. The expression level and phosphorylation of focal adhesion kinase (FAK) were reduced by genistein treatment. These results suggest that genistein may constitute a potential antitumor compound against melanoma occurring at oral mucosa and skin.
Apoptosis ; Caspase 3 ; Caspase 6 ; Cause of Death ; Cell Line ; Chromatin ; DNA ; DNA Fragmentation ; Electrophoresis ; Focal Adhesion Protein-Tyrosine Kinases ; Genistein ; Humans ; Incidence ; Lamin Type A ; Melanoma ; Mouth Mucosa ; Phosphorylation ; Proteins ; Soybeans

OBJECTIVE: Promoter methylation of Bcl-2 family genes in cancer cells were studied to verify possible correlation between DNA methylation pattern of Bcl-2 family members and cancer. METHODS: The genomic DNAs were extracted from different cancer cell lines, HeLa, CaSki and K562, and ovarian cancer tissue from patients. The cytosine residues were converted to uracil by sodium bisulfite treatment. MSP (methylation specific PCR) was performed to determine the methylation status of Bcl-2, Mcl-1, Noxa, and Harakiri promoters. Using primers that distinguish methylated DNA from unmethylated DNA after bisulfite modification of DNA, MSP was conducted to observe the methylation pattern of Bcl-2 family genes in different cancer cells. RESULTS: The promoter regions of Bcl-2 family genes including Mcl-1, Bcl-2, and Noxa were not methylated in cancer cells, whereas the proapoptotic Bcl-2 family gene Harakiri was detected as methylated in the cancer cell lines and hypomethylated in the ovarian cancer tissue. CONCLUSION: The present study demonstrated the differential methylation profiles of Bcl-2 family genes in cancerous cells, which suggests a possible connection between the methylation pattern of some of Bcl-2 family genes and ovarian cancer.
Cell Line ; Cytosine ; DNA Methylation* ; DNA* ; Humans ; Methylation ; Ovarian Neoplasms ; Promoter Regions, Genetic ; Sodium ; Uracil