Biomedical subjects

Dong-Ik Kim

Publications and source records attributed to Dong-Ik Kim.

At least 19 recordsLinked to original sources

PubMed2006

Expression of heat shock protein 27 in human atherosclerotic plaques and increased plasma level of heat shock protein 27 in patients with acute coronary syndrome.

BACKGROUND: We intended to identify proteins that are differentially expressed in human atherosclerotic plaques. METHODS AND RESULTS: Comparative 2-dimensional electrophoretic analysis on carotid atherosclerotic endarterectomy specimens (n = 10) revealed that heat shock protein 27 (Hsp27) expression was significantly increased in the nearby normal-appearing area compared with the plaque core area from the same vessel specimen, which was further confirmed by Western blot analysis. The Hsp27 expression in the adjacent normal-appearing vessel areas was much higher than that in nonatherosclerotic reference arteries. The phosphorylation of Hsp27 showed a gradation in the degree of phosphorylation: greatest in the reference arteries, intermediate in the adjacent normal-appearing area, and lowest in plaque core area. Immunohistochemical analysis showed that the phosphorylation of Hsp27 of smooth muscle cells in the carotid endarterectomy specimens was decreased compared with that in the reference artery specimen. The mean plasma level of Hsp27 was significantly higher in patients with acute coronary syndrome (ACS) (n = 27; 106.1 +/- 74.1 ng/mL) than in the normal reference subjects (n = 29; 45.8 +/- 29.5 ng/mL; P < 0.005). The plasma levels of Hsp27 were significantly correlated with those of heat shock protein 70 (Hsp70) (r = 0.422, P < 0.0005), with adjustment for ACS/reference status. CONCLUSIONS: In the atherosclerotic lesion, Hsp27 expression is increased in the normal-appearing vessel adjacent to atherosclerotic plaque, whereas levels in the plaque itself are significantly decreased. Both plaque and adjacent artery show decreased Hsp27 phosphorylation compared with reference vessel. In ACS, plasma Hsp27 and Hsp70 are increased, and levels of Hsp27 correlate with Hsp70, C-reactive protein, and CD40L levels.

Adult↗

PubMed2006

Angiogenesis facilitated by autologous whole bone marrow stem cell transplantation for Buerger's disease.

We hypothesized that angiogenesis can be triggered by autologous whole bone marrow stem cell transplantation. Twenty-seven patients (34 lower limbs) with Buerger's disease, who were not candidates for surgical revascularization or radiologic intervention, were enrolled in this study. Six sites of the tibia bone were fenestrated using a 2.5-mm-diameter screw under fluoroscopic guidance. Clinical status and outcome were determined using the "Recommended Standards for Reports." To mobilize endothelial progenitor cells (EPCs) from bone marrow, recombinant human granulocyte colony-stimulating factor (r-HuG-CSF) was injected subcutaneously as a dose of 75 microg, preoperatively. During the follow-up period (19.1 +/- 3.5 months), one limb showed a markedly improved outcome (+3), and 26 limbs showed a moderately improved outcome (+2). Thirteen limbs among 17 limbs with nonhealing ulcers healed. Postoperative angiograms were obtained for 22 limbs. Two limbs showed marked (+3), five limbs moderate (+2), and nine limbs slight (+1) collateral development. However, six limbs showed no collateral development (0). Peripheral blood and bone marrow samples were analyzed for CD34 and CD133 molecules to enumerate potential EPCs, and EPC numbers were found to be increased in peripheral blood and in bone marrow after r-HuG-CSF injection. In conclusion, the transplantation of autologous whole BMCs by fenestration of the tibia bone represents a simple, safe, and effective means of inducing therapeutic angiogenesis in patients with Buerger's disease.

Adult↗

PubMed2006

Enhancement of in vivo endothelialization of tissue-engineered vascular grafts by granulocyte colony-stimulating factor.

Successful reconstruction of large-diameter blood vessel in humans has been demonstrated using the tissue engineering technique, but improvement in patency of small-diameter bioartificial vascular graft remains a great challenge. This study reports that granulocyte colony-stimulating factor (G-CSF) can enhance in vivo endothelialization of tissue-engineered vascular grafts, which could be used to improve patency of small-diameter vascular graft. Vascular grafts were tissue engineered with decellularized canine abdominal aortas and canine autologous bone marrow-derived cells. Prior to cell seeding onto decellularized graft matrices, bone marrow-derived cells were induced to differentiate into endothelial cells and smooth muscle cells. The cell-seeded vascular grafts were implanted into the abdominal aortas of bone marrow donor dogs. Before and after graft implantation, G-CSF was administered subcutaneously to the dogs (n = 3). The grafts implanted into the dogs not receiving G-CSF were used as controls (n = 3). Eight weeks after implantation, grafts in both groups showed regeneration of vascular tissues including endothelium and smooth muscle. Importantly, endothelium formation was more extensive in the G-CSF-treated grafts than in the control grafts, as assessed with reverse transcription polymerase chain reaction, western blot, and immunohistochemistry. In addition, intimal hyperplasia was significantly reduced in the G-CSF-treated grafts compared to the control grafts. This study suggests that G-CSF administration could be applied to improve patency of small-diameter tissue-engineered vascular grafts.

Animals↗

PubMed2006

Risk factors for leg length discrepancy in patients with congenital vascular malformation.

OBJECTIVES: This study was conducted to determine the clinical risk factors for the development of leg length discrepancy (LLD) in patients with congenital vascular malformation (CVM) affecting the lower extremity. METHODS: A retrospective analysis was conducted of a prospectively collected database that included 361 patients who underwent assessment of a CVM lesion from September 1994 to January 2005. We measured LLD using lower extremity scanograms of 229 patients who were suspected of having LLD on physical examination. The risk factor analysis for a clinically significant LLD (>2 cm) was performed with the variables of age, gender, features of CVM (type, extent and depth), and the deep vein status (agenesis, hypoplasia, phlebectasia) of the affected limb. Fisher's exact test and the chi(2) test were used for the univariate analysis, and a logistic regression test was performed for the multivariate analysis. Among the patients with LLD, we compared the overgrowth group and undergrowth group with the Fisher's exact test to identify differences between the two subgroups. RESULTS: The included patients were 153 males (42%) and 208 females (57%) with a mean age of 20 +/- 14 years (range, 1 to 62). There were 157 patients (43%) in the still growing age group (age <15 years) and 204 (57%) were in the finished growing age group (age >15 years). The types of CVMs included 215 venous (60%), 43 arteriovenous (12%), 46 lymphatic (13%), and 57 (16%) combined venolymphatic malformations. On the lower extremity scanogram, 26 patients (7%) had a LLD of >2 cm due to overgrowth (n = 20) or undergrowth (n = 6) of the affected limbs. The univariate analysis showed that a venolymphatic malformation (P = .003) and a whole leg CVM (P = .000) were significant risk factors for development of LLD. However, the multivariate analysis identified the whole leg CVM lesion as a single independent risk factor for LLD (P = .004; odds ratio, 6.512, 95% confidence interval, 1.788 to 23.713). On subgroup analysis, a whole leg CVM was also identified as a risk factor for overgrowth of the affected limb. In a comparison between two subgroups of LLD (overgrowth v. undergrowth), overgrowth was significantly (P = .022) more common in female than in male patients. CONCLUSIONS: As a clinical risk factor for development of LLD, the extent of the CVM lesion was a single independent risk factor regardless of the type or depth of the CVM lesion. In addition, our data suggest that overgrowth or undergrowth of the affected limb, as a cause of LLD, might be related to gender.

Adolescent↗

PubMed2006

Preliminary experience with tissue engineering of a venous vascular patch by using bone marrow-derived cells and a hybrid biodegradable polymer scaffold.

OBJECTIVE: Currently available synthetic polymer vascular patches used in cardiovascular surgery have shown serious shortcomings, including thrombosis, calcification, infection, and lack of growth potential. These problems may be avoided by vascular patches tissue-engineered with autologous stem cells and biodegradable polymeric materials. The objective of this study was to develop a tissue-engineered vascular patch by using autologous bone marrow-derived cells (BMCs) and a hybrid biodegradable polymer scaffold. METHODS: Hybrid biodegradable polymer scaffolds were fabricated from poly(lactide-co-epsilon-caprolactone) (PLCL) copolymer reinforced with poly(glycolic acid) (PGA) fibers. Canine bone marrow mononuclear cells were induced in vitro to differentiate into vascular smooth muscle cells and endothelial cells. Tissue-engineered vascular patches (15 mm wide x 30 mm long) were fabricated by seeding vascular cells onto PGA/PLCL scaffolds and implanted into the inferior vena cava of bone marrow donor dogs. RESULTS: Compared with PLCL scaffolds, PGA/PLCL scaffolds exhibited tensile mechanical properties more similar to those of dog inferior vena cava. Eight weeks after implantation of vascular patches tissue-engineered with BMCs and PGA/PLCL scaffolds, the vascular patches remained patent with no sign of thrombosis, stenosis, or dilatation. Histological, immunohistochemical, and scanning electron microscopic analyses of the retrieved vascular patches revealed regeneration of endothelium and smooth muscle, as well as the presence of collagen. Calcium deposition on tissue-engineered vascular patches was not significantly different from that on native blood vessels. Immunofluorescent double staining confirmed that implanted BMCs survived after implantation and contributed to regeneration of endothelium and vascular smooth muscle in the implanted vascular patches. CONCLUSIONS: This study demonstrates that vascular patches can be tissue-engineered with autologous BMCs and hybrid biodegradable polymer scaffolds.

Absorbable Implants↗

PubMed2006

Arteriovenous malformations of the body and extremities: analysis of therapeutic outcomes and approaches according to a modified angiographic classification.

PURPOSE: To propose a modified angiographic classification for peripheral arteriovenous malformations (AVMs) and to determine its value for assessing therapeutic outcomes and approaches to ethanol embolization of AVMs in the body and extremities. METHODS: AVMs of the trunk and extremities were categorized according to the angiographic morphology of the nidus: type I (arteriovenous fistulae), type II (arteriolovenous fistulae), type IIIa (arteriolovenulous fistulae with non-dilated fistula), and type IIIb (arteriolovenulous fistulae with dilated fistula). Sixty-six patients (41 women; mean age 28.3 years, range 5-53) with inoperable AVMs in the body and extremities who underwent staged ethanol embolizations were retrospectively analyzed. Therapeutic outcomes and approaches were evaluated according the above classification system. RESULTS: The 66 AVMs were composed of 30 (45%) type IIIb, 13 (20%) type II, 12 (18%) mixed types IIIa and IIIb, 9 (14%) mixed types II and IIIb, and 2 (3%) type IIIa. Ethanol embolization was most effective for type II (100%), and more effective for type IIIb (83%) than for type IIIa or mixed types (< or = 50%). Despite the use of the transarterial approach, direct puncture and transvenous approaches were more relevant for treating type II AVMs. Only the transarterial approach was used for treating type IIIa; both direct puncture and transarterial approaches were used for treating the other types. CONCLUSION: The described angiographic classification provides considerable information concerning the characteristics of AVMs in the body and extremities, the optimal therapeutic approach, and the likely therapeutic outcome.

Adolescent↗

PubMed2006

Surgical management of Takayasu's arteritis.

The results of surgical bypass and endarterectomy in Takayasu's arteritis (TA) were reported to be poor compared to usual atherosclerosis patients. However, if ischemic symptoms due to occlusive disease were severe, surgical procedures were inevitable. We report surgical experience of 5 patients with TA. Five women (ranged from 26 to 58 yr) were operated between June 1998 and May 2004. Three patients showed occlusion of main branches of aortic arch and had symptoms of cerebral ischemia. One patient showed near total occlusion in the midabdominal aorta and had symptoms of orthopnea and uncontrolled hypertension. One patient showed total occlusion of abdominal aorta at the level of aortic bifurcation and had a symptom of severe claudication on both legs. Bypasses from the ascending aorta to the carotid artery were performed in 3 cases. Bypass from the thoracic aorta to the left common iliac artery was performed in one case and endarterectomy of abdominal aorta in one case. The ischemic symptoms related with arterial occlusion were resolved after surgery. And the symptoms of cardiac failure disappeared. The symptomatic TA frequently required arterial reconstruction. The symptomatic improvement and excellent mid-term patency could be expected after arterial reconstruction and endarterectomy.

Adult↗

PubMed2005

Synergistic effect of sustained delivery of basic fibroblast growth factor and bone marrow mononuclear cell transplantation on angiogenesis in mouse ischemic limbs.

Combined angiogenic therapies may be superior to single angiogenic therapy for treatment of limb ischemia. First, we investigated whether the angiogenic efficacy of basic fibroblast growth factor (bFGF) administration and bone marrow-derived mononuclear cell (BMMNC) transplantation can be enhanced by sustained delivery (SD) of bFGF and BMMNC transplantation using a matrix, respectively, in mouse ischemic limbs. Next, we investigated whether the angiogenic efficacy of combination of two angiogenic strategies is superior to either strategy alone. One day after surgical induction of mouse hindlimb ischemia, mice were randomized to receive either no treatment, daily injection (DI) of bFGF, SD of bFGF, BMMNC transplantation using culture medium, BMMNC transplantation using fibrin matrix (FM), or combination of SD of bFGF with BMMNC transplantation using FM. The SD of bFGF significantly increased the microvessel density, compared with DI of bFGF (659+/-48/mm2 versus 522+/-39/mm2, p<0.05). BMMNC transplantation using FM significantly increased the microvessel density, compared with BMMNC transplantation using culture medium (523+/-103/mm2 versus 415+/-75/mm2, p<0.05). Importantly, combination of bFGF sustained release with BMMNC transplantation using FM further increased the densities of microvessels and arterioles, compared to either strategy alone (p<0.05). The SD method of angiogenic protein and cell transplantation using matrix potentiate the angiogenic efficacy of bFGF and BMMNC transplantation, respectively, for limb ischemia. In addition, the combined therapy of SD of bFGF and BMMNC transplantation synergistically enhances angiogenesis in mouse ischemic limb, compared to each separate therapy.

Animals↗

PubMed2005

Differential expression of immunoglobulin kappa chain constant region in human abdominal aortic aneurysm.

BACKGROUND: A number of the research into the pathogenesis of the abdominal aortic aneurysm (AAA) have focused on the alteration of gene expression. The current technique for elucidating alterations of gene expression has a setback in that many artifact complementary DNA (cDNA) products present abnormal polymerase chain reaction (PCR) amplification. Our study was designed to identify differentially expressed genes in AAA using the annealing control primer (ACP) system, which was recently developed to identify only authentic genes. MATERIALS AND METHODS: The tissues of the human abdominal aorta were obtained from the patients of AAA and aortic occlusive disease (AOD), and normal abdominal aorta (NA) from brain death donors. Total RNAs were isolated from three groups of human abdominal aorta (10 AAA, five NA, three AOD) and then reverse transcribed into complementary DNA (cDNA). The ACP method was done to screen the difference in the expression pattern of the mRNA (mRNA). RESULTS: One differentially expressed cDNA band was detected in AAA but not in NA and AOD. This cDNA was sequenced and computer searching against the GenBank revealed that the cDNA had more than 90% identity with the immunoglobulin kappa chain constant region (Ig kappa-C). DISCUSSION: Our finding suggests that differentially expressed Ig kappa-C gene only in AAA is a candidate gene that may play a pivotal role in the pathogenesis of AAA formation. The correlation of mRNA level and protein level is, however, not clear. Thus, to directly identify the role of Ig light chains in the pathogenic event of AAA, the further study comparing the level and kinds of expressed protein with the corresponding Ig kappa-C gene will be required.

Aortic Aneurysm, Abdominal↗

PubMed2005

Involvement of TL1A and DR3 in induction of pro-inflammatory cytokines and matrix metalloproteinase-9 in atherogenesis.

TL1A (VEGI/TNFSF15) is the ligand for DR3 (TNFRSF12) and is a newly identified member of the tumor necrosis factor superfamily (TNFSF). Previously, DR3 has been shown to have a role in atherogenesis through stimulation of matrix degrading enzymes including matrix metalloproteinase (MMP)-9. Immunohistochemical staining of human carotid atherosclerotic plaques revealed a high-level expression of TL1A in regions rich in macrophage/foam cells. To investigate the role of TL1A and DR3 in the functioning of macrophage/foam cells in relation to atherogenesis, we have analyzed cellular events mediated by TL1A and DR3 in a human macrophage-like cell line, THP-1. Treatment of THP-1 cells with immobilized anti-DR3 monoclonal antibody in combination with IFN-gamma caused induction of pro-atherogenic cytokines/chemokines such as TNF-alpha, monocyte chemoattractant protein (MCP)-1, and interleukin (IL)-8. Treatment of THP-1 cells with recombinant TL1A in combination with IFN-gamma also caused induction of MMP-9 and IL-8. Furthermore, the expression of DR3 in peripheral blood monocytes was induced after atherogenic stimulation. These data suggest that TL1A and DR3 is involved in atherosclerosis via the induction of pro-inflammatory cytokines/chemokines and decreasing plaque stability by inducing extracellular matrix degrading enzymes.

Aged↗

PubMed2005

Vascular patches tissue-engineered with autologous bone marrow-derived cells and decellularized tissue matrices.

Synthetic polymer vascular patches used in cardiovascular surgery have shortcomings such as thrombosis, intimal hyperplasia, calcification, infection, and no growth potential. Tissue-engineered vascular patches using autologous vascular cells may solve these problems. In this study, we developed a tissue-engineered vascular patch using autologous bone marrow-derived cells (BMCs) and decellularized tissue matrices. Vascular smooth muscle cells and endothelial cells were differentiated from bone marrow mononuclear cells in vitro. Tissue-engineered vascular patches were fabricated by seeding these cells onto decellularized canine inferior vena cava matrices and implanted into the inferior vena cava of dogs. Three weeks after implantation, the tissue-engineered vascular patches were patent with no sign of thrombus formation. Histological, immunohistochemical, and electron microscopic analyses of the vascular patches retrieved 3 weeks after implantation revealed regeneration of endothelium and smooth muscle and the presence of collagen and elastin. BMCs labeled with a fluorescent dye prior to implantation were detected in the retrieved vascular patches, indicating that the BMCs survived after implantation and contributed to the vascular tissue regeneration. This study demonstrates that vascular patches can be tissue-engineered with autologous BMCs and decellularized tissue matrices.

Animals↗

PubMed2005

Identification of differentially expressed genes in primary varicose veins.

BACKGROUND: A number of changes in protein expression have been described in primary varicose veins, but the altered gene expressions in this disease are unknown. The aim of this study was to identify differentially expressed genes in primary varicose veins. MATERIALS AND METHODS: Total RNAs were isolated from two groups of greater saphenous veins (four primary varicose veins and three normal) and then were reverse transcribed into cDNAs. We used the differential display reverse transcription-polymerase chain reaction technique to screen the differences in the mRNA expression profiles of the groups. RESULTS: We found that three cDNAs showed differences in expression patterns between normal and diseased saphenous veins. The cDNAs are prominently expressed only in patients with varicose veins. We identified that the cDNAs had significant similarities to the L1M4 repeat sequence of clone RP11-57L9, clone RP11-299H13, and Alu repetitive sequence of human tropomyosin 4 mRNA. CONCLUSIONS: Our results suggest that the screened cDNA clones are useful disease markers in the genetic diagnosis of primary varicose vein and that the L1 and Alu elements possibly participated in the development of primary varicose veins through their expression patterns in genes encoded with structural proteins, such as collagen, elastin, and tropomyosin. Further studies are required to elucidate the potential relationship between repeat sequences and primary varicose veins.

Collagen↗

PubMed2005

Ethanol embolization of arteriovenous malformations: interim results.

PURPOSE: To assess retrospectively the interim results and the complications of ethanol embolization treatment of arteriovenous malformations (AVMs). MATERIALS AND METHODS: Institutional review board approval was obtained for a retrospective review of patient medical and imaging records. Informed consent was not required by the institutional review board. Written consent for the procedure was obtained from all patients after a discussion about the advantages and risks of the procedure. After a general anesthetic was administered, 40 patients (16 male, 24 female; age range, 9-53 years) with inoperable AVMs in the body and extremities underwent staged ethanol embolizations (range, 1-24; median, 3). Pulmonary artery pressure and arterial blood pressure were monitored as ethanol was injected. Ethanol embolizations (50%-100% ethanol mixed with nonionic contrast material) were performed by using transcatheter and/or direct puncture techniques. Ten patients underwent additional coil deployment during ethanol embolization. Clinical follow-up (range, 2-48 months; mean, 14.6 months; median, 12 months) was performed in all patients, and results from imaging follow-up (range, 0-48 months; mean, 8.4 months; median, 6 months) were available from the last treatment session in 28 patients. Therapeutic outcomes were established by evaluating the clinical outcome of symptoms and signs, as well as the degree of devascularization at follow-up angiography. RESULTS: One hundred seventy-five ethanol embolizations were performed in 40 patients. Sixteen (40%) of 40 patients were cured, 11 (28%) had partial remission, seven (18%) had no remission, and one (2%) experienced aggravation. Treatment failed in five patients (12%). Ethanol embolization was considered effective (cure, 16 patients; partial remission, 11 patients) in 27 patients (68%). Eleven patients will need further treatment sessions for residual AVMs. Twenty-one patients (52%) experienced complications. Twenty-seven minor complications (skin and transient peripheral nerve injuries) (27 [15%] of 175 procedures) occurred in 18 (45%) of 40 patients. All minor complications were healed with wound dressing and observation. Five major complications (five [3%] of 175 procedures) occurred in five (12%) of 40 patients, and four patients recovered completely. CONCLUSION: Ethanol embolization has the potential for cure in the management of AVMs of the body and extremities but with acceptable risk of minor and major complications.

Adolescent↗

PubMed2005

Prospective analysis of cerebral infarction after carotid endarterectomy and carotid artery stent placement by using diffusion-weighted imaging.

BACKGROUND AND PURPOSE: Small emboli arising from a friable plaque during carotid endarterectomy (CEA) and carotid artery stent placement (CAS) constitute a potentially important cause of periprocedural ischemic complications. To evaluate the frequency and significance of cerebral ischemic lesions of embolic origin after CEA and CAS, we examined patients with moderate to severe carotid stenosis by using diffusion-weighted (DW) imaging. METHODS: Twenty-four patients undergoing 26 CEAs and 20 patients undergoing 22 CAS were prospectively studied with pre- and post-treatment DW imaging of the brain within 7 days (mean, 2.3 days) before and within 7 days (mean, 3.2 days) after treatment. DW images were analyzed by two neuroradiologists blinded to the clinical results after CEA and CAS. Any new hyperintense lesion on DW image was interpreted as a post-treatment ischemic lesion. We compared post-treatment ischemic lesions with change in neurologic status, presence of plaque ulcerations, and severity of stenosis and compared the frequency of overall post-treatment complications between the two procedures. RESULTS: In 25 (96%) of 26 CEAs, post-operative brain DW images were unchanged. In one patient (4%), a new single asymptomatic hyperintensity was observed in the striatocapsule on the surgical side. In 14 (64%) of 22 CAS procedures, post-operative brain DW images were unchanged. In eight CAS cases (36%), new hyperintensities were seen on DW images. Among them, two were symptomatic with a major neurologic deficit lasting more than 7 days. Post-treatment brain or retinal major stroke rates were 4% (n = 1) for CEA and 14% (n = 3) for CAS. Overall symptomatic complication rates were 19.2% and 13.6%, respectively. CONCLUSION: Rate of ischemic brain lesions was significantly lower after CEA than after CAS, although most of these brain lesions were silent. Also, CEA is a safer procedure carrying a lower risk of post-operative cerebral ischemia. CAS, however, may be a comparable procedure considering the total complication rate and can be a more reliable procedure with advances in neuroprotective means.

Adult↗

PubMed2004

Vascular endothelial growth factor-induced angiogenic gene therapy in patients with peripheral artery disease.

This phase 1 clinical trial tested the safety of intramuscular gene transfer by using naked plasmid DNA encoding the gene for VEGF, and analyzed the potential therapeutic benefits in patients with severe peripheral arterial disease (PAD). This study was an open-labeled, dose- escalating, single-center trial on nine male patients with severe debilitating PAD who had not responded to conventional therapy. Seven had Buerger's disease and two had arteriosclerosis obliterans. Plasmid DNA (pCK) containing human VEGF165 was given by eight intramuscular injections in and around the area in need of new blood vessels. The study evaluated three escalating total doses (2, 4, and 8 mug of pCK- VEGF165), with half of each total dose given four weeks apart. The follow-up duration was nine months. The gene injections were well tolerated without significant side effects or laboratory abnormalities related to gene transfer. Three patients showed transient edema in their extremities. Ischemic pain of the affected limb was relieved or improved markedly in six of seven patients. Ischemic ulcers healed or improved in four of six patients. The mean ankle-brachial index (ABI) improved significantly. Six of nine patients showed an increase in collateral vessels around the injection sites demonstrated by digital subtraction angiography. However, there was no relationship between the degree of ABI improvement and the dose given. Mean plasma levels of VEGF did not increase significantly. In conclusion, intramuscular injections of pCK- VEGF165 can be performed safely to induce therapeutic angiogenesis in patients with severe PAD.

Adult↗

PubMed2004

Venous hemodynamic changes in the surgical treatment of primary varicose vein of the lower limbs.

Venous hemodynamic changes after the surgery of primary varicose veins were evaluated. (Materials and methods) We retrospectively analyzed 1,211 patients (1,407 limbs) who underwent surgery for primary varicose veins from 1994 to 2002. The venous hemodynamics were evaluated using air- plethysmography (APG) preoperatively and one month postoperatively in the viewpoints of ambulatory venous pressure (AVP), venous volume (VV), venous filling index (VFI), and ejection fraction (EF). (Results) The surgical modalities included 958 cases of greater saphenous vein high ligation (GSV HL) and stripping with varicosectomy (VS), 222 cases of short saphenous vein (SSV) HL and VS, 143 cases of external banding valvuloplasty of GSV and VS, and 44 cases using VNUS and VS. The reduction rate of VV was 20.9 +/- 14.1% in the GSV stripping group, 12.0 +/- 14.7% in the GSV valvuloplasty group, 18.3 +/- 16.1% in the VNUS group, and 20.6 +/- 15.9% in the SSV group. The reduction rate of VFI was 63.6 +/- 20.7% in the GSV stripping group, 38.8 +/- 40.9% in the GSV valvuloplasty group, 60.1 +/- 23.9% in the VNUS group, and 37.6 +/- 30.2% in the SSV group. The increasing rate of EF was 25.0 +/- 28.2% in the GSV stripping group, 21.0 +/- 30.0% in the GSV valvuloplasty group, 29.4 +/- 31.9% in the VNUS group, and 30.0 +/- 36.5% in the SSV group. The reduction rate of AVP was 25.4 +/- 32.2% in the GSV stripping group, -6.1 +/- 58.1% in the GSV valvuloplasty group, 28.4 +/- 38.5% in the VNUS group, and 14.1 +/- 49.0% in the SSV group. All of the patients showed improvements in venous hemodynamics by showing a decrease in VV, VFI, AVP, and an increase in EF. However, there was no difference in the change of venous hemodynamics according to the type of surgery.

Adult↗

PubMed2004

Excisional surgery for chronic advanced lymphedema.

PURPOSE: We conducted a retrospective study to evaluate the efficacy of excisional surgery to treat chronic advanced lymphedema. Excisional surgery was performed to reduce the extremity size, improve limb function, and decrease the frequency of lymphangitis and prevent sepsis. METHODS: Between August 1997 and December 2001, we performed excisional surgery on one or two affected legs in 20 patients with chronic lymphedema (total 24 legs). The lymphedema was graded as stage III in 5 extremities and as stage IV in 19 extremities. Five patients had primary lymphedema and 15 had secondary lymphedema. The mean duration of follow-up was 17.8 months. RESULTS: Excisional surgery resulted in clinical improvement in 18 extremities, all of which received regular physiotherapy after surgery. However, lymphedema progressed to the preoperative status in six extremities, four of which did not receive regular physiotherapy after surgery. CONCLUSIONS: Excisional surgical therapy can be effective for chronic advanced lymphedema, but appropriate postoperative physiotherapy is essential to ensure that the effects last.

Chronic Disease↗

PubMed2004

Smooth muscle-like tissues engineered with bone marrow stromal cells.

Bone marrow-derived cells have demonstrated the ability to differentiate into multiple mesenchymal cell lineages. Here we tested whether smooth muscle (SM)-like tissues can be created in vivo with bone marrow stromal cells (BMSCs). Cultured canine BMSCs, which expressed SM cell-specific markers including SM alpha-actin and SM myosin heavy chain, were seeded on three-dimensional, biodegradable polymer scaffolds and implanted into peritoneal cavity of athymic mice. The cell-scaffold constructs retrieved 4 weeks after implantation formed three-dimensional tissues. Immunohistochemical analyses showed that the tissue reconstructs expressed SM alpha-actin and SM myosin heavy chain. Masson's trichrome staining showed the presence of significant amounts of collagen in the tissue reconstructs. Cells labeled with a fluorescent tracer prior to implantation were still present in the tissue reconstructs 4 weeks after implantation. Non-seeded scaffolds (control groups) retrieved 4 weeks after implantation did not exhibit extensive tissue formation. This study demonstrates the potential of BMSCs as an alternative cell source for tissue engineering of SM.

Absorbable Implants↗