• Title/Summary/Keyword: Vascular surgery

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Tissue Engineering of Smooth Muscle under a Mechanically Dynamic Condition

  • Kim, Byung-Soo;Jeong, Sung-In;Cho, Seung-Woo;Nikolovski, Janeta;Mooney, David-J.;Lee, Soo-Hong;Jeon, O-Ju;Kim, Tae-Wan;Lim, Sang-Hyun;Hong, Yoo-Sun;Choi, Cha-Yong;Lee, Young-Moo;Kim, Soo-Hyun;Kim, Young-Ha
    • Journal of Microbiology and Biotechnology
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    • v.13 no.6
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    • pp.841-845
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    • 2003
  • In order for engineered tissues to find clinical utility, the engineered tissues must function appropriately. However, smooth muscle (SM) tissues engineered in vitro with a conventional tissue engineering technique may not exhibit contractile functions, because smooth muscle cells (SMCs) cultured in vitro typically revert from a contractile, differentiated phenotype to a synthetic, nondifferentiated phenotype and lose their ability to contract. SMCs in vivo typically reside in mechanically dynamic environments. We hypothesized that cyclic mechanical stretch induces the features of SMCs in in vitro engineered tissues to be similar to those of SMCs in native tissues. To test the hypothesis, aortic SMCs were seeded onto elastic, three-dimensional scaffolds and cultured in vitro under a cyclic mechanical stretching condition for 4 weeks. A significant cell alignment in a direction parallel to the cyclic stretching direction was found in the SM tissues exposed to cyclic stretching. The cellular alignment and alignment direction were consistent with those of native vascular SM tissues, in which SMCs in vivo align in the radial direction (parallel to stretching direction). In control tissues (SM tissues engineered without stretching), cells randomly aligned. The expression of SM ${\alpha}-actin$ and SM myosin heavy chain, phenotypic markers of SMCs in a contractile state, was upregulated in the stretched tissues by 2.5- and 2.0-fold, respectively, compared to SMCs in the control tissues. The cellular features of alignment and contractile phenotype of SMCs in the SM tissues engineered under a mechanically dynamic environment could allow the engineered SM tissues to exhibit contractile functions.

Factors Influencing on Early Patency Rate of Autogenous Arteriovenous Fistula for Hemodialysis (혈액투석을 위한 자가 동정맥루 수술에 있어서 조기개존율에 영향을 미치는 요인)

  • 민선경;한재진;원태희;안재호
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.342-348
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    • 2004
  • It is very important for hemodialysis in patients with end stage renal disease to obtain vascular access that resists repeated punctures and maintains adequate blood flow. This study was designed to indentify factors that may influence early patency rate of autogenous arteriovenous fistula. Material and Method: 49 cases in 47 patients who underwent radiocephalic fistula formation in our hospital from June 2002 through May 2003 were reviewed and analyzed. Result: The early patency rate was 79.6%. Age, sex, hypertension, and diabetes mellitus were not significant factors for patency. Body mass index and duration of hypertension and diabetes did not influence the early results either. Cephalic vein diameter measured preoperatively and blood flow at radio-cephalic fistula were significantly positive correlative factors. Groups with the vein diameter less than 2.7mm, or with the blood flow less than 100 mL/min had significantly lower early patency rate than the other groups. Conclusion: To improve early patency rate of radiocephalic fistula, large sized cephalic vein should be selected and if the intraoperative flow at radiocephalic fistula is less than 100 mL/min, another arteriovenous fistula formation should be considered.

Prognostic Evaluation of Categorical Platelet-based Indices Using Clustering Methods Based on the Monte Carlo Comparison for Hepatocellular Carcinoma

  • Guo, Pi;Shen, Shun-Li;Zhang, Qin;Zeng, Fang-Fang;Zhang, Wang-Jian;Hu, Xiao-Min;Zhang, Ding-Mei;Peng, Bao-Gang;Hao, Yuan-Tao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5721-5727
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    • 2014
  • Objectives: To evaluate the performance of clustering methods used in the prognostic assessment of categorical clinical data for hepatocellular carcinoma (HCC) patients in China, and establish a predictable prognostic nomogram for clinical decisions. Materials and Methods: A total of 332 newly diagnosed HCC patients treated with hepatic resection during 2006-2009 were enrolled. Patients were regularly followed up at outpatient clinics. Clustering methods including the Average linkage, k-modes, fuzzy k-modes, PAM, CLARA, protocluster, and ROCK were compared by Monte Carlo simulation, and the optimal method was applied to investigate the clustering pattern of the indices including platelet count, platelet/lymphocyte ratio (PLR) and serum aspartate aminotransferase activity/platelet count ratio index (APRI). Then the clustering variable, age group, tumor size, number of tumor and vascular invasion were studied in a multivariable Cox regression model. A prognostic nomogram was constructed for clinical decisions. Results: The ROCK was best in both the overlapping and non-overlapping cases performed to assess the prognostic value of platelet-based indices. Patients with categorical platelet-based indices significantly split across two clusters, and those with high values, had a high risk of HCC recurrence (hazard ratio [HR] 1.42, 95% CI 1.09-1.86; p<0.01). Tumor size, number of tumor and blood vessel invasion were also associated with high risk of HCC recurrence (all p< 0.01). The nomogram well predicted HCC patient survival at 3 and 5 years. Conclusions: A cluster of platelet-based indices combined with other clinical covariates could be used for prognosis evaluation in HCC.

Impingement Syndrome & Rotator Cuff Tear: Etiology (견관절 충돌 증후군 및 회전근 개 파열의 병인)

  • Cho, Nam Su;Lee, Sang Hoon
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.72-78
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    • 2012
  • The rotator cuff is situated in a potential tight subacromial space and undergoes senescent structural changes commonly observed in other joints of the body. When the cuff fails, spontaneous healing of the torn tendon is not expected to occur, and multiple factors may be responsible. Its fibers are under tension and typically retract on tearing. The subacromial bursal inflammation and alterations in normal glenohumeral kinematics have been considered in the development of symptoms. Controversy continues to exist concerning the pathogenesis of rotator cuff disease. The heterogeneity of the disorder, as well as the notion that rotator cuff disease may not actually represent a continuum of the same process, but rather, is a compilation of independent disorders, may partly explain the differing viewpoints on its origin. Two contrasting pathogenetic mechanisms have been extensively described and include vascular, or intrinsic, causes and impingement, or extrinsic, factors. Other etiologies have also been reported that include trauma, congenital or developmental factors, and instability. For successful treatment of the rotator cuff diseases, it is essential to understand the structure and function of rotator cuff and to clarify the pathogenesis and natural history of its disorder.

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Expression of Intercellular Adhesion Molecule- 1 after Ischemia Reperfusion Injury of the Canine Lung (폐장의 허혈-재관류 손상과 세포간부착물질-1 의 발현)

  • 성숙환;김영태;김문수;이재익;강문철
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.87-93
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    • 2002
  • Background: Predicting the important role of intercellular adhesion molecule-1 expression on the acute ischemia-reperfusion injury, we set out to demonstrate it by assessing the degree of expression of ICAM-1 after warm ischemia-reperfusion in canine unilateral lung ischemia model. Material and Method: Left unilateral lung ischemia was induced by clamping the left hilum for 100 minutes in seven adult mongrel dogs. After reperfusion, various hemodynamic pararmeters and blood gases were analyzed for 4 hours, while intermittently clamping the right hilum in order to allow observation of the injured Ieft lung function. The pulmonary venous blood was collected serially to measure TNF- and cICAM-1 level. After 4 hours of reperfusion, the lung tissue was biopsied to assess cICAM-1 expression, and to measure tissue malondialdehyde(MDA) and ATP level. Result: The parameters including arterial oxygen partial pressure, pulmonary vascular resistance and tissue MDA and ATP level suggested severe lung damage. Serum TNF-$\alpha$ level was 8.76$\pm$2.37 ng/ml at 60 minutes after reperfusion and decreased thereafter. The cICAM-1 level showed no change after the reperfusion during the experiment. The tissue cICAM-1 expression was confirmed in 5 dogs. Conclusion: The increase of TNF-$\alpha$ Ievel and expression of tissue ICAM-1 were demonstrated after ischemia reperfusion injury in canine lung model.

The Clinical Analysis of Modified B-T Shunt Using 3 mm and 3.5 mm PTFE graft (3mm와 3.5mm PTFF graft를 이용한 변형 B-T 단락술의 임상적 분석)

  • 정성호;윤태진;임한중;민경석;서동만;윤소영;김영휘;고재곤;박인숙
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.716-722
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    • 2000
  • Background: Modified Blalock-Taussig shunt using 3mm or 3.5mm PTFE graft has been performed in patients with small body weight or in candidates for single ventricle palliation. However, there are few reports concerning clinical outcomes in terms of pulmonary artery growth and shunt patency rate after shunt operations using such a small graft. Material and Method: Twenty-five patients rate after shunt operations using 3 or 3.5 mm sized grafts from September 1996 to August 1999. We retrospectively assessed the pulmonary artery growth and the shunt patency rate by reviewing the pre-and post-operative pulmonary angiograms. The risk factors for late death and second shunt operations were also analyzed. To assess the presence of any correlation between body weight and selection of the graft size, regression analysis was done in 81 cases of shunt operations performed during the same period. Result: There were 1(4%) early death and 5(20%) late deaths. The survivors were followed up for an average of 7.34 months. The pulmonary artery index increased significantly from 129$\pm$66$\textrm{mm}^2$/$m^2$ to 213$\pm$114 $\textrm{mm}^2$/$m^2$(p=0.002). The shunt patency rate assessed at postoperative 2, 4, 6 and 8 months were 82.5%, 77%, 73% and 42% respectively with a marked decline between 6 and 8 months. Asplenia was a frequent finding for the patients with late death although the incidence failed to reach statistical significance(p=0.078). Pre-operative diagnosis of PA with VSD was found to be a statistically significant risk factor for a second shunt operation(p=0.01). Body weight(a) at operation and graft size(b) used in the shunt operations revealed strong correlation and could be expressed by the following formula; b=0.128a + 3.233. Conclusion: Adequate growth of pulmonary artery and satisfactory early patency rate could be obtained by modified Blalock-Taussing shunt using 3mm or 3.5mm graft. However, during 6 to 8 months after shunt operations, the patency rate fell sharply, which implicates that close observation and early intervention are mandatory in this period.

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Two Cases of Neonatal Persistent Pulmonary Hypertension Treated by Veno-venous Extracorporeal Membrane Oxygenation (V-V ECMO) (정맥-정맥 도관 체외막형 산소섭취로 치료한 신생아의 지속성 폐동맥 고혈압증 2례)

  • Yu, Hee-Joon;Sung, Se-In;Kim, Jin-Kyu;Seo, Hyun-Joo;Choi, Seo-Heui;Yoo, Hye-Soo;Ahn, So-Yoon;Kim, Eun-Sun;Yang, Ji-Hyuk;Huh, June;Chang, Yun-Sil;Kang, I-Seok;Jun, Tae-Kook;Park, Won-Soon
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.109-115
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    • 2010
  • Persistent pulmonary hypertension in newborns (PPHN) is a disorder of the vascular transition from fetal to neonatal circulation. It results in cyanosis due to right-to-left shunting of the blood through the ductus arteriosus and/or foramen ovale manifesting as hypoxemic respiratory failure. We managed two cases of PPHN after meconium aspiration with high frequency oscillating ventilators and inhaled nitric oxide. They did not respond to conventional management. Veno-venous extracorporeal membrane oxygenation (ECMO) was provided, and ECMO weaning was possible resulting survivals in two cases. We report two PPHN cases, which were treated successfully with veno-venous ECMO for the first time in Korea.

The Effect of Autophagy to Cell Death in Nutrient-Deprived H460 Cells (영양분이 결핍된 H460 세포주에서 자가포식이 세포사멸에 미치는 영향)

  • Jang, Hye-Yeon;Jo, Hyang-Jeong;Hwhang, Ki-Eun;Kim, So-Young;Lee, Kang-Kyoo;Moon, Sun-Rock;Shin, Jeong-Hyun;Cho, Kyung-Hwa;Lee, Mi-Kung;Lee, Sam-Youn;Park, Soon-Ah;Park, Jong-Kun;Kim, Hui-Jung;Yang, Sei-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.2
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    • pp.81-94
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    • 2010
  • Background: Autophagy is an important adaptive mechanism in normal development and in response to changing environmental stimuli in cancer. Previous papers have reported that different types of cancer underwent autophagy to obtain amino acids as energy source of dying cells in nutrient-deprived conditions. However, whether or not autophagy in the process of lung cancer causes death or survival is controversial. Therefore in this study, we investigated whether nutrient deprivation induces autophagy in human H460 lung cancer cells. Methods: H460, lung cancer cells were incubated in RPMI 1640 medium, and the starved media, which are BME and RPMI media without serum, including 2-deoxyl-D-glucose according to time dependence. To evaluate the viability and find out the mechanism of cell death under nutrient-deprived conditions, the MTT assay and flow cytometry were done and analyzed the apoptotic and autophagic related proteins. It is also measured the development of acidic vascular organelles by acridine orange. Results: The nutrient-deprived cancer cell is relatively sensitive to cell death rather than normal nutrition. Massive cytoplasmic vacuolization was seen under nutrient-deprived conditions. Autophagic vacuoles were visible at approximately 12 h and as time ran out, vacuoles became larger and denser with the increasing number of vacuoles. In addition, the proportion of acridine orange stain-positive cells increased according to time dependence. Localization of GFP-LC3 in cytoplasm and expression of LC-3II and Beclin 1 were increased according to time dependence on nutrient-deprived cells. Conclusion: Nutrient deprivation induces cell death through autophagy in H460 lung cancer cells.

TLE1: A New Molecular Target of Synovial Sarcoma (활액막 육종에서 새로운 종양 표지자로서 TLE1의 가치)

  • Cho, Eun-Yun;Kim, Dong-Wook;Seo, Sung-Wook
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.7-12
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    • 2009
  • Purpose: This study was aimed to assess TLE1 as a target molecule of synovial sarcoma. Method: We obtained tissue samples and clinical data from 36 patients who were diagnosed and treated for synovial sarcoma in our hospital. Immunohistochemical staining was performed to detect the expression of TLE1 in synovial sarcoma and normal tissues such as fat, skeletal muscle, peripheral nerve, vascular endothelium, and epithelium. Univariate survival analysis was performed to find whether overexpression of TLE1 is correlated to poor prognosis. Results: TLE1 was expressed in 35 (97%) cases (grade 1 was 5 cases, grade 2 was 28 cases, grade 3 was 2 cases.). Normal tissues from mesenchymal origin did not express TLE1. However, epithelial and endothelial cells showed weak expression (grade 1) of TLE1. The level of TLE1 expression did not have any prognostic significance according to univariate survival analysis. Conclusion: TLE1 may be a new molecular target of synovial sarcoma that differentiates synovial sarcoma from normal mesenchymal cells.

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1,2-Dichloropropane (1,2-DCP)-Induced Angiogenesis in Dermatitis

  • Jin, Meiying;Hong, Youngeun;Lee, Hyunji;Tran, Quangdon;Cho, Hyeonjeong;Kim, Minhee;Kwon, So Hee;Kang, Nak Heon;Park, Jisoo;Park, Jongsun
    • Toxicological Research
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    • v.35 no.4
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    • pp.361-369
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    • 2019
  • 1,2-Dichloropropane (1,2-DCP) has been used as an industrial solvent and a chemical intermediate, as well as in soil fumigants. Human exposure may occur during its production and industrial use. The target organs of 1,2-DCP are the eyes, respiratory system, liver, kidneys, central nervous system, and skin. Repeated or prolonged contact may cause skin sensitization. In this study, 1,2-DCP was dissolved in corn oil at 0, 2.73, 5.75, and 8.75 mL/kg. The skin of mice treated with 1,2-DCP was investigated using western blotting, hematoxylin and eosin staining, and immunohistochemistry. 1,2-DCP was applied to the dorsal skin and both ears of C57BL/6J mice. The thickness of ears and the epidermis increased significantly following treatment, and the appearance of blood vessels was observed in the dorsal skin. Additionally, the expression of vascular endothelial growth factor, which is tightly associated with neovascularization, increased significantly. The levels of protein kinase-B (PKB), phosphorylated PKB, mammalian target of rapamycin (mTOR), and phosphorylated mTOR, all of which are key components of the phosphoinositide 3-kinase/PKB/mTOR signaling pathway, were also enhanced. Taken together, 1,2-DCP induced angiogenesis in dermatitis through the PI3K/PKB/mTOR pathway in the skin.