Augmentation Cystoplasty using Hydroxapatite/chitosan Composite Sheet Seeded with Autologous Muscle-derived Stem Cells / 대한비뇨기과학회지

PURPOSE: This study was designed to investigate the feasibility of a hydroxyapatite/chitosan (HAp/chitosan) composite, seeded with autologous muscle-derived stem cells, as a partial bladder substitute in rats. MATERIALS AND METHODS: Muscle-derived stem cells were isolated from the gastrocnemius muscle of 6 female Sprague-Dawley rats, using the preplate technique, and cultured on HAp/chitosan composite sheets. Sheets with 10mm diameters were implanted into the urinary bladder of rats following a hemicystectomy in an autologous fashion. Three rats were sacrificed 4 and 8 weeks postoperatively, and the morphological changes subsequently assessed by H&E and immunofluorescence staining using DAPI, myogenin and alpha-smooth muscle actin (SMA). RESULTS: All rats survived the scheduled duration. Adequate epithelialization was observed to be completed after postoperative week 4. Abundant muscle bundles, showing positive alpha-SMA staining, were observed after the 4th week. The bladder shape was well preserved after the 8th week. Ingrowing smooth muscles were observed on the periphery of the composite and muscular bundles, with positive myogenin immunostaining in the middle of the composite. CONCLUSIONS: A HAp/chitosan composite sheet, seeded with autologous muscle-derived stem cells, showed a degree of skeletal muscle differentiation 8 weeks after augmentation cystoplasty, in an autologous fashion. This new material seeded with muscle-derived stem cells may, in the future, prove to be a viable option as a partial bladder substitute.

Arm Morbidity after Breast Cancer Treatments and Analysis of Related Factors / 대한방사선종양학회지

PURPOSE: To evaluate the incidence of arm morbidity following breast cancer surgery including axillary dissection and to identify related factors. MATERIASL AND METHODS: One hundred and fifty nine patients were studied using a self-report questionnaire and a clinical examination. Lymphedema, reduction of range of motion in shoulder joint and subjective symptoms (pain, impaired arm movement, numbness, stiffness) were evaluated. As related factors, demographic, oncologic characteristics and types of treatment were analysed. RESULTS: The incidence of lymphedema (> or =2 cm difference comparing to unaffected arm) was 6.3%, 10.7%, 22.6% and 23.3% at each 10 cm, 20 cm, 30 cm, and 40 cm from wrist. Reduction of range of motion in shoulder joint (> or =20 degree difference comparing to unaffected arm) was noted in more than 1/3 patients for flexion, abduction and internal rotation. Especially the reduction of range of motion in internal rotation was severe (> 50% reduction) in 1/3 patients. Approximately 50 to 60% of patients complained impaired arm movement, numbness, stiffness and pain. Body mass index (BMI) was the significant risk factor for lymphedema. CONCLUSION: Lymphedema was present in 1/3 of patients and the common sites of edema were 30 cm 40 cm proximal from the wrist. Also most severe reduction of range of motion in shoulder joint was with internal rotation. There needs weight control for lymphedema because BMI was the significant risk factor for lymphedema. Also rehabilitation program for range of motion especially internal rotation in shoulder joint should be developed.

A Clinical Use of CT Scan in Rectal Cancer / 영남의대학술지

Authors evaluated the accuracy of preoperative pelvic CT scan staging and its effects on management in 12 biopsy proved rectal cancer patients. Authors also studied postoperative CT in 5 patients to detect disease recurrence and metastasis. Preoperative CT staging was identical to surgical and/or pathological staging in 9 patients (75%), but it was underestimated in two cases and overestimated in one instance than in surgical stagings. In 7 cases, CT scan did not alter original choice of procedures. However, preoperative CT staging gave definitive informations to change management plans in 5 cases otherwise the treatment would be difficult and inadequate. Postoperative CT showed local recurrence in one and liver metastases in 2 cases. One of them was not detected at exploratory laparotomy.

Leiomyosarcoma of Small Intestine: Two Cases Report with Literatural Review / 영남의대학술지

Small bowel malignancy consists 1~2% of overall gastrointestinal tract cancer and leiomyosarcomas of small intestine are 10~20% of small bowel malignancy. Small bowel leiomyosarcomas are rare in incidence and have no specific symptoms, signs or definite radiologic findings, so it is not easy to diagnose at early stage of disease. They are found occasionally by unknown origined gastrointestinal bleeding, abdominal pain, intestinal obstruction, perforation and palpable mass, and diagnosed mostly by operation. Recently annual case reports are increasing trend in Korea. We experienced two cases of small bowel leiomyosarcomas which was diagnosed finally by pathologic findings, so we report them with literatural review.