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1.  Modification of a Rodent Hindlimb Model of Secondary Lymphedema: Surgical Radicality versus Radiotherapeutic Ablation 
BioMed Research International  2013;2013:208912.
Secondary lymphedema is an intractable disease mainly caused by damage of the lymphatic system during surgery, yet studies are limited by the lack of suitable animal models. The purpose of this study was to create an improved model of secondary lymphedema in the hindlimbs of rodents with sustained effects and able to mimic human lymphedema. This was achieved by combining previously reported surgical methods and radiation to induce chronic lymphedema. Despite more radical surgical destruction of superficial and deep lymphatic vessels, surgery alone was not enough to sustain increased hindlimb volume. Radiotherapy was necessary to prolong these effects, with decreased lymphatic flow on lymphoscintigraphy, but hindlimb necrosis occurred after 4 weeks due to radiation toxicity. The applicability of this model for studies of therapeutic lymphangiogenesis was subsequently tested by injecting muscle-derived stem cells previously cocultured with the supernatant of human lymphatic endothelial cells in vitro. There was a tendency for increased lymphatic flow which significantly increased lymphatic vessel formation after cell injection, but attenuation of hindlimb volume was not observed. These results suggest that further refinement of the rodent hindlimb model is needed by titration of adequate radiation dosage, while stem cell lymphangiogenesis seems to be a promising approach.
doi:10.1155/2013/208912
PMCID: PMC3856125  PMID: 24350251
2.  Prospective investigation of penile length with newborn male circumcision and second to fourth digit ratio 
Canadian Urological Association Journal  2016;10(9-10):E296-E299.
Introduction:
We prospectively investigated the relationship between newborn male circumcision (NMC) and second to fourth digit ratio with penile length.
Methods:
As participants for our study, we identified already circumcised young patients who visited our hospital for urological treatment. The age at which the circumcision had been done was assessed. The patients’ height and weight were measured. Second to fourth digit ratio was calculated by measuring the second and fourth digit lengths. The flaccid and erectile penile lengths were measured from the base of the penis to the tip of the glans in standing position.
Results:
A total of 248 patients were included in our study. In univariate analysis, height, second to fourth digit ratio, flaccid penile length, and age of circumcision were associated with erectile penile length. Among these variables, second to fourth digit ratio, flaccid penile length, and age of circumcision were significant predictive factors for erectile penile length in multivariate analysis. The subjects were divided into two groups, including 72 patients in the NMC group and 176 patients in the non-NMC group. No significant difference was found in height, weight, and second to fourth digit ratio between both groups. However, flaccid (p<0.001) and erectile (p=0.001) penile lengths were shorter in the NMC group than in the non-NMC group.
Conclusions:
Despite the small number of subjects, this study shows that NMC was associated with shorter penile length. Second to fourth digit ratio, flaccid penile length, and age of circumcision were also significant predictive factors for erectile penile length. Further multicentre studies with larger number of subjects and biochemical analyses are needed for potential clinical applicability.
doi:10.5489/cuaj.3590
PMCID: PMC5028213  PMID: 27695583
3.  Rescue Therapy of Inadvertent Coil Migration for Endovascular Treatment of Type II Endoleak 
Coil migration during endovascular procedures is not an unusual complication, but there is no standard management strategy for bailout. Here, we describe a technique for removal of a migrated coil using a snare. During embolization of type II endoleak from the inferior mesenteric artery in a post-endovascular aneurysm repair patient, the coil migrated to the sigmoidal artery causing an occlusion. We used a microsnare loop and successfully retrieved the migrated coil. This is the first case in Korea that uses a loop snare for the removal of a migrated coil during visceral endovascular treatment to our knowledge. This technique of using a microsnare for removal of displaced coils can be a good resort in selected cases.
doi:10.5758/vsi.2016.32.1.22
PMCID: PMC4816022  PMID: 27051657
Endovascular aneurysm repair; Type 2 endoleak; Coil embolization
4.  Ureteropelvic junction obstruction and renal cell carcinoma in a patient with solitary functioning kidney 
Canadian Urological Association Journal  2016;10(3-4):E114-E116.
We present a case of ureteropelvic junction obstruction (UPJO) and renal cell carcinoma (RCC) in a solitary functioning kidney (SFK), managed by robot-assisted dismembered pyeloplasty with partial nephrectomy in a single stage. To our best knowledge, we report the first case of UPJO with RCC in a congenital SFK.
doi:10.5489/cuaj.3002
PMCID: PMC4907773  PMID: 27330578
5.  Spontaneous Iliac Vein Rupture 
Spontaneous iliac vein rupture (SIVR) is a rare entity, which usually occurs without a precipitating factor, but can be a life-threatening emergency often requiring an emergency operation. This is a case report of SIVR in a 62-year-old female who presented to the emergency room with left leg swelling. Workup with contrast-enhanced computed tomography revealed a left leg deep vein thrombosis with May-Thurner syndrome and a hematoma in the pelvic cavity without definite evidence of arterial bleeding. She was managed conservatively without surgical intervention, and also underwent inferior vena cava filter insertion and subsequent anticoagulation therapy for pulmonary thromboembolism. This case shows that SIVR can be successfully managed with close monitoring and conservative management, and anticoagulation may be safely applied despite the patient presenting with venous bleeding.
doi:10.5758/vsi.2015.31.2.62
PMCID: PMC4508654  PMID: 26217647
Spontaneous rupture; Iliac vein; Hemoperitoneum
6.  Recent Advances in the Development of Experimental Animal Models Mimicking Human Aortic Aneurysms 
Aortic aneurysm is a common and life-threatening disease that can cause death from rupture. Current therapeutic options are limited to surgical or endovascular procedures because no pharmacological approaches have been proven to decrease the chance of expansion or rupture. The best approach to the management of aortic aneurysm would be the understanding and prevention of the processes involved in disease occurrence, progression, and rupture. There is a need for animal models that can reproduce the pathophysiological features of human aortic aneurysm, and several such models have been studied. This review will emphasize recent advances in animal models used in the determination of mechanisms and treatments of aortic aneurysms.
doi:10.5758/vsi.2015.31.1.1
PMCID: PMC4480291  PMID: 26217637
Aorta; Aneurysm; Animal model; Research
7.  Tracking the Fate of Muscle-derived Stem Cells: an Insight into the Distribution and Mode of Action 
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 timede pendent 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 found 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.
doi:10.5758/vsi.2014.30.1.11
PMCID: PMC4480300  PMID: 26217610
Vascular diseases; Stem cell niche; Survival; Adult stem cells
8.  Prospective nonrandomized comparison of quality of life and recurrence between high ligation and stripping and radiofrequency ablation for varicose veins 
Purpose
Varicose veins are a major problem worldwide and improvement in quality of life (QoL) is the ultimate goal after treatment of this benign disease. However QoL is highly dependent on personal and social factors. This study compares high ligation and stripping (HS) and radiofrequency ablation (RFA) in terms of QoL and recurrence in Korea.
Methods
A retrospective analysis of prospectively collected data between August 2006 and October 2008 was performed for patients undergoing HS and RFA at a single institution. QoL was assessed with a questionnaire preoperatively, at 3 months postoperatively and annually thereafter. Recurrence was assessed by Duplex ultrasound annually after surgery.
RESULTS
A total of 272 patients completed the questionnaire at 3 months. Among these patients, 155 patients returned for their annual follow-up. There were no significant differences between HS and RFA in global QoL scores, although RFA showed less pain. However, paresthesia rates were also higher after RFA. Recurrence rates were similar between the two modalities, although technical failures were more common after RFA.
Conclusion
Overall QoL and recurrence rates were similar between the two modalities. The benefits of RFA do not seem to be enough to overcome the higher costs of HS in Korea.
doi:10.4174/jkss.2013.84.1.48
PMCID: PMC3539110  PMID: 23323236
Varicose veins; Radiofrequency catheter ablation; Recurrence; Quality of life
9.  Experience of non-vascular complications following endovascular aneurysm repair for abdominal aortic aneurysm 
Journal of the Korean Surgical Society  2011;80(Suppl 1):S67-S70.
Endovascular aneurysm repair (EVAR) for the treatment of abdominal aortic aneurysm (AAA) is a widely used method, and its decreased invasiveness compared to traditional surgical repair has brought about reduced rates of morbidity and mortality. Several vascular complications related to the procedure have been reported, but non-vascular complications have rarely occurred. We report herein the case of a 78-year-old man who underwent EVAR for AAA and presented with active duodenal ulcer bleeding and acute acalculous cholecystitis as complications after the procedure. We must consider that a wide spectrum of complications may occur following EVAR, and therefore it is important to evaluate the risks of complication and to take the necessary measures to minimize them.
doi:10.4174/jkss.2011.80.Suppl1.S67
PMCID: PMC3205366  PMID: 22066089
Complication; Endovascular aneurysm repair; Abdominal aortic aneurysm

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