• 종양간호연구
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• 제1권1호
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• pp.18-31
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• 2001

This Research was designed to develop an instrument that can be used for measuring and analysing the degree of the quality of life of the Allogenic bone marrow transplantation survivors and to provide basic data to help them attain a better quality of life. The subjects of this study were a total of 101 people who were undergone Allogenic bone marrow transplantation and were over 100 days after transplantation. Data were collected during the period from September 3 to December 2. 2000. In Developing this instrument, the researcher established a conceptual framework based on the result of previous research, interview of patients and medical staff and researcher's experience. The scale for this instrument consisted of 51 items. Responses were obtained from the respondents through a self reporting method and each item had a possible score of 5. The collected data were analyzed using the SPSS program. The reliability of the scale was tested by Cronbach‘s alpha. For the examination of the component factors of the measuring instruments, factor analysis method was used. Examination of the difference in the quality of life as related to demographic variables was done using t-test, analysis of variance(ANOVA). For the examination of the major variables influencing the quality of life, Pearson's Correlations was used. The results were as follows: (1) The reliability of the instrument was 0.90 (Cronbach's alpha) (2) The validity of the instrument was tested by factor analysis. The result of the factor analysis of the 51 items is making up the instruments were classified into the following factor; emotional state, Interpersonal problem, physical problem, spiritual state, social problem, decrease of physical energy, physical problem-eye, physical problem-skin and mucosa, health awareness, elimination problem, worry about health, financial problem, sexual problem. (3) Demographic variables related to quality of life is the time after transplantation. GVHD experience, lose of job. Age at the transplantation, diagnosis, type of the transplantation, marital status, monthly income, educational background, sex, religion are not related to the quality of life.

• 보험의학회지
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• 제7권1호
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• pp.7-16
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• 1988

• 대한지역사회영양학회지
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• 제7권4호
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• pp.578-584
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• 2002

This study was designed to investigate the association between the period of engraftment and the nutritional status of patient s undergoing bone marrow transplantation for acute myelogenous leukemia (AML). Nutritional status was evaluated by body mass index (BMI), percentage of ideal body weight (PIBW), percentage of weight loss, and serum albumin, total protein (T protein), hemoglobin (HGB) and hematocrit (HCT) levels on the day prior to transplantation and on the day of bone marrow transplantation. The periods of engraftment were determined by absolute neutrophil counts (ANC) above $500/mm^3$ from the day of bone marrow transplantation. The study subjects were 80 patients (55 males, 25 females) with acute myelogenous leukemia admitted to the University Hospital in Seoul. The result of this study is as follows : Tie nutritional status values of the majority of patients on the day prior to transplantation were in the normal range except for HGB and HCT ; however, during hospitalization, all of the levels of the nutritional status values were significantly decreased. The periods of engraftment of the abnormal group according to their BMI, PIBW, HGB and HCT levels on the day of bone marrow transplantation showed no difference when compared to the normal group. However, the periods of engraftment of the abnormal group, according to the percentage of weight loss, albumin, and T protein levels were significantly decreased when compared to the normal group. Therefore, the nutritional status of patients at the time of transplant had a noticeable influence on the periods of engraftment. Our results suggested that nutritional status is a critical factor of engraftment in BMT during pre-transplant and post-transplant. Futhermore, we recommend that the process of nutritional preparation for the transplant should initiate immediately after the transplant decision has been made.

• 대한임상검사과학회지
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• 제38권1호
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• pp.9-15
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• 2006

Peripheral bood stem cell collection (PBSCC), including peripheral blood stem cell transplantation (PBSCT), has been utilized worldwide as a very beneficial treatment method instead of allogenic Bone Marrow Transplantation (BMT) because it has many advantages such as rapid bone marrow engraftment and hematopoietic recovery, easy and safe accessibility and lower risk of rejection compared with allogenic BMT. In order to identify most the observable parameter in PBSCC, we analyzed various hematological parameters before and after PBSCC, and evaluated the correlation between the time of bone marrow engraftment and the number of CD34+ cells. Thirteen patients, who underwent 54 PBSCCs from January, 2003 to August, 2004 at Chungnam National University Hospital due to various systemic neoplasms, were analyzed in aspects of various hematological parameters including CD34+ cells using by Flow Cytometry (FCM). PBSCC harvests are described below: Mononuclear cells (MNC) $2.3{\pm}1.4{\times}10^8/kg$ and CD34+ cells $0.63{\pm}0.35{\times}10^6/kg$ on average, respectively. There was a statistical significance in Hb and Hct before and after PBSCC, but not in WBC and platelet counts. The period to reach the hematological bone marrow engraftment was 13.4(10~21) days and 19.5(11~38) days according to the criteria of absolute neutrophile counts (ANC) ${\geq}500/uL$ and platelet counts ${\geq}50,000/{\mu}L$ in peripheral blood, respectively. There was a significant correlation between the numbers of CD34+ cell and ANC (p<0.05), and a borderline significance between MNC and ANC (p=0.051). We found that a group of patients, who were infused with CD34+ cells more than $3.5{\times}10^6/kg$, reached more rapidly the period of bone marrow engraftment in platelet counts (p=0.040). This present study suggested that Hb and Hct were the most useful parameters and should be closely monitored before and after PBSCC, that a PBSCT with the dosage of more than $3.5{\times}10^6/kg$ of CD34+ cells was needed to perform successful bone marrow engraftment, and additionally that platelet counts could be more useful in indicating bone marrow engraftment than ANC.

• Tuberculosis and Respiratory Diseases
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• 제49권2호
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• pp.207-216
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• 2000

연구배경 : 동종골수이식은 난치성 혈액질환의 효과적인 치료법이나 약 40%에서 치료와 관련된 합병증으로 사망하고, 그중 10-40%가 폐합병증이 주된 사인이므로 폐합병증의 발생유무는 동종골수이식 치료성적에 중요한 영향을 미친다. 국내에서는 이식편대숙주질환이 서구보다 적고 CMV감염률이 높아 폐합병중이 서구와는 다른 양상으로 나타나리라 사료되어 국내에서 동종 골수이식 후 발생한 폐합병증의 임상양상을 알아보고자 본 연구를 시행하였다. 방법 : 1993년 12월부터 1999년 5월까지 서울중앙병원에서 동종골수이식을 시행한 100명의 성인환자를 대상으로 후향적 코호트법으로 연구하였다. 패합병증은 발생시기에 따라 골수가 생착하는 시기인 30일 전후로 나누고 다시 병인에 따라 감염성 혹은 비감염성으로 분류하였다. 감염성 합병증은 혈액이나 BAL액, 흉막액, 객담검사등에서 병원체가 증명된 경우에서나 임상적으로 감염성 합병증이 의심되는 경우에서 항균제 혹은 항진균제를 사용하여 임상적, 방사선학적 호전이 있는 경우로 정의하였다. 결과 : 1) 폐합병증은 100명중 54명에서 83건이 발생하였다. 2) 30일 이전에는 비감염성 합병증이, 30일 이후에는 감염성 합병증이 더 많이 발생 하였고, 기저질환이 재발되거나 만성 이식편대숙주질환이 없으면 1년 이후에는 감염성 합병증은 발생하지 않았다. 3) 비감염성 합병증으로는 흉막액이 27건으로 가장 많았고, 그 외 비감염성 합병증으로는 폐부종 8건, 미만성 폐포출혈 1 건, BO 2건, BOOP 1건이 있었다. 4) 감염성 합병증은 세균성 폐렴 9 건, 바이러스성 폐렴 4건, 폐결핵 3건, PCP 1건, 진균성 폐렴 5건, 결핵성 흉막염 3건이 있었다. 5) CMV감염과 호중구 회복지연은 폐합병증과 관련된 위험인자로 확인되었다. 6) 폐합병증이 발생한 경우 동종골수이식 후 사망률이 유의하게 높았다. 결론 : 동종골수이식 후 폐합병증은 54%에서 발생하였고, 폐합병증이 발생한 경우에 이식 후 사망률이 증가하였다.

• Tuberculosis and Respiratory Diseases
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• 제57권2호
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• pp.183-187
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• 2004

저자들은 30세 남자 환자에서 골수이식 후 발생한 만성 이식편대숙주질환에 의한 폐쇄성 세기관지염으로 인하여 발병한 이차성 재발성 기흉의 임상적 진단 및 스테로이드와 면역 억제제 치료 후 호전된 증례를 경험하였기에 이에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.98-101
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• 2015

Bronchiolitis obliterans (BO), which is associated with graft-versus-host disease after allogenic hematopoietic stem cell transplantation, is a major obstacle to survival after bone marrow transplantation due to its gradual progress, eventually leading to respiratory failure. Pumpless extracorporeal interventional lung assist (iLA) is effective in treatment of reversible hypercapnic respiratory failure. In this paper, we present a 23-year-old female patient who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) for acute lymphocytic leukemia. After 6 months, she complained of shortness of breath and was diagnosed with BO. Five months later, she developed an upper respiratory tract infection that worsened her BO and caused life-threatening hypercapnia. Since mechanical ventilation failed to eliminate $CO_2$ effectively, iLA was applied as rescue therapy. Her hypercapnia and respiratory acidosis showed significant improvement within a few hours, and she was successfully weaned off iLA after 12 days. This is the first case report of iLA application for temporarily aggravated hypercapnia of PBSCT-associated BO followed by successful weaning. This rescue therapy should be considered in ventilator-refractory reversible hypercapnia in BO patients.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2007년도 추계국제학술대회 및 컨퍼런스
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• pp.588-588
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• 2007

• Journal of Oral Medicine and Pain
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• 제37권3호
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• pp.147-154
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• 2012

조혈줄기세포이식은 면역 결핍 질환, 자가 면역 질환, 악성 조혈 종양의 주된 치료법이다. 이종 조혈줄기세포이식의 주요한 합병증은 이식편대 숙주질환이다. 구강 점막 생검은 이식편대 숙주 질환의 확진과 치료계획 수립을 위해 필요하나 영양 결핍과 화학 요법으로 인해 전신상태가 불량한 환자에게 출혈과 균혈증을 일으킨다. 본 논문에서는 레이저를 이용한 최소 침습적 조직생검의 효능을 평가하였다. 모두 3개의 증례가 소개되었고 모든 환자의 의료 기록, 임상 사진, 조직병리학적 결과가 레이저를 이용한 조직생검의 효능을 평가하기 위해 검토되었다. 모든 환자는 생검 후 불편감이 없었고 심각한 합병증이 발생하지 않았다. 생검 조직의 질이 이식편대 숙주 질환을 확진하는 데에 적당했다. 구강 점막의 레이저를 이용한 최소 침습적 생검은 통상의 조직병리학적 생검에 비해 출혈을 일으키지 않아 감염과 균혈증, 술 후 흉터 생성을 줄이므로 이식편대 숙주 질환의 확진에 이로울 것이다.

• Journal of Oral Medicine and Pain
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• 제25권2호
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• pp.159-165
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• 2000

Subsequent to an allogenic stem cell transplantation(ASCT) on patients with hematologic malignancy(AML, ALL, CML, multiple myeloma, lymphoma etc.), chronic GVHD(graft versus host disease), which is an immunological reaction, occurs. With treatment results from patients who were diagnosed with ALL(acute lymphocytic leukemia), undergone BMT(bone marrow transplantation) and showed oral and skin lesions due to GVHD, treatment of oral manifestations of leukemia and its general management were studied. 90% of patients with chronic GVHD show change in the oral mucosa causing oral manifestations such as leukoplakia, lichenoid change of the oral mucosa, mucosal atrophy, erythema, ulceration and xerostomia. In treating GVHD, extensive systemic immunosuppression cause bacterial, viral, fungal infection that are fatal, and even if the treatment is successful, the patient is already in a severe immunosuppressed state. Therefore, localized target therapy is preferred. In another words, topical application(rinse, cream, ointment etc.) of cyclosporin and steroid in treating oral chronic GVHD is highly recommended, and the use of PUVA(Psoralen Ultraviolet A) and thalidomide is reported to be effective. In treating such diseases, dental treatment to control pain and prevent secondary infection of oral manifestations is very important. To those patients with systemic diseases who show limited effect by general dental treatment, non-invasive treatment such as the dental laser, in addition to the use of drugs, may be necessary to actively treat pain and help the healing process. For greater results, new effective methods are to be developed for treatment.