• Clinical and Experimental Pediatrics
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• 제58권12호
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• pp.459-465
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• 2015

Postinfectious bronchiolitis obliterans (PIBO) is an irreversible obstructive lung disease characterized by subepithelial inflammation and fibrotic narrowing of the bronchioles after lower respiratory tract infection during childhood, especially early childhood. Although diagnosis of PIBO should be confirmed by histopathology, it is generally based on history and clinical findings. Irreversible airway obstruction is demonstrated by decreased forced expiratory volume in 1 second with an absent bronchodilator response, and by mosaic perfusion, air trapping, and/or bronchiectasis on computed tomography images. However, lung function tests using spirometry are not feasible in young children, and most cases of PIBO develop during early childhood. Further studies focused on obtaining serial measurements of lung function in infants and toddlers with a risk of bronchiolitis obliterans (BO) after lower respiratory tract infection are therefore needed. Although an optimal treatment for PIBO has not been established, corticosteroids have been used to target the inflammatory component. Other treatment modalities for BO after lung transplantation or hematopoietic stem cell transplantation have been studied in clinical trials, and the results can be extrapolated for the treatment of PIBO. Lung transplantation remains the final option for children with PIBO who have progressed to end-stage lung disease.

• IMMUNE NETWORK
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• 제11권6호
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• pp.368-375
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• 2011

Background: Recent clinical observation reported that there was a significant correlation between change in circulating vascular endothelial growth factor (VEGF) levels and the occurrence of severe acute graft-versus-host disease (GVHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT), but the action mechanisms of VEGF in GVHD have not been demonstrated. Methods: This study investigated whether or not blockade of VEGF has an effect on acute GVHD in a lethally irradiated murine allo-HSCT model of $B6\;(H-2^b)\;{\rightarrow}B6D2F1\;(H-2^{b/d})$. Syngeneic or allogeneic recipient mice were injected subcutaneously with anti-VEGF peptides, dRK6 ($50{\mu}g/dose$) or control diluent every other day for 2 weeks (total 7 doses). Results: Administration of the dRK6 peptide after allo-HSCT significantly reduced survival with greaterclinical GVHD scores and body weight loss. Allogeneic recipients injected with the dRK6 peptide exhibited significantly increased circulating levels of VEGF and expansion of donor $CD3^+$ T cells on day +7 compared to control treated animals. The donor $CD4^+$ and $CD8^+$ T-cell subsets have differential expansion caused by the dRK6 injection. The circulating VEGF levels were reduced on day +14 regardless of blockade of VEGF. Conclusion: Together these findings demonstrate that the allo-reactive responses after allo-HSCT are exaggerated by the blockade of VEGF. VEGF seems to be consumed during the progression of acute GVHD in this murine allo-HSCT model.

• 기본간호학회지
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• 제13권3호
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• pp.428-436
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• 2006

Purpose: To investigate the levels of uncertainty and anxiety at admission and discharge to the isolation unit for patients undergoing hematopoietic stem cell transplantation (HSCT). Method: The data were collected from 60 patients who were admitted to the department of HSCT. Uncertainty and anxiety were assessed using the Mishel Uncertainty in Illness Scale (MUIS) and Anxiety Inventory (STAI). Collected data were analyzed using the SAS program. Results: The mean score for anxiety at admission was 2.20, and at discharge 2.10. The mean score for uncertainty at admission was 2.19, and at discharge 2.07. The anxiety at admission the group with physical discomfort was higher than that of group without physical discomfort. A positive relationship was found between anxiety and uncertainty at admission and at discharge. The major variables were expectation for cure and physical discomfort, explaining 25.87% of the anxiety at admission. The major variable was expectation for cure, explaining 20.94% of the uncertainty at admission. Conclusion: Front the above results, it can be concluded that support and consideration are required to reduce anxiety of the inpatient in single room.

• 대한의생명과학회지
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• 제18권2호
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• pp.131-138
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• 2012

Autologous peripheral blood stem cell transplantation (PBSCT) has been used as a major treatment strategy for hematological malignancies. The number of CD34 positive cells in the harvested product is a very important factor for achieving successful transplantation. We studied the factors that can predict the number of CD34 positive cells in the harvested product of acute myelocytic leukemia (AML), multiple myeloma (MM) and Non-Hodgkin's lymphoma (NHL) patients after mobilizing them with chemotherapy plus G-CSF. A total of 73 patients (AML 19 patients, MM 28 patients, NHL 26 patients) with hematological malignancies had been mobilized with chemotherapy and granulocyte colony-stimulating growth factor from April, 2000 to February, 2012. Group's characteristics, checkup opinion of pre-peripheral blood on the day of harvest & outcome of PBSC were analyzed and evaluated using SPSS statistics program after grouping patients as below; group 1: CD34 cell counts < $2{\times}10^6/kg$ (n=16); group 2: $2{\times}10^6/kg{\leq}CD34$ cell counts < $6{\times}10^6/kg$ (n=32); group 3: CD34 cell counts ${\geq}6{\times}10^6/kg$ (n=25). We analyzed the clinical characteristics, the peripheral blood (PB) parameters and the number of CD34 positive cells in the PB and their correlation with the yield of CD34 positive cells collected from the mobilized patients. The total number of leukapheresis sessions was 263 (mean: 3.55 session per patient), and the mean number of harvested CD34 positive cells per patient was $7.37{\times}10^6/kg$. The number of CD34 positive cells in product was significantly correlated with the number of platelet and CD34 positive cells in peripheral blood (P<0.05). The number of PB CD34 positive cells was the best significant factor for the quantity of harvested CD34 positive cells on the linear regression analysis (P<0.05). Many factors could influence the mobilization of peripheral blood stem cells. Platelet count and PB CD34 positive cells count were the two variables which remained to be significant in multivariate analysis. Therefore, the number of platelet and CD34 positive cells in peripheral blood on the day of harvest can be used as an accurate predictor for successful peripheral blood stem cell collection.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2001년도 추계학술발표대회
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• pp.475-478
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• 2001

체외에서 hematopoietic cells의 배양은 필수이식으로 하여금 hematopoietic malignancies로 인해 고통받는 환자들을 치료할 수 있다. 본 실험에서는 골수의 초기 농도$1.5{\times}10^6cells/ml$로 하여 IL-3(5ng/ml), SCF(5ng/ml)과 FL(25ng/ml)의 성장 인자들을 첨가함으로써 bone marrow의 전체 cell의 증식은 생성시키지 못 했지만 LTC-IC는 3.6배의 증식을 가져왔다.

• Clinical and Experimental Pediatrics
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• 제56권7호
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• pp.298-303
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• 2013

Purpose: The purpose of this study was to evaluate short-term thyroid dysfunction and related risk factors in pediatric patients who underwent hematopoietic stem cell transplantation (HSCT) during childhood. Methods: We studied 166 patients (100 boys and 66 girls) who underwent HSCT at the Catholic HSCT Center from January 2004 through December 2009. The mean age at HSCT was $10.0{\pm}4.8$ years. Thyroid function of the patients was tested before and during 3 months of HSCT. Results: Out of 166 patients, 165 (99.4%) underwent allotransplantation. Acute graft-versus-host disease (GVHD, grades II to IV) developed in 76 patients. Conditioning regimens before HSCT include total body irradiation (n=57), busulfan (n=80), and reduced intensity (n=29). Forty-five (27.1%) had thyroid dysfunction during 3 months after HSCT (29 euthyroid sick syndrome [ESS], 6 subclinical hyperthyroidism, 4 subclinical hypothyroidism, 3 hypothyroxinemia, 2 overt hyperthyroidism, and 1 high $T_4$ syndrome). In a univariate logistic regression analysis, age at HSCT (P=0.002) and acute GVHD (P=0.009) had statistically significant relationships with thyroid dysfunction during 3 months after HSCT. Also, in a univariate logistic regression analysis, ESS (P=0.014) showed a strong statistically significant association with mortality. Conclusion: In our study 27.1% patients experienced thyroid dysfunction during 3 months after HSCT. Increase in age and acute GVHD may be risk factors for thyroid dysfunction during 3 months after HSCT. There was a significant association between ESS and mortality.

• Clinical and Experimental Pediatrics
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• 제58권6호
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• pp.199-205
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• 2015

Severe aplastic anemia (SAA) is a life-threatening disorder for which allogeneic hematopoietic stem cell transplantation (HSCT) is the current available curative treatment. HSCT from matched sibling donors (MSDs) is the preferred therapy for children with acquired SAA. For patients who lack MSDs, immunosuppressive therapy (IST) is widely accepted as a first-line treatment before considering HCT from an unrelated donor (URD). Given the recent progress in HSCT using URDs for childhood SAA, well-matched URDs became a realistic alternative for pediatric patients who have no suitable related donors and who are refractory to IST. However, it is quite challenging to treat patients with refractory SAA who lack suitable related or URDs. Even though haploidentical HSCT from genetically mismatched family members seemed to be an attractive procedure with the amazing benefit of readily available donors for most patients, early attempts were disappointing because of refractory graft-versus-host disease (GVHD) and excessively high transplant-related mortality. Recent advances with effective ex vivo depletion of T cells or unmanipulated in vivo regulation of T cells, better supportive care, and optimal conditioning regimens have significantly improved the outcome of haploidentical transplant. Besides considerable progress in the treatment of malignant diseases, recent emerging evidences for haploidentical HSCT in SAA has provided additional therapeutic options for patients with refractory diseases. Further improvements to decrease the rates of graft failure, GVHD, and infectious complications will facilitate the emergence of haploidentical HSCT as a front-line therapy for treating acquired SAA in children and adolescents who have no suitably matched donors.

• 성인간호학회지
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• 제28권1호
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• pp.30-42
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• 2016

Purpose: This study aimed to examine the relationships among social support(family support, medical team support), hope, anxiety, and depression in patients with hematologic cancers before they received hematopoietic stem cell transplantation (HSCT) to obtain baseline data for developing a nursing intervention. Methods: The participants were 70 adult patients expecting to receive HSCT from 5 university hospitals in Seoul, Gyeonggi-do, and Jeollanam-do regions. A cross-sectional survey was done using standardized instruments for social support (Tae's Family Support Scale and Professional Medical Support Scale), hope (Kim & Lee Hope Scale), anxiety and depression (Hospital Anxiety and Depression Scale). The data were analyzed by SPSS/WIN 19.0 program using frequency, percentage, item mean and standard deviation, t-test, ANOVA, and Pearson's correlation coefficient. Results: Hope was significantly correlated with social support (r=.40, p=.001), anxiety (r=-.40, p<.001) and depression (r=-.58, p<.001). Anxiety was correlated with depression (r=.54, p<.001). Conclusion: The findings of this study show greater social support for patients who expect to receive HSCT is significantly correlated to a higher level of hope, as well as low levels of anxiety and depression. In nursing practice, clinical nurses may develop a nursing intervention to reinforce social support and hope, as well as reduce anxiety and depression for patients preparing for HSCT.

• 재활간호학회지
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• 제6권2호
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• pp.127-136
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• 2003

Purpose: This study is to assess the quality of life(QOL) of hematic cancer survivors after hematopoietic stem cell transplantation(HSCT) and received chemotherapy(RC) to prepare basic information for nursing interventions in order to improve the patients' QOL. Method: The data were collected by self-reporting questionnaire from January to March, 2003 intended for outpatients at the Cancer center of D university hospital in Busan. All 44 of them were diagnosed as hematic cancer and had spent 100 days after getting HSCT and complete remission(CR) throughout RC. The collected data were analyzed with descriptive statistics, t-test, ANOVA using SPSS/WIN 10.0 program. Results: The total mean score of the QOL was moderate. In case of survivors in HSCT, the total mean score of the QOL was $5.81{\pm}1.08$, and that of survivors in RC was $5.94{\pm}1.13$. The facts above has not been considered statistically as the result of analysis of differences in each domain of the QOL depending on the general characteristics of the objects of this study. Conclusion: The total mean score of the QOL was at moderate levels, indicating that the survivors after HSCT and RC were perceiving their QOL as moderate. In the nursing business aspect, the most important thing is to understand the QOL which the 2 groups of the survivors perceive, and the plans of nursing intervention that can be helpful to more qualitative life should be studied constantly.

• 한국융합학회논문지
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• 제8권4호
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• pp.49-57
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• 2017

본 연구는 소아암 환아의 조혈모세포이식 후 성장을 확인하고, 이에 영향을 미치는 요인들을 조사하고자 진행된 융합연구이다. 2009년 2월부터 3월까지 조혈모세포이식을 받은 소아암 환아 112명의 의무기록으로부터 키와 몸무게를 조사하였으며 자료 분석을 위해 혼합효과 모델을 사용하였다. 연구 결과 조혈모세포이식 후 대상자의 신장과 체중의 표준과의 평균표준편차값이 음의 값이었으며 동종이식 보다 자가이식의 경우 신장(p=0.0008)과 체중(p=0.0012)의 평균이 낮았다. 이식 후 신장에 영향을 주는 것으로 대상자의 이식 시 연령(p=0.0251)과 이식 형태(p=0.0020)가 확인되었으며. 동종이식 환아에서는 성장에 영향을 주는 것으로 스테로이드의 사용량이 확인되었다(p=0.0403). 대상자의 이식 후 체중은 이식 시 연령(p=0.0042), 이식형태(p=0.0035) 그리고 총정맥영양의 주입기간(p=0.0159)에 영향을 받는 것으로 나타났다. 본 연구 결과를 바탕으로 소아암 환아의 조혈모세포이식 후 성장이 잘 이루어질 수 있도록 성장저하의 고위험군을 식별할 수 있도록 하여야하며, 이러한 환아에게 적절한 간호중재가 수행되어야 할 것이다.