• 제목/요약/키워드: bone marrow transplantation

검색결과 180건 처리시간 0.026초

외측 거골 골연골 병변에 대한 자가 골연골 이식술 후의 중기 추시 임상결과 (Intermediate-Term Clinical Outcomes after Autologous Osteochondral Transplantation for Lateral Osteochondral Lesions of the Talus)

  • 김성후;조병기
    • 대한족부족관절학회지
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    • 제27권4호
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    • pp.137-143
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    • 2023
  • Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

소아 및 청소년기에서 골수이식 후에 발생할 수 있는 내분비 기능 부전 (Endocrine dysfunction after bone marrow transplantation during childhood and adolescence)

  • 진혜영;최진호;임호준;서종진;문형남;유한욱
    • Clinical and Experimental Pediatrics
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    • 제53권3호
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    • pp.420-427
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    • 2010
  • 목 적 : 소아와 청소년기에 골수이식을 받은 환자들은 여러 가지 조기 또는 후기 합병증이 발생할 수 있다. 본 연구에서는 이식 후 발생할 수 있는 내분비 기능 부전에 대해 분석하여 이식 후 추적 관리에 도움이 되고자 하였다. 방 법 : 골수이식을 받은 100명(남자 61명, 여자 39명)의 환자들을 대상으로 진단명, 이식 당시 연령, 전처치 방법, 만성 이식편대 숙주병 유무, 성장 패턴, 갑상샘 기능, 사춘기 발달 상태 등을 후향적으로 조사하여 내분비 기능 부전과 관련이 있는 위험 인자가 있는지 분석하였다. 결 과 : 이식 당시, 이식 1년후, 최종 내원시의 신장 표준편차 점수는 각각 $0.08{\pm}1.04$, $-0.09{\pm}1.02$, $-0.27{\pm}1.18$로 의미있게 감소하였다(P =0.001). 전처치로 TBI를 받은 경우 TBI를 받지 않은 군에 비하여 이식 전보다 신장 표준편차 점수가 더 많이 감소하였다(P =0.017). TBI를 시행한 환자 중 1명에서 성장 호르몬 결핍을 보였다. 갑상샘 기능 검사를 시행한 94명 중 30명(31.9%)이 보상성 갑상샘저하증이었고 만성 이식편대 숙주병이 있었던 환자에서 보상성 갑상샘저하증의 빈도가 높았다(odds ratio=2.82, P =0.025). 최종 내원 시 만 14세 이상 남자 17명, 만 13세 이상 여자 15명 중에서 비정상적인 LH 또는 FSH의 상승을 보인 경우는 남자 3명, 여자 13명으로 여아가 의미 있게 많았다(odds ratio=30.3, P =0.001). 결 론 : 소아나 청소년기에 골수이식을 받은 환자에서 가장 흔한 내분비 기능 이상은 난소 기능 부전이며 그 외 높은 빈도의 내분비 기능 이상을 보이므로 정기적인 내분비 기능 검사가 필요하다.

방사선 전신조사 (Total Body Irradiation in Leukemia - Preliminary Report -)

  • 장홍석;정수미;최일봉;김춘열;박용휘;김춘추;김동집;이재수
    • Radiation Oncology Journal
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    • 제6권2호
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    • pp.247-251
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    • 1988
  • 1987년 8월부터 1988년 월까지 가톨릭의대 부속 성모병원 방사선과에서는 20명의 급성 백혈병 환자와 만성과립성 백혈병 환자를 6MV선형가속기를 사용하여 전신조사 하였다. 20명의 환자 중 8명은 총 방사선량 1200cGy책 1회 방사선 조사를 받았다. 나머지 2명 중 1명은 4회 분할 조사로 총 850cGy를 받았으며, 다른 1명은 2회 분할 조사하여 총 1100cGy를 받았다. 이식편은 20명중 17명이 동종 이식편을 받았고, 2명이 자가 이식편을 받았으며, 오직 1명만이 부적합 이식편을 받았다. 현재 13멍이 생존해 있고, 7명이 사망했으며, 전신조사에 의한 합병증은 설사, 점막염증, 구토와 구역, 피부발진 등의 순으로 나타났다.

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Gender-independent efficacy of mesenchymal stem cell therapy in sex hormone-deficient bone loss via immunosuppression and resident stem cell recovery

  • Sui, Bing-Dong;Chen, Ji;Zhang, Xin-Yi;He, Tao;Zhao, Pan;Zheng, Chen-Xi;Li, Meng;Hu, Cheng-Hu;Jin, Yan
    • Experimental and Molecular Medicine
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    • 제50권12호
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    • pp.12.1-12.14
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    • 2018
  • Osteoporosis develops with high prevalence in both postmenopausal women and hypogonadal men. Osteoporosis results in significant morbidity, but no cure has been established. Mesenchymal stem cells (MSCs) critically contribute to bone homeostasis and possess potent immunomodulatory/anti-inflammatory capability. Here, we investigated the therapeutic efficacy of using an infusion of MSCs to treat sex hormone-deficient bone loss and its underlying mechanisms. In particular, we compared the impacts of MSC cytotherapy in the two genders with the aim of examining potential gender differences. Using the gonadectomy (GNX) model, we confirmed that the osteoporotic phenotypes were substantially consistent between female and male mice. Importantly, systemic MSC transplantation (MSCT) not only rescued trabecular bone loss in GNX mice but also restored cortical bone mass and bone quality. Unexpectedly, no differences were detected between the genders. Furthermore, MSCT demonstrated an equal efficiency in rectifying the bone remodeling balance in both genders of GNX animals, as proven by the comparable recovery of bone formation and parallel normalization of bone resorption. Mechanistically, using green fluorescent protein (GFP)-based cell-tracing, we demonstrated rapid engraftment but poor inhabitation of donor MSCs in the GNX recipient bone marrow of each gender. Alternatively, MSCT uniformly reduced the $CD3^+T$-cell population and suppressed the serum levels of inflammatory cytokines in reversing female and male GNX osteoporosis, which was attributed to the ability of the MSC to induce T-cell apoptosis. Immunosuppression in the microenvironment eventually led to functional recovery of endogenous MSCs, which resulted in restored osteogenesis and normalized behavior to modulate osteoclastogenesis. Collectively, these data revealed recipient sexually monomorphic responses to MSC therapy in gonadal steroid deficiency-induced osteoporosis via immunosuppression/anti-inflammation and resident stem cell recovery.

가토 모델에서 인체지방유래 줄기세포가 슬관절의 퇴행성 변화에 미치는 영향 (The Effects of Human Adipose Tissue-derived Stem Cells on Degenerative Change of Knee in Rabbit Model)

  • 정기환;김석권;정재우;허정;권용석;이근철
    • Archives of Plastic Surgery
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    • 제35권6호
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    • pp.637-644
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    • 2008
  • Purpose: The survival of bone marrow derived stem cell was reported several times. But the survival of adipose tissue derived stem cells(hASCs) was not mentioned on. We studied the adipose tissue derived stem cell's survival and effect on articular cartilage in rabbits. Methods: Osteoarthritis was induced in twenty New Zealand white rabbits by intraarticular injection of monosodium iodoacetate(MIA). After four weeks, hASCs were also injected into the knee joints space without any vehicle, but the control group received phosphate buffered saline only. The histologic grade of articular cartilage was measured in 4 and 8 weeks after the transplantation of hASC and the viability of injected stem cells measured by Fluorescent in situ Hybridization (FISH) examination. Results: After 4 and 8 weeks from hASCs transplantation, histologic grade was not significantly difference between two groups(p>0.05), and the Y chromosome of the transplanted hASCs was not detected in articular cartilage. Conclusion: We found that direct injection of hASC in joint space didn't work on damaged articular cartilage repair.

백혈병 환자의 구강악안면 증상 발현에 관한 증례보고 (Oral Chronic GVHD) (A Case Report on Oro-Facial Manifestations in Leukemia (Oral Chronic GVHD))

  • 안형준;권병기;신경진;최종훈;김종열
    • 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.

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Characterization of the KG1a Cell Line for Use in a Cell Migration Based Screening Assay

  • Bernhard O. Palsson;Karl francis;Lee, Gyun-Min
    • Biotechnology and Bioprocess Engineering:BBE
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    • 제7권3호
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    • pp.178-184
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    • 2002
  • High-throughput screening has become a popular method used to identify new “leads”for potentially therapeutic compounds. Further screening of these lead compounds is typically done with secondary assays which may utilize living, functioning cells as screening tools. A problem (or benefit) with these cell-based assays is that living cells are very sensitive to their environment. We have been interested in the process of stem cell migration and how it relates to the cellular therapy of bone marrow transplantation. In this study we describe a secondary, cell-based assay for screening the effects of various in-vitro conditions on Immature Hematopoietic Cell (IHC) migration. Our results have revealed many subtle factors, such as the cell's adhesive characteristics, or the effect of a culture's growth phase, that need to be accounted for in a screening protocol. Finally, we show that exponentially glowing KG1a cells (a human IHC cell line) were 10 times more motile than those in the lag or stationary phases. These data strongly suggest that KG1a cells secrete a chemokinetic factor during the exponential growth phase of a culture.

Inhibition Effect of Human Cytomegalovirus Replication by Peptide nucleic acids (PNA)

  • Park, Young-Doo;Eum, Jin-Seong;Paik, Soon-Young;Hong, Seong-Karp
    • 한국정보통신학회:학술대회논문집
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    • 한국해양정보통신학회 2008년도 춘계종합학술대회 A
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    • pp.971-975
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    • 2008
  • Human cytomegalovirus (HCMV) provokes fatal infections in AIDS patients that have deficient immune functions and patients that have cellular immune responses repressed after bone marrow transplantation. A new candidate for therapeutic against HCMV is needed because conventional treatments as ganciclovir, acyclovir, cidofovir, and foscarnet cytosine used currently are improper due to their side effects and advent of resistant HCMV. In this study, peptide nucleic acids (PNAs) against UL54 (DNA polymerase) and UL97 (phosphotransferase) that were essential in replication of HCMV were applied in inhibition of replication of HCMV. From the results of this study, 4 PNAs $_{PNA}UL97-1$, $_{PNA}UL97-2$, $_{PNA}UL54-3$, and $_{PNA}UL54-4$ showed 3.7, 3.1, 1.7, and 1.6 folds of inhibition effect against replication of HCMV in the human fibroblast cells. These PNA suggest a novel possibility as therapeutic against HCMV.

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Neo-Adjuvant Chemotherapy Followed by Surgery for Extensive Calvarial Metastases of a Neuroblastoma

  • Kim, Sang-Deok;Jung, Tae-Young;Jung, Shin;Baek, Hee-Jo
    • Journal of Korean Neurosurgical Society
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    • 제49권1호
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    • pp.68-70
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    • 2011
  • Neuroblastoma is a common tumor of children. We report a patient with extensive calvarial metastases of a neuroblastoma as an initial presentation. A 2-year-old girl presented with a history of gradually increasing head size and fever. A brain CT showed a multilobulated, large, extra-axial tumor involving both frontotemporoparietal areas with a sunray-spiculated hyperostosis of the skull and marked contrast enhancement. A brain MRI demonstrated extensive calvarial lesions with simultaneous involvement of the orbits. A biopsy was performed and a ganglioneuroblastoma was diagnosed. On systemic evaluation, an enlarged abdominal mass was detected. After neo-adjuvant chemotherapy, most of the tumors disappeared except for a tumor in the left parietal area; there was a corresponding decrease in the circumference of the head. We performed surgery for the remnant mass. Intensive chemotherapy was administered and a bone marrow transplantation was performed. Adequate neo-adjuvant chemotherapy followed by surgery to the neuroblatoma with extensive metastases to the skull and orbit may be helpful.

유전성 대사질환의 치료 및 관리 (Treatment and management of patients with inherited metabolic diseases)

  • 이진성
    • Clinical and Experimental Pediatrics
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    • 제49권11호
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    • pp.1152-1157
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    • 2006
  • Inherited metabolic disease is rare disorders that show symptoms mainly in pediatric age and early treatment is important for preventing complications of the disease. Recent development in molecular and biochemical techniques help clinicians with proper diagnosis of patients, however, many of the disease still remain lack of effective therapeutic strategies. Better understanding on biochemical and molecular basis of pathogenesis of the disease combined with advanced medical care would provide new sight on the disease that can also improve the quality of life and long-term prognosis of patients. Traditionally, there are several modalities in the treatment of metabolic diseases depend on the biochemical basis of the disease such as diet restriction, removing or blocking the production of toxic metabolites, and stimulating residual enzyme activity. The inherited metabolic disease is not familiar for many clinicians because the diagnosis is troublesome, treatment is complicated and prognosis may not as good as expected in other diseases. Recently, new therapeutic regimens have been introduced that can significantly improve the medical care of patients with metabolic disease. Enzyme replacement therapy has showed promising efficacy for lysosomal storage disease, bone marrow transplantation is effective in some disease and gene therapy has been trying for different diseases. The new trials for treatment of the disease will give us promising insight on the disease and most clinicians should have more interest in medical progress of the metabolic disease.