• Journal of Chest Surgery
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• 제40권9호
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• pp.617-623
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• 2007

배경: 침습성 폐아스페르길루스증은 면역체계가 낮은 환자들에게 흔한 진균감염으로, 특히 백혈병으로 항암제 치료를 받고 있는 환자들에서는 항진균제 치료에 반응이 적은 것으로 알려져 있다. 저자들은 백혈병의 치료 중 합병된 폐아스페르길루스증에 대하여 모두 폐절제술을 시행하였으며, 그의 효과 등을 알아보고자 하였다. 대상 및 방법: 1998년 2월부터 2007년 4월까지 혈액암 질환의 진단과 함께 침습성 폐아스페르길루스증 진단을 받은 환자 14명을 대상으로 후향적인 검토를 하였다. 환자의 의무기록을 통해 혈액암(기저질환)의 종류와 그에 따른 치료, 침습성 폐아스페르길루스증의 진단방법, 수술 전 혈액학적 상태와 처치, 수술방법, 수술 후 합병증과 사망여부, 수술 후 폐아스페르길루스증의 재발현율 및 골수이식 여부 등을 조사하였다. 결과: 침습성 폐아스페르길루스증이 합병된 혈액암 환자 14명에서 모두 폐엽절제술이 시행되었다. 수술 후 1명의 환자에서 기관지흉막루가 발생되었으나, 기타 창상감염, 출혈 등의 위중한 합병증이나 수술 후 사망한 환자는 없었으며, 모두 백혈병치료를 지속할 수 있었다. 결론: 침습성 폐아스페르길루스증은 혈액암에 대한 치료 도중 종종 발생되는 위중한 질환이나, 폐엽절제술은 안전하며 효과적으로 혈액암의 치료를 유지시켜 줄 수 있는 치료법으로 생각한다.

• Annals of Clinical Neurophysiology
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• 제25권2호
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• pp.84-92
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• 2023

Background: Clinical spectrum of immunoglobulin M (IgM) monoclonal gammopathy varies from IgM monoclonal gammopathy of unknown significance (IgM-MGUS) to hematological malignancies. We evaluated the clinical features, electrophysiological characteristics, and prognosis of patients with peripheral neuropathy associated with IgM monoclonal gammopathy (PN-IgM MG). Methods: We retrospectively evaluated 25 patients with PN-IgM MG. Peripheral neuropathy was classified as axonal, demyelinating, or undetermined, based on electrophysiological studies. We classified the enrolled patients into the IgM-MGUS and malignancy groups, and compared the clinical and electrophysiological features between the groups. Results: Fifteen patients had IgM-MGUS and 10 had hematologic malignancies (Waldenström's macroglobulinemia: two and B-cell non-Hodgkin's lymphoma: eight). In the electrophysiological evaluation, the nerve conduction study (NCS) criteria for demyelination were met in 86.7% of the IgM-MGUS group and 10.0% of the malignancy group. In particular, the distal latencies of the motor NCS in the IgM-MGUS group were significantly prolonged compared to those in the malignancy group (median, 9.1 ± 5.1 [IgM-MGUS], 4.2 ± 1.3 [malignancy], p = 0.003; ulnar, 5.4 ± 1.9 [IgM-MGUS], 2.9 ± 0.9 [malignancy], p = 0.001; fibular, 9.3 ± 5.1 [IgM-MGUS], 3.8 ± 0.3 [malignancy], p = 0.01; P-posterior tibial, 8.3 ± 5.4 [IgM-MGUS], 4.4 ± 1.0 [malignancy], p = 0.04). Overall treatment responses were significantly worse in the malignancy group than in the IgM-MGUS group (p = 0.004), and the modified Rankin Scale score at the last visit was higher in the malignancy group than in the IgM-MGUS group (2.0 ± 1.1 [IgM-MGUS], 4.2 ± 1.7 [malignancy], p = 0.001), although there was no significant difference at the initial assessment. Conclusions: The risk of hematological malignancy should be carefully assessed in patients with PN-IgM MG without electrophysiological demyelination features.

• 종양간호연구
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• 제7권1호
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• pp.56-67
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• 2007

Purpose: This study was designed to identify the relationship between spiritual health and depression with the hematological malignancies patients in an isolated room. Method: The obtained data were analyzed using SPSS Win 12.0. For the statistical anayses, Pearson correlation coefficients, multiple linear regression analysis, t-test and ANOVA were calculated. Results: The mean scores of the status of spiritual health, depression were 111.62 and 29.78, respectively. The score of spiritual health was significant differences by the faith (F=19.65, p=0.000). Depression score was significant differences by age (F=4.561, p=0.002) and spiritual state (F=4.843, p=0.004). Spiritual health and depression was moderately correlated (r=-.681, p=.000). Conclusion: From the above results, oncology nurse should consider spiritual health and depression when caring patients with hematological malignancies.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7415-7419
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• 2013

The diagnosis of latent Mycobacterium tuberculosis infection (LTBI) is recommended in hematological malignancy patients and before hematopoietic stem cell transplantation (Guidelines for the prevention and management of infectious complications of solid organ transplantation, 2004). Compared to traditional methods such as tuberculin skin test (TST), T-SPOT.TB has been shown to be more specific. In the present study we enrolled 536 patients for whom T-SPOT.TB was performed, among which 295 patients also received the TST test. The agreement (79%) between T-SPOT.TB and TST was poor (x=0.274, P<0.001). The patients with positive T-SPOT.TB results numbered 62 (11.6%), in which only 20 (48.8%) of the 41 receiving the TST test had positive results. A majority of the patients with T-SPOT.TB positive results had some other evidence ofTB, such as TB history, clinical symptoms and an abnormal chest CT scan. Active TB was found in 9 patients, in which 2 had negative TST results. We followed up the patients and no one developed active TB. Our study suggested that the T-SPOT.TB may be more useful for screening LTBI and active TB in hematological malignancy patients and hematopoietic stem cell transplant recipients than the TST test.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.4009-4011
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• 2016

Background: Classical Hodgkin's lymphoma (cHL) is a B-cell lymphoid neoplasm characterized by a distinctive biological behavior with potentially curable disease characteristics. It is an uncommon hematological malignancy which primarily affects younger individuals. The rationale of this study was to determine its clinico-hematological profile along with stage stratification in Pakistani patients. Materials and Methods: In this descriptive study, adult patients with Hodgkin's lymphoma were enrolled from January 2010 to December 2014. Results: Sixty two histopathologically confirmed cases of cHL were identified. There were 42 males and 20 females, with a male to female ratio of 2: 1. The mean age was $29.7{\pm}13.8$ years with the median age of 30 years. B symptoms were present in 72.5% of patients. Histopathologically, the mixed cellularity type constituted 62.9% of cases, followed by nodular sclerosis in 25.8%, lymphocyte predominant in 9.6% and lymphocyte depleted in 1.6%. Stages I and II were present in 43.5% of patients at disease presentation, with 56.4% in stages III and IV. Conclusions: Our analysis shows that clinico-pathological features of Hodgkin's lymphoma in Pakistan are comparable to published data. Mixed cellularity is the commonest histological variant and advanced stage at presentation are common findings in our patients.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.534-539
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• 2017

Objective : Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. Methods : From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results. Results : The most common diagnosis of hematological malignancy was multiple myeloma (96 patients, 49.7%), followed by chronic myeloid leukemia (30, 15.2%), acute myeloid leukemia (22, 11.2%), and lymphoma (15, 7.56%). The major presenting symptoms were mechanical axial pain (132, 67.7%) resulting from pathologic fractures, and followed by radiating pain (49, 25.1%). Progressive neurologic deficits were noted in 15 patients (7.7%), which revealed as cord compression by epidural mass or compressive myelopathy combined with pathologic fractures. Reconstructive surgery for neurologic compromise was done in 16 patients. Even though surgical intervention was useful for early paralysis (Frankel grade D or E), neurologic recovery was not satisfactory for the progressed paralysis (Frankel grade A or B). Conclusion : Hematological malignancies may cause various spinal problems related to disease progression or consequences of treatments. Conservative and palliative treatments are mainstay for these lesions. However, timely surgical interventions should be considered for the cases of pathologic fractures with progressive neurologic compromise.

• Mycobiology
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• 제51권6호
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• pp.468-470
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• 2023

• Childhood Kidney Diseases
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• 제21권1호
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• pp.21-25
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• 2017

Severe hypercalcemia is rarely encountered in children, even though serum calcium concentrations above 15-16 mg/dL could be life-threatening. We present a patient having severe hypercalcemia and azotemia. A 14-year-old boy with no significant past medical history was referred to our hospital with hypercalcemia and azotemia. Laboratory and imaging studies excluded hyperparathyroidism and solid tumor. Other laboratory findings including a peripheral blood profile were unremarkable. His hypercalcemia was not improved with massive hydration, diuretics, or even hemodialysis, but noticeably reversed with administration of calcitonin. A bone marrow biopsy performed to rule out the possibility of hematological malignancy revealed acute lymphoblastic leukemia. His hypercalcemia and azotemia resolved shortly after initiation of induction chemotherapy. Results in this patient indicate that a hematological malignancy could present with severe hypercalcemia even though blast cells have not appeared in the peripheral blood. Therefore, extensive evaluation to determine the cause of hypercalcemia is necessary. Additionally, appropriate treatment, viz., hydration or administration of calcitonin is important to prevent complications of severe hypercalcemia, including renal failure and nephrocalcinosis.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1411-1414
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• 2014

Background: Hepatitis B and C are the leading causes of liver diseases worldwide. For hematological and solid malignancy patients undergoing chemotherapy, increases in HBV DNA and HCV RNA levels can be detected which may result in reactivation and hepatitis-related morbidity and mortality. The aim of this study was to determine the seroprevalence of Hbs ag and Anti HCV positivity in patients with solid malignancies undergoing chemotherapy and consequences during follow-up. Materials and Methods: The files of 914 patients with solid malignancies whose hepatitis markers were determined serologically at diagnosis were reviewed retrospectively. All underwent adjuvant/palliative chemotherapy. For the cases with HBV and/or HCV positivity, HBV DNA and HCV RNA levels, liver function tests at diagnosis and during follow-up and the treatment modalities that were chosen were determined. Results: Of 914 cases, Hbs Ag, anti Hbs and anti HCV positivity were detected in 40 (4.4%), 336 (36.8%) and 26 (2.8%) of the cases respectively. All of the Hbs ag positive patients received prophylactic lamuvidine before the start of chemotherapy. In the Hbs ag and anti HCV positive cases, liver failure was not detected during chemotherapy and a delay in chemotherapy courses because of hepatitis was not encountered. Conclusions: Just as with hematological malignancies, screening for HBV and HCV should also be considered for patients with solid tumors undergoing chemotherapy. Prophylactic antiviral therapy for HBV reduces both the reactivation rates and HBV related mortality and morbidity. The clinical impact of HCV infection on patients undergoing chemotherapy is still not well characterized.

• 임상간호연구
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• 제14권3호
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• pp.27-36
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• 2008

Purpose: This study was to investigate the effects of foot massage on fatigue and depression among patients undergoing chemotherapy with hematological malignancies. Method: The subjects were 60 patients hospitalized for undergoing chemotherapy from September 2007 to March 2008, and 30 of them were the experimental group and the other 30 were the control group. To the subjects in the experimental group, foot massage was provided for 30 minutes everyday before the chemotherapy at the same time for 4 days, and the effect was measured on Day 4 and 5 after chemotherapy. Fatigue was measured using the Brief Fatigue Inventory (BFI) developed by Mendoza et al. (1999), and depression was measured by psychiatric rating scale SCL-90-R developed by Derogatis (1977) and translated by Kim Gwang il et al. The data were analyzed through $x^2$-test, Fisher's exact test, unpaired t-test and repeated measures ANOVA using SPSS 12.0. Results: Fatigue and depression were significantly lower in the experimental group than in the control group. Even on Day 5, fatigue and depression were significantly lower in the experimental group than in the control after finish foot massage. Conclusion: The findings of the study demonstrated that foot massage would be an effective nursing intervention to reduce fatigue and depression in patients with hematological malignancies.