• Title/Summary/Keyword: 급성 백혈병

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Comparison of growth and neuropsychological function after treatment for hematologic and oncologic diseases in monozygotic twins (일란성 쌍생아에서 혈액 및 종양 질환 치료 후 성장 및 정신신경학적 발달에 대한 비교연구)

  • Kim, Gi Hwan;Kook, Hoon;Baek, Hee Jo;Han, Dong Kyun;Song, Eun Song;Jo, Young Kook;Choi, Ic Sun;Kim, Young Ok;Kim, Chan Jong;Woo, Young Jong;Yang, Soo Jin;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.182-189
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    • 2007
  • Purpose : The primary purpose of this study was to evaluate the growth and neuropsychologic function following treatments for pediatric hematologic and oncologic diseases. Healthy monozygotic twins served as ideal controls for comparison to exclude possible confounding factors. Methods : Seven children treated with various hematologic and oncologic diseases were included in the study: acute lymphoblastic leukemia (ALL; n=2), Diamond-Blackfan anemia twins (n=2), and aplastic anemia (n=3). The median age at the diagnosis was 5.2 (0.3-15) years. The median duration of follow-up was 7.2 (4.9-10) years. Controls were healthy monozygotic twins. Growth was measured and the percentile channels were evaluated sequentially for patients. The K-WISC III was applied and compared in 5 pairs of patients and controls. Results : Similar growth profiles were noted for the twins. The percentiles at diagnosis was 3-10 in 3, 25-50 in 2, and 50-75 in 2 cases. All patients stayed in their growth percentiles through follow-up, except for 1 patient who became obese. For IQ tests, the mean behavioral, verbal and full scale IQ scores of patients were 88.0, 93.8, and 89.8, respectively, and those from their corresponding controls were 92.2, 97.0, and 91.7 (P>0.05). However, 2 children who were treated for ALL had lower IQ scores. Conclusion : Similar growth profiles were observed in the monozygotic twins in terms of height and weight. The IQ scores of patients were similar to those of monozygotic twins. However, prophylactic CNS-directed therapy for leukemia might adversely affect the IQ scores. A further prospective study on larger number of twins is warranted.

Analysis of Acute Kidney Injury in Pediatric Patients with Stem Cell Transplantation (소아에서 조혈모세포이식 후 급성 신질환의 분석)

  • Kim, Sae-Yoon;Choi, Jung-Youn;Ha, Jeong-Ok;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.130-137
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    • 2009
  • Purpose : Stem cell transplantation (SCT) has gained worldwide acceptance as a treatment for hematologic disorders. This study was performed to evaluate the clinical characteristics and outcomes of the acute kidney injury after SCT in children. Methods : The records of 53 patients who were treated with SCT at the pediatric department of Yeungnam University Hospital between January, 1996 and April, 2009 were used as subjects. Their were divided into two groups ; 'Early renal insufficiency' (ERI, n=18) and 'Non-early renal insufficiency' (NERI, n=35). ERI had greater than 25% of drop in GFR after SCT. Results: Total 53 patients were analyzed. In cord blood SCT (n=11), ERI was 4 (36.4%) and NERI was 7 (63.6%). In bone marrow SCT (n=16), ERI was 8 (50.0%) and NERI was 8 (50.5%). In autologous peripheral blood SCT (n=26), ERI was 6 (23.1%) and NERI was 20 (76.9%). There is no difference in both groups according to kinds of SCT. GVHD was developed in 22 patients, and there is no difference in each group. Twenty two of 53 patients died. ERI was 12 (66.7%) and NERI was 10 (28.6%). Acute renal failure is most important cause of the deaths. Conclusion : Out of 53 pediatric patients who were treated with SCT, 18 patients had greater than 25% of drop in GFR. There is no difference in both groups according to kinds of SCT. GVHD was found in 22 patients and there is no relation between GVHD development and acute kideney injury.

Results of Total Body Irradiation in Allogeneic Bone Marrow Transplantation for Acute Non-Lymphocytic Leukemia (급성 골수성 백혈병에서 동종골수이식을 위한 전신 방사선 조사의 치료 결과)

  • Chung Su Mi;Choi Ihl Bohng;Kim In Ah;Kim Sung Hwan;Kang Ki Mun;Shinn Kyung Sub;Kim Choon Choo;Kim Dong Jip
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.247-253
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    • 1992
  • Between August 1987 and July 1991, 22 patients with acute nonlymphocytic leukemia have received allogeneic bone marrow transplantation (BMT) with non-T-lymphocyte-depleted marrow obtained from matched sibling donors. Of these patients, 12 patients were in first complete remission (CR) and 10 patients in second CR or greater or in relapse. All patients were treated with a preparative regimen consisting of cyclophosphamide (CTX, 60 mg/kg) or combined drugs, and 850 cGy single-dose or $150\~200$ cGy fractionated total body irradiation (TBI) administered twice daily for a total dose of $1200\~1320$ cGy. Survivors have been followed from 8 to 64.5 months (median, 24 months). The overall 2 year survival rate, relapse rate and incidence of radiation pneumonitis and graft versus host disease (GVHD) have been evaluated by age, phase of disease, initial WBC count, modality of TBI or conditioning chemotherapy. Overall 2 year survival was $58{\%}$. The median survival was 31 months and mean survival was 23.2 months. Overall survival have significant impact in patients of age >19 years old (p=0.008), patients in first CR (p=0.09). Two year survival rate is significantly correlated with age ( >19 vs $\leqq$19, $79.4\%$ vs $14.3\%$, p=0.0008), regimen of chemotherapy (CTX vs combined drug, $76.9\%\;vs\;33.3\%$, p=0.04), phase of disease (1st CR vs \geqq2nd$ CR or relapse, $83.3\%\;vs\;30\%$, p=0.01) and method of TBI (fractionated vs single dose, $70.7\%\;vs\;37.5\%$, p=0.05). The influence of French-American-British (FAB) subtypes on relapse rate is not significant, but initial WBC count > 20000/$mm^3$ is associated with increased relapse rate. There is difference in the rate of radiation pneumonitis ($14.3\%\;vs\;25\%$), GVHD ($14.3\%\;vs\;50\%$) and relapse ($21.4\%\;vs\;50\%$) according to fractionated versus single-dose TBI. As mentioned above, fractionated TBI is compatible for the preparative regimen combined with chemotherapy En allogeneic BMT of first CR patients under 41 years of age with suitable donor. Those results from a retrospective, non-randomized study clearly need additional clinical data, ideally from a randomized study.

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The Cytotoxic effects of several Herbs against human cancer cell-lines (수종(數種)의 한약재(韓藥材)가 인체(人體) 암세포주(癌細胞柱)에 미치는 세포(細胞) 독성(毒性))

  • Jeong, Hyeon-U
    • The Journal of Internal Korean Medicine
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    • v.18 no.1
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    • pp.231-241
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    • 1997
  • The purpose of this research was to investigate effect of water extract of Euphorbiae Pekinensis Radix and Moutan Cortex Radicis on the proliferation of human cancer cell-lines. The effects of Euphorbiae Pekinensis Radix and Moutan Cortex Radicis on the proliferation of A431, HeLa, MOLT-4, K562 cells, Balb/c 3T3 cells, mouse thymocytes, splenocytes and human lymphocytes were estimated by MTT colorimetric assay. The results were as follows; 1. In proliferation of A431, HeLa, MOLT-4 and K562 cell-lines, Euphorbiae Pekinensis Radix and Moutan Cortex Radicis inhibited the proliferation of K562 cells. 2. In the combined effect of Euphorbiae Pekinensis Radix and mitomycin C, Moutan Cortex Radicis and mitomycin C, all herbs stimulated the proliferation of MOL T-4 cells. 3. Euphorbiae Pekinensis Radix and Moutan Cortex Radicis did not inhibited the proliferation of Balb/c 3T3 cells. 4. Euphorbiae Pekinensis Radix and Moutan Cortex Radicis stimulated the proliferation of mouse thymocytes. 5. Euphorbiae Pekinensis Radix and Moutan Cortex Radicis stimulated the proliferation of mouse splenocytes. 6. Euphorbiae Pekinensis Radix and Moutan Cortex Radicis stimulated the proliferation of human lymphocytes.

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

  • Jang Hong Seok;Chung Su Mi;Choi Ihl Bohng;Kim Choon Yul;Bahk Yong Whee;Kim Choon Choo;Kim Dong Jip;Lee Jae Soo
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.247-251
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    • 1988
  • Total body irradiation has been applied to treat acute leukemia and chronic granulocytic leukemia.20 patients with acute leukemia or chronic granulocytic leukemia were treated with total body irradiation using 6 MV linear accelerator before bone marrow transplantation at the Division of Therapeutic Radiology, Department of Radiology, St. Mary's Hospital, Catholic University Medical College from August 1987 to September 1988. Among 20 patients, 8 patients received 6 fractions of 200 cGy (total 1200 cGy),10 patients received a single 850 cGy radiation,1 patient received 4 fractions totalling 850 cGy (200, 200, 200, 250), and 1 patient received 1100 cGy in 2 fractions (850, 250).17 patients received allogenic grafts, 2 patients received autologous grafts, and only one patient received one locus mismatched graft. 13 patients are still alive and 7 patients died. The complications induced by total body irradiation were nausea and vomiting, diarrhea, skin erruption, mucositis, and pneumonitis.

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Study of Acute Myelocytic Leukemia Patient Treatment That Used Total Skin Electron Beam (Total Skin Electron Beam을 이용한 급성 골수성 백혈병 환자 치료에 대한 연구)

  • Lee, Sang-Ryul;Kang, Min-Kyu;Kim, Sung-Kyu
    • Progress in Medical Physics
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    • v.20 no.3
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    • pp.152-158
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    • 2009
  • Total Skin Electron Beam Therapy (TSEBT) of linear accelerator has become use so as to be useful, 2~9 MeV of energy territories came to be used with mycosis fungoides and cutaneous lymphomas in the superficial lesion treatment which covers the major portion of the body. I treat a patient to Stanford technique in this study, and it is $60^{\circ}$ around the patients whom Stanford technique irradiated electronic beam to a linear accelerator in horizontal directions and there is a way a standard of TSEBT treat it to six located field (anterior, posterior, and four obliques) becoming. An each field does horizontally it and consist to beam of the two component which fitted the center to a suitable angle. a patient treats it to three dual field a day in order to make short treatment time. when a first day, we treat one dual field at anterior position and two dual field at posterior position. when the second day, treat one dual field at posterior position and two dual field at anterior position. Therefore, six dual field is finished in perfect periodic two days. we made cylindrical acrylic phantom, and I inserted a dosimeter film between phantom. in order to measure a dose distribution calculation before treat a patient, and a patient checked it in six field directions that got from a treatment. It is after that thermoluminescent dosimetry (TLD) as it uses Rando phantom and then measurement dose distribution in six field directions after attaching at chest, the right and left flank, a back after irradiation.

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Induction of Apoptosis in Jurkat T Lymphocytes by Extract of Ailanthus altissima (저근백피(Ailanthus altissima) 물 추출물에 의한 급성림프성백혈병 Jurkat T Lymphocytes의 세포고사 유도)

  • Hwang, Sang-Gu;Lee, Hyung-Chul;Kim, Chun-Kwan;Chun, Hyun-Ja;Jeung, Seung-Il;Jeon, Byung-Hun
    • Korean Journal of Pharmacognosy
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    • v.32 no.4 s.127
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    • pp.274-279
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    • 2001
  • Ailanthus altissima belonging to the family Simaroubaceae has been used to settle an upset stomach, to combat a fever, and as an insecticide. Apoptosis is an active process, which is a critical feature of the regulated development of multicellular organisms. We investigated whether the extract of A. altissima induced apoptotic cell death in Jurkat T-acute lymphoblastic leukemia (ALL) cells. Upon treatments with the extract, the dose-dependent inhibitions of cell viability were observed. It also caused apoptosis as measured by cell morphology and DNA fragmentation. The capability of the extract to induce apoptosis was associated with proteolytic cleavage of specific target protein such as poly(ADP-ribose)polymerase (PARP) protein, suggesting the possible involvement of the activations of caspases. Further study showed that Bcl-2 protein levels were not changed in all treated groups compared to control group. These results suggest that A. altissima induces Bcl- 2-independent apoptosis in Jurkat T cells.

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SUGICAL TREATMENT OF MUCOSITIS AND FUNGAL INFECTION IN THE ACUTE LEUKEMIC PATIENTS (급성 백혈병 환자에서 점막 질환과 진균감염의 외과적 처치)

  • Ha, Won-Suk;Ye, Young-Geun;Park, Jae-Hong;Pyo, Sung-Un;Yun, Hyun-Jung;Lee, Sang-Hwa
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.2
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    • pp.172-177
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    • 2006
  • It is generally known that mucositis which often occur on hematopoietic disease patients, shows local necrosis of oral mucosa when the CBC is below the normal range. But sometimes, the lesions are occasionally infiltrate into adjacent tissue. When the pathologic destructive expansion is occurred, differential diagnosis with fungal infection, one of opportunistic infections, is needed. This means treatment and prognosis can be changed according to the diagnosis. So the diagnostic process is more important in this hematopoietic disease patients. In case of fungal infection, the range of tissue damage can expand broadly, and also proper antifungal agent and surgical extirpation should be done. After operation, continuous antifungal therapy and observations are needed. We made a comparative study of following 2 cases of fungal infection appeared on the acute lymphatic leukemia patients to discuss what the proper surgical treatment and medications are, and when the proper surgical intervention time is.

ORAL MANIFESTATION AND TREATMENT OF ACUTE MYELOID LEUKEMIA: A CASE REPORT (급성 골수성 백혈병의 구강 내 발현 및 치료: 증례 보고)

  • Kim, Ji-Youn;Min, Seung-Ki;Lim, Ho-Kyung;Suh, Jin-Won;Hwang, Soon-Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.535-540
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    • 2009
  • Proliferation of abnormal hematopoietic cells with impaired differentiation, regulation and programmed cell death leads to leukemia. AML(acute myeloid leukemia) is a malignancy with malfunction of myeloid hematopoietic cells with acute behavior. The oral manifestations of the disease are posterior palate hemorrhage, gingival bleeding and gingival ulceration as a result of infection by normal oral flora and gingival infiltration by leukemic cells. A 49-year-old male patient was referred from local dental clinic. The patient was diagnosed with AML FAB M1 (acute myeloid leukemia French-American-British classification M1 myeloblastic leukemia without maturation). The oral infection focus was removed by a conservative treatment. 2 days after the dental treatment, the patient underwent chemotherapy. At 8-month follow-up, the overall outcome was excellent. Oral manifestations of AML are often the first indications of the malignancy. Therefore it is essential for dentists, especially oral and maxillofacial surgeons, to be aware of the diagnostic signs and complications associated with leukemia for better diagnosis and subsequent treatment and management.

Long-Term Complete Remission in an Acute Myeloid Leukemia Patient with Isolated Central Nervous System Relapse after Allogeneic Hematopoietic Stem Cell Transplantation (급성골수성 백혈병에서 동종조혈모세포 이식 후 고립성 중추신경계 재발에서의 장기 완전 관해 1예)

  • Kim, Myung Jin;Ko, Sung Ae;Jang, Hyo Jin;Jeong, Da Eun;Park, Jeung Min;Lee, Kyoung Hee;Kim, Min Kyoung;Bae, Young Kyung;Hyun, Myung Soo
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.96-101
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    • 2012
  • Allogeneic hematopoietic stem cell transplantation (HSCT) is considered the optimal curative treatment for acute myeloid leukemia (AML), but some patients develop bone marrow relapse due to remnant leukemia, and few patients develop extramedullary relapse without bone marrow relapse. Isolated extramedullary relapse (IMER) is defined as extramedullary relapse without bone marrow relapse. IMER has been reported in various sites, including the skin, soft tissue, and central nervous system(CNS). Isolated CNS relapse is relatively rare and is associated with poor prognosis due to the absence of an optimal treatment for it. Reported herein is a case involving an adult AML woman who suffered from isolated extramedullary relapse in the CNS after allogeneic HSCT. She was treated with intrathecal chemotherapy and whole-brain and spine radiotherapy, followed by systemic chemotherapy. She is currently well, with no evidence of leukemia recurrence for over six years.

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