• The Journal of the Korea Contents Association
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• v.14 no.4
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• pp.249-255
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• 2014

Total body irradiation use one of the pre-treatment as hematopoietic stem cell transplantation in the treatment of leukemia. According to the study of Korean network for organ sharing 2013 report, continue to increase the number of hematopoietic stem cell transplantation. however, the current dose evaluation fall short before treatment. So purpose of this study is Surface dose and deep organ dose evaluation and then find the most ideal conditions when change of the thickness on tissue compensator in TBI. Result, surface dose in 4 MV, SSD 280 cm, compensators thickness 0.5 cm, was measured the highest dose 5.84 mGy/min. And the ideal dose showed when compensator thickness less than 1 cm.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.305-310
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• 2011

조혈모세포이식술(또는 HSCT)을 받은 환자에게는 이식관련 부작용의 예방 또는 치료를 위해 면역억제 약물이 투여되는데, 그 중 하나인 cyclosporine은 therapeutic index가 작고 다양한 요인에 의해 혈중농도가 변화되므로 사용시에는 세심한 관찰과 조절이 필요하다. 특히 HSCT 환자에서 발생하는 호중구 감소성 발열(또는 NPF)의 치료목적으로 투여하는 항생제에 의하여 cyclosporine의 혈중농도가 변화될 수 있고, 또 임상적 경과에 따라 항생제 처방이 중도에 변경되는 경우도 빈번하지만, 실제로 항생제 처방의 중간변경에 의한 cyclosporine의 혈중농도 변화양상을 연구한 결과는 많지 않다. 이에, 과거 2년 동안 한 상급종합병원에서 HSCT후 cyclosporine을 투여 받았던 환자 중에서 통상적인 NPF 치료용 항생제인 ciprofloxacin을 투여하다가 치료성과를 높이기 위하여 cefepime으로 대체 투여했던 환자들의 의무기록을 후향적으로 분석하였다. 1차 선택약인 ciprofloxacin에서 항생제를 변경했을 때 cyclosporine의 혈중농도가 유의성 있게 증가했는데, 이는 ciprofloxacin 보다 cefepime이 간에서 cyclosporine을 분해시키는 효소생성을 억제시켰기 때문일 것으로 예측되며, HSCT 환자에서 NPF 치료용 항생제를 ciprofloxacin에서 cefepime으로 변경 시에는 병용중인 cyclosporine 유지용량을 약 13% 감량하는 것이 cyclosporine의 효과는 유지하면서 부작용의 발생위험을 감소시키는 데 유용한 방안이 될 것으로 사료된다.

• Journal of Chest Surgery
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• v.40 no.2 s.271
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• pp.147-150
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• 2007

Desmoplastic small round cell tumor (DSRCT) is rare and a recently described, poorly differentiated malignant tumor and it usually presents with widespread intra-abdominal involvement. We report a case of DSRCT arising form the mediastinum which was treated with multimodality anticancer therapy in 15 year-old girl.

• Korean Journal of Adult Nursing
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• v.28 no.1
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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.

• The Korean Journal of Rehabilitation Nursing
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• v.6 no.2
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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.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1153-1160
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• 2009

Purpose:To evaluate the risk factors for mortality and prognostic factors in pediatric hemato-oncology patients admitted to the pediatric intensive care unit (PICU). Methods:We retrospectively reviewed the medical records of pediatric hemato-oncology patients admitted at the PICU of the Asan Medical Center between September 2005 and July 2008. Patients admitted at the PICU for perioperative or terminal care were excluded. Results:Total 88 patients were analyzed. Overall ICU mortality rate was 34.1%. Mean age at PICU admission was $7.0{\pm}5.7$ years and mean duration of PICU stay was $18.1{\pm}22.2$ days. Hematologic diseases contributed to 77.3% of all the primary diagnoses, and the primary cause of admission was respiratory failure (39.8%). The factors related to increased mortality were C-reactive protein level (P<0.01), ventilation or dialysis requirement (P<0.01), and hematopoietic stem cell transplantation (P<0.05). In all, 3 scoring systems were investigated [Number of Organ System Failures (OSF number), the Pediatric Risk of Mortality III (PRISM III) score, and the Sequential Organ Failure Assessment (SOFA) score]; higher score correlated with worse outcome (P<0.01). The Oncological Pediatric Risk of Mortality (O-PRISM) scores of the 21 patients who had received hematopoietic stem cell transplantation were higher among the non-survivors, but not statistically significant (P=0.203). Conclusion:The PRISM III and SOFA scores obtained within 24 hours of PICU admission were found to be useful as early mortality predictors. The highest OSF number during the PICU stay was closely related to poor outcome.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.37-44
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• 2005

Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.

• Korean Journal of Clinical Pharmacy
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• v.12 no.1
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• pp.7-12
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• 2002

Pharmacokinetic parameters and dosage of aminoglycosides (AGs) were studied retrospectively in 36 patients with neutropenic fever after stem cell transplantation in Seoul National University Hospital from July 1996 to June 2001. AGs pharmacokinetic parameters were calculated with steady-state peak and trough serum drug concentrations by the method of Sawchuk and Zaske et at. The calculated aminoglycosides volume of distribution and clearance were greater than population value $(0.36\pm0.06\;L/kg,\;116\pm32\;ml/min/1.73\;m^2,\;respectively)$. The average dosage of aminoglycosides required to maintain optimal serum AGs concentration was also greater than recommended dose in insert paper. The average dosage of amikacin was $11\pm2.1$ mg/kg every 12 hours (In case of tobramycin, $2.09\pm0.37$ mg/kg every 8 hours or $2.59\pm0.20$ mg/kg every 12 hours). The relationship between AGs volume of distribution and sex, serum albumin (g/dl), body mass index $(kg/m^2)$, body weight change $(\%)$, the amount of fluid inpu (ml/kg/day), the degree of hematocrit decrease $(\%)$ were studied respectively. Univariate anlysis revealed that body mass index $(kg/m^2)$, the amount of fluid input (ml/kg/day) and the degree of hematocrit decrease $(\%)$ had significant correlation with aminoglycosides volume of distribution. But sex, serum albumin, body weight change $(\%)$ had no significant correlation with aminoglycosides volume of distribution.

• Asian Oncology Nursing
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• v.6 no.1
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• pp.27-36
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• 2006

Purpose: The present study was to investigate the effect of music therapy on anxiety, nausea, and vomiting in patients undergoing total body irradiation (TBI) for hematopoietic stem cell transplantation (HSCT). Method: A untreated control group with pretest and posttest was used in this study. A total of 35 patients receiving TBI for HSCT were recruited from a medical center at a university in Korea. The music therapy taking for 15-20 minutes per a time was performed twice a day for three days while the patients in the experimental group were undergoing the TBI. Results: The scores of state anxiety, nausea and vomiting tended to increase in the control group as compare with those in the experimental group. The patients in the control group had been administerd antiemetics more often than those in the experimental group. The levels of systolic and diastolic blood pressure and the pulse rates in the experimental group tended to decrease after the experiment. However, there was no statistically significant differences in anxiety, nausea, vomiting, blood pressure, and pulse between the groups. Conclusion: It is suggested to repeat this study with a enough sample size.

• Asian Oncology Nursing
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• v.8 no.1
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• pp.1-7
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• 2008

Purpose: Peripheral blood stem cell transplantation (PBSCT) has been widely used. The optimal time for collection is a critical factor to obtain proper counts of CD34 cell by peripheral blood stem cell collection (PBSC). The purpose of this study was to identify the factors influencing peripheral blood stem cell collection in order to figure out the more effective timing for PBSC. Method: The subjects of this study were 189 patients undergoing 3 leukapheresis from January 28, 2005 to December 31,2006. Group's characteristics, checkup opinion of pre-peripheral blood on the day of harvest & outcome of PBSC were analyzed and evaluated using SAS statistics program after grouping patients as below; group 1-CD34 cell counts $<2{\times}10^6/kg$ (n=97); group $2-2{\times}10^6/kg$ ${\leq}CD34$ cell counts $<4{\times}10^6/kg$ (n=26); group 3-CD34 cell counts ${\geq}4{\times}10^6/kg$ (n=63). Results: Based on outcome of peripheral blood stem cell according to diagnosis, acute myelocytic leukemia (AML) was 65.5% at Group 1, Lymphoma was 21.7% at Group 2 and multiple myeloma (MM) was 70.8% at Group 3. There were significant differences in CD34 cell counts according to diagnosis (p=0.00004). Type of cytokine mobilization according to diagnosis, Lenograsim was using 62.5% of MM & 38.2% of AML and filgrastim is using 22.0% of AML only. Circular peripheral blood CD34 cell counts prior to harvest was $258.1/{\mu}L$ at Group 3 which was much higher comparing to Group 1 ($10.5/{\mu}L$) and Group 2 ($39.9/{\mu}L$) (p<0.001). TNC counts of collected peripheral blood stem cell was $15.36{\times}10^6/kg$ at Group 3 and it's much higher than Group 2 ($13.16{\times}10^6/kg$) and Group 1 ($12.36{\times}10^6/kg$) (p=0.083). There was no significant difference in MNC counts inbetween 3 groups. Conclusions: Circular peripheral blood CD34+ cell counts prior to harvest was much higher at Group 3 than Group 1 and Group 2. Therefore, the number of CD34+ cells on the day of harvest can be used as an accurate predictor for peripheral blood stem cell.