• Journal of Medicine and Life Science
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• 제17권3호
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• pp.103-106
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• 2020

Bone marrow failure, such as aplastic or myelophthisic anemia, can occur due to an underlying lymphoid malignancy and cause life-threatening events. A 58-year-old man diagnosed with angioimmunoblastic T-cell lymphoma had recently visited the emergency department because of an altered level of consciousness caused by acute severe anemia. The laboratory findings were strongly suggestive of bone marrow failure syndrome. Bone marrow examination was immediately performed and, subsequently, dexamethasone was initiated to control the underlying lymphoma. Intravenous immunoglobulin was also administered in combination due to combined immune hemolytic anemia and thrombocytopenia. Bone marrow examination revealed a packed marrow with marked fibrosis and lymphoma involvement. A diagnosis of secondary myelofibrosis related to the underlying lymphoma was made, and sequential combination chemotherapy was introduced despite the presence of severe anemia and thrombocytopenia. After combination chemotherapy, his hematologic profile and underlying lymphoma improved. Better understanding of various hematologic manifestations and knowledge of the rare condition of lymphoma are essential for appropriate diagnostic approaches and treatment.

• 임상간호연구
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• 제25권1호
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• pp.91-97
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• 2019

Purpose: The purpose of this study was to investigate hemato-oncology patients' discomfort and bleeding in relation to the bedrest time after bone marrow examination. Methods: A descriptive correlational study was conducted. The data were collected using self- report questionnaire from total of 131 patients who underwent bone marrow examination from January 2017 to September 2017. Data were analyzed with descriptive statistics, Wilcoxon Signed-rank test, McNemar's test and logistic regression. Results: The level of discomfort after 4 hours of bedrest was significantly higher when compared to 2 hours of bedrest(p<.001). The occurrence of bleeding after 2 hours of bedrest was significantly higher than 4 hours of bedrest(p<.001), however the degree of bleeding was slight. No bleeding occurred in 84% of the patients after 2 hours of bedrest. Conclusion: The results of this study demonstrated that shortening the bed rest time after bone marrow examination was helpful in improving the patient's well-being. Bedrest time could be shortened according to the site of bone marrow examination and patient's condition.

• 임상간호연구
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• 제27권2호
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• pp.179-186
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• 2021

Purpose: The purpose of our study was to identify the bleeding risk factors and to validate the safety of shortening the bed rest time after bone marrow examination in pediatric hemato-oncologic patients. Methods: From July 2019 to September 2020, 145 patients were enrolled from a single center. Medical records were reviewed retrospectively. Descriptive statistics were presented, and the data were analyzed using 𝑥²-test, Fisher's exact test, and a logistic regression. Results: After two hours of bed rest, most of the patients (91.7%) did not have bleeding complications, and only 8.3% of the patients had a minor bleeding. The rate of major bleeding complications, including hematoma, retroperitoneal hemorrhage rate was zero. The bleeding complications was frequently found on bilateral procedures than unilateral procedures and the difference were statistically significant (p<.05). Conclusion: Two hours of bed rest time after bone marrow examination could be safe and adequate in pediatric hemato-oncologic patients.

• 한국임상수의학회지
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• 제36권1호
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• pp.30-37
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• 2019

The purpose of this present study was to objectively evaluate gastrointestinal and bone marrow AEs after administration of various chemotherapeutic agents in canines with malignant tumors, using the Veterinary Cooperative Oncology Group-Common Terminology Criteria for Adverse Events (VCOG-CTCAE), which includes descriptive terminology used for adverse events (AEs) reported in dogs and cats. The medical records of 42 dogs with malignant tumor that underwent chemotherapy were reviewed retrospectively. There were no significant differences in the prevalence of gastrointestinal AEs among the 5 chemotherapeutic agents (vincristine, cyclophosphamide, doxorubicin, lomistine, and carboplatin). The prevalence of bone marrow AEs was significantly higher after administration of lomustine than after administration of vincristine or doxorubicin. Grade 1 AEs of the gastrointestinal tract and bone marrow were most often observed after administration of various chemotherapeutic agents. Delayed and cumulative myelosuppression of lomustine in some dogs receiving regular blood examination were identified. The findings of this study will help predict possible gastrointestinal and bone marrow AEs due to the use of chemotherapeutic agents to treat canines with malignant tumors.

• 종양간호연구
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• 제1권1호
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• pp.18-31
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• 2001

This Research was designed to develop an instrument that can be used for measuring and analysing the degree of the quality of life of the Allogenic bone marrow transplantation survivors and to provide basic data to help them attain a better quality of life. The subjects of this study were a total of 101 people who were undergone Allogenic bone marrow transplantation and were over 100 days after transplantation. Data were collected during the period from September 3 to December 2. 2000. In Developing this instrument, the researcher established a conceptual framework based on the result of previous research, interview of patients and medical staff and researcher's experience. The scale for this instrument consisted of 51 items. Responses were obtained from the respondents through a self reporting method and each item had a possible score of 5. The collected data were analyzed using the SPSS program. The reliability of the scale was tested by Cronbach‘s alpha. For the examination of the component factors of the measuring instruments, factor analysis method was used. Examination of the difference in the quality of life as related to demographic variables was done using t-test, analysis of variance(ANOVA). For the examination of the major variables influencing the quality of life, Pearson's Correlations was used. The results were as follows: (1) The reliability of the instrument was 0.90 (Cronbach's alpha) (2) The validity of the instrument was tested by factor analysis. The result of the factor analysis of the 51 items is making up the instruments were classified into the following factor; emotional state, Interpersonal problem, physical problem, spiritual state, social problem, decrease of physical energy, physical problem-eye, physical problem-skin and mucosa, health awareness, elimination problem, worry about health, financial problem, sexual problem. (3) Demographic variables related to quality of life is the time after transplantation. GVHD experience, lose of job. Age at the transplantation, diagnosis, type of the transplantation, marital status, monthly income, educational background, sex, religion are not related to the quality of life.

• Journal of Chest Surgery
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• 제13권3호
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• pp.306-311
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• 1980

Pure red cell aplasia is unusual cause of anemia and a selective aplastic disorder that affects the erythroid series of the bone marrow. Fifty percent of all patients with red cell aplasia will have a thymoma. Twenty-five to 30% of those who undergo thymectomy will be cured. A 57-years-old man was admitted to the medical department of Korea University hospital with complaints. Physical examination reveals a sick looking man with a pale lip, anemic conjunctiva and subicteric sclera. On auscultation, coarse breathing sound and moist rale was heard on the right lung field. Neither the liver nor spleen was palpable. A blood count showed the erythrocytes to number 2,640,000/mm3 and hemoglobin to be 7.0gm/dl. A white blood cell count was 5,000/mm3 and a platelet count was 328,000/mm3 Reticulocyte count was 0.7%. Examination of the peripheral blood smear showed the red cell, to be normocytic and normochromic. Urine sugar was three positive and GTT was positive. The anterior-posterior and lateral view of Chest X-ray was suggestive of an anterior mediastinal mass. A bone marrow biopsy reveals absence of red cell precursors and a normal myeloid series and megakaryocytes. At thoracotomy in May 1980 an encapsulated, lobulated, benign thymoma, which measured 5x7x5 cm was removed, microscopic examination showed it was of the spindle cell type. The postoperative course was uneventful, but the patient never had a return of hemoglobin to the blood. The patient was discharged on the postoperative] 3 days. At postoperative 1 month, the patient was readmitted for bone marrow study and had no return of red cells to bone marrow. At now, patient has been treated with steroid and the further follow up study will be needed.

• BLOOD RESEARCH
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• 제53권4호
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• pp.281-287
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• 2018

Background Bone marrow involvement (BMI) affects the lymphoma stage, survival, and treatment. Bone marrow biopsy (BMB) and fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) are useful techniques to detect BMI. Both have advantages and disadvantages. We aimed to identify factors that could be used to predict BMI with positive and negative results on PET/CT compare them with BMB in newly diagnosed patients with lymphoma. Methods We included 22 non-Hodgkin and 16 Hodgkin lymphoma patients in this single center study. All patients had PET/CT examination and BMB before treatment. BMI in BMB was reported as negative or positive. Bone marrow was classified into 3 types by FDG uptake on PT/CT; diffuse involvement, focal involvement, and normal bone marrow. Results PET/CT and BMB results were concordant (7 positive, 15 negative) in 22 patients (57%). We evaluated concordant and discordant patient characteristics and risk-stratified patients for BMI. Our findings suggest that patients with diffuse FDG uptake on PET/CT, especially patients with advanced age and low platelet and white blood cell counts, are likely to have BMI and could potentially forego BMB. Patients with negative PET/CT findings and no significant laboratory abnormalities are very unlikely to have BMI. Conclusion Our results suggest that BMI should not be decided solely based PET/CT or BMB findings. It is reasonable to use both diagnostic assays along with clinical and laboratory findings. PET/CT result, clinical and laboratory findings could be useful for predicting BMI in patient for whom BMB is contraindicated.

• 대한임상검사과학회지
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• 제48권4호
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• pp.371-377
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• 2016

탈회방법은 골수조직의 병리학적 진단을 위해서 항상 시행되는 과정이다. HCl 탈회용액과 같이 주로 사용하고 있는 산성용액은 탈회과정 동안에 조직내의 항원성에 손상을 입힌다. 특히, 골수조직 내의 RNA나 DNA에 심하게 손상을 준다. 따라서 조직의 항원성을 보존하기 위한 표준화된 탈회방법이 필요하다. 본 연구는 일반적으로 가장 많이 사용되는 HCl 기반의 상품화된 탈회용액과 직접 제조한 EDTA 탈회용액이 골수조직의 탈회과정에 어떤 영향을 미치는지 분석하였다. 환자로부터 채취된 73예의 골수생검조직을 HCl 탈회와 EDTA 탈회의 두 그룹으로 나누어 탈회과정을 진행하였다. 골수생검조직의 탈회과정 후 결과의 차이는 hematoxylin & eosin 염색과 reticulum 염색, Ki-67, CD20, CD138의 항체를 이용한 면역조직화학염색, DNA 추출 및 분석, in situ hybridization, IGH gene rearrangement 와 같은 분자병리검사를 시행하여 분석하였다. 일반적인 염색과 특수염색에서는 두 탈회용액간의 차이는 없었다. 또한 세포증식 표지자와 같은 세포막 혹은 세포질에서 발현되는 항체는 탈회용액간의 차이 없이 잘 염색되었다. 반면 HCl 탈회 용액에 처리한 후 핵 내 단백질인 Ki-67의 염색상은 현저히 불량한 것으로 관찰되었다. HCl 탈회용액과 비교하여 EDTA 탈회용액에서의 골수생검조직 내의 DNA와 RNA가 잘 보존되었음을 다양한 분자병리검사를 통해 확인할 수 있었다. 특히 HCl 탈회용액에 처리한 28예와 EDTA 탈회용액에 처리한 12예의 DNA의 순도와 농도을 비교한 결과 통계학적으로 유의한 수준으로 차이가 있음을 확인하였다. 이로써 EDTA 탈회용액이 조직 내의 항원성을 잘 유지시키며, 면역조직화학염색과 분자병리검사에 적합한 방법임을 확인 할 수 있었다.

• Clinical and Experimental Pediatrics
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• 제45권2호
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• pp.256-260
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• 2002

골수괴사는 골수를 침범하는 매우 드문 조직 소견으로 저자들은 급성 혼합형 백혈병 환아가 요통, 발열을 주소로 방문하여 세번째 재발하였을 때 골수 천자 도말 검사에서 골수괴사가 동반되고 혈청 LDH와 ferritin이 증가되었으며 자기공명영상에서 골수괴사의 특징적인 소견을 보인 1례를 경험하였기에 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제45권8호
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• pp.1007-1015
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• 2002

목 적: 혈구 탐식 조직구 증식증은 양성 질환으로는 드물게 치명율이 높은 질환으로, 발열, 간비장 종대, 림프절 종대 등의 증상이 있고, 검사 소견에서 양성의 혈구 탐식 조직구가 나타난 경우 진단되나 치료가 혼란스러운 경우가 많다. 골수 검사상 양성의 혈구 탐식조직구가 나타난 예들의 임상적 특징을 분석하여 진단 및 치료 방향과 예후 판정에 도움이 되고자 이 연구를 시행하였다. 방 법 : 1995년 1월부터 2001년 11월까지 계명대학교 동산병원에서 골수 검사상 양성의 혈구 탐식 조직구가 나타난 환아 30례를 대상으로, 특징적 임상 증상, 진찰 소견, 혈액 검사 소견, 골수 검사 소견, 치료 방법과 예후에 대하여 임상 기록지를 후향적으로 분석하였다. 또한 골수 도말에서 혈구 탐식 조직구의 수에 따라 a few, some, many로 나누어 환아의 예후와 비교하였다. 결 과 : 골수 검사상 양성 혈구 탐식 조직구를 보인 예들을 분석한 결과 이들의 연령 분포는 2개월에서 15세로, 평균 연령은 5.6세였고, 남녀비는 2.3 : 1로 남아가 많았다. 입원 당시 증상으로는 발열이 가장 많았으며, 호흡기 증상, 위장관 증상 등의 순이었고, 평균 발열 기간은 19.5일이었으며, 진찰 소견은 간비종대, 피부 발진, 림프절 비대 순으로 많았다. 혈액 검사 소견상 백혈구 감소증이 23례(76.7%)로 가장 많았고, 혈소판 감소증이 16례(53.3%), 빈혈이 15례(50.0%), 간기능 검사 이상이 15례(50.0%)로 나타났다. 기저 질환으로 급성 림프구성 백혈병, 악성 림프종 등 면역 저하된 상태가 5례였고, 건강했던 경우가 25례 였으며, 관련 질환의 종류로는 패혈증, 폐렴, 전염성 단핵구증 등의 순이었고, 원인으로는 세균이 많았으며, 바이러스로는 EBV가 4례였고, candida가 1례였다. 골수 도말 소견상 세포 충실도가 정상이 25례(83.3%)였고, 5례(16.7%)에서 감소되어 있었으며, 혈구 탐식 조직구의 수에 따라 분류하였을 때, some이 15례(50.0%), many가 9례(30.0%), a few가 6례(20.0%)이었다. 치료는 보존 요법, 항생제와 항바이러스제, 항진균제, 면역 글로불린, steroid, etoposide, cyclosporine 등의 병용 요법을 시행하였다. 사망율은 30명 중 8명으로 26.7%였으며, 연령이 낮은 군과 혈구 탐식 조직구 수가 some 이상인 경우에 사망률이 높았다. 결 론 : 고열, 간비종대, 범혈구 감소증과 간기능 이상 등의 소견을 보이는 환아에서 조기에 골수 검사를 시행하여 혈구 탐식 조직구가 보일 때, 원인 치료 및 대증 요법과 함께 면역 화학 요법을 시행하는 것이 예후에 도움이 될 것으로 생각되며, 골수 소견과 예후와의 관계는 지속적인 연구 관찰이 필요할 것으로 사료된다.