• Title/Summary/Keyword: Bone Transplantation

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Management of Osteoporosis in Liver Transplant Recipients (간이식 후 골다공증 관리)

  • Choi, Hojeong;Kim, Boram;Kim, Yoonhee;Lee, Jungwha;Lee, Eunsook;Lee, Euni;Cho, Jai Young;Choi, YoungRok
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.1
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    • pp.51-58
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    • 2020
  • Background: Prevention of osteoporosis and bone fracture is one of the important issues for liver transplant recipients because a long history of liver disease and lifelong use of immunosuppressants, including corticosteroids, may cause these diseases. In this study, we aimed to analyze liver recipient bone status, 10-year fracture risk, and medication history. Methods: The electronic medical records of adult patients aged >40 years who received liver transplantation at Seoul National University Bundang Hospital between January 2009 and June 2017 were reviewed retrospectively. On the basis of their bone mineral density and fracture history, their fracture risks were analyzed using the Korean fracture risk assessment tool. Results: A total of 57 liver transplant recipients were treated with corticosteroids during a mean of 8.8 months after transplantation. 30 patients (52.6%) showed bone metabolism dysfunction such as osteopenia or osteoporosis. The 10-year femoral fracture risk was 2.1%, and dual-energy X-ray absorptiometry monitoring was performed, including right before liver transplantation every 27.5±19.2 months. The mean femoral bone mineral density decreased by -7.2%±7.3%. Four patients (7.0%) had a fracture after liver transplantation. Osteoporotic fracture occurred in 3 patients with osteoporosis (25.0%). Among the osteopenia patients with moderate fracture risk who were not treated with bisphosphonate, 1 patient (12.5%) had a history of bone fracture after liver transplantation. Conclusions: Considering the deterioration of bone density and moderate fracture risk, medication for osteoporosis should be prescribed to liver transplant recipients with regular monitoring of bone density after transplantation.

BONE FORMATION BY HUMAN ALVEOLAR BONE CELLS (사람 치조골세포를 이용한 골형성)

  • Choi, Byung-Ho;Park, Jin-Hyoung;Huh, Jin-Young;Oh, Jin-Rok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.42-45
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    • 2002
  • Cultures of primary human alveolar bone-derived cells were established from alveolar bone chips obtained from normal individuals undergoing tooth extraction. These cells were expanded in vitro until passage 3 and used for the in vivo assays. Cells were loaded into transplantation vehicles, and transplanted subcutaneously into immunodeficient mice to study the capacities of human alveolar bone-derived cells to form bone in vivo. Transplants were harvested 12 weeks after transplantation and evaluated histologically. Of 10 human alveolar bone-derived cell transplants, two formed a bone-like tissue that featured osteocytes and mineral. Eight of the ten formed no osseous tissue. These results show that cells from normal human alveolar bone are capable of forming bone-like tissue when transplanted into immunodeficient mice.

Leucostim, A Human Granulocyte-Colony Stimulating Factor, Facilitates Granulopoiesis After Bone Marrow Transplantation In Mice

  • Ahn, Byoung-Ok;Kang, Soo-Hyoung;Kim, Won-Bae
    • Biomolecules & Therapeutics
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    • v.8 no.3
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    • pp.213-216
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    • 2000
  • In vivo administration of Leucostim, a human recombinant granulocyte colony-stimulating factor (G-CSF), was evaluated for the effects on survival, hematologic recovery, and colony forming unit- spleen (CFU-5) in murine bone marrow transplantation (BMT) model. Sublethally irradiated (9 Gy) mice received bone marrow cells from untreated mice, and then were treated with G-CSF subcutaneously at doses of 2.5,5, or $10\mu\textrm{g}$/kg or vehicle solution (control) for 14 days from one day after BMT. There was no effect of irradiation and BMT on mortality. The repeated subcutaneous injections of Leucostim for 14 days post- BMT significantly facilitated hematologic recovery compared with vehicle control in a dose-dependent manner. Moreover, mice treated with Leucostim had significantly increased numbers of CFU-s colonies on day 10 post-BMT. These results suggest that Leucostim, a new G-CSF, has beneficial effects on hematologic reconstitution after BMT.

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Early Diagnosis of Avascular Necrosis of Bone Following Renal Transplantation By Bone Scan (골주사검사(骨走査檢査)로 조기진단한 신장이식수술후 Avascular bone necrosis 2예(例))

  • Shin, Hyun-Ho;Kim, Han-Su;Ihm, Chun-Gyoo;Kim, Myung-Jae
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.2
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    • pp.97-102
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    • 1982
  • Avascular necrosis of bone has become a well-recognized complication of renal transplantation. While preexisting metabolic bone disease, especially hyperparathyroidism, and metabolic disturbances induced by steroids have been implicated as etiological factors, the pathogenesis is controversial. The diagnosis of avascular necrosis of bone had been based on a history of joint pain and radiographic demonstration of bone necrosis. Recently the bone scan using 99mTc-methylene diphosphonate is helpful in determining the early stage of bone necrosis. We report two cases of avascular necrosis of femur head, of which diagnosis was made by the bone scan using 99mTc-methylene diphosphonate.

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Analysis change in Bone Mineral Density before and after Kidney Transplant in Renal Failure Patient (신부전환자의 신장이식 전후 골밀도변화 분석)

  • Park, Hyong-Hu;Ok, Chi-Sang;Park, Young-In;Lee, Jin-Soo;Kim, Chang-Soo
    • The Journal of the Korea Contents Association
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    • v.12 no.9
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    • pp.250-256
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    • 2012
  • Disease, such as osteopenia, osteoporosis, etc caused by reduced bone density are common to women after menopause and as the social medical cost increases due to osteoporosis fractures the medical interest in bone density reduction has increased. The bone density reduction is observed even for renal failure patients, due to their decreased ability to synthesize vitamin D which leads to bone fibrosis because of deficiency in calcium absorption. Thus renal failure patients not only suffer from kidney dysfunction, but also are exposed to complications, such as osteoporosis, due to reduced bone density. This research observed the change in bone density of patients receiving renal failure treatment and analyzed the change in bone density before and after kidney transplantations. Subjects were 214 renal failure patients at the department of nephrology Busan B General Hospital. The change in bone density was studied for subjects with and without kidney transplantation according to their age and sex. The research showed improvement or maintenance of bone density for subjects that received kidney transplantation, but showed a tendency of consistent decrease in bone density for subjects without kidney transplantation. Kidney transplantation can be considered as the best cure for renal failure patients, and this researched confirmed that bone density can be improved through kidney transplantation. Thus, this study can also be used as data for preventing complications due to renal failures.

Chronic Myeloid Leukemia - Prognostic Value of Mutations

  • Kaleem, Bushra;Shahab, Sadaf;Ahmed, Nuzhat;Shamsi, Tahir Sultan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7415-7423
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    • 2015
  • Chronic myeloid leukemia (CML) is a stem cell disorder characterized by unrestricted proliferation of the myeloid series that occurs due to the BCR-ABL fusion oncogene as a result of reciprocal translocation t(9;22) (q34;q11). This discovery has made this particular domain a target for future efforts to cure CML. Imatinib revolutionized the treatment options for CML and gave encouraging results both in case of safety as well as tolerability profile as compared to agents such as hydroxyurea or busulfan given before Imatinib. However, about 2-4% of patients show resistance and mutations have been found to be one of the reasons for its development. European Leukemianet gives recommendations for BCR-ABL mutational analysis along with other tyrosine kinase inhibitors (TKIs) that should be administered according to the mutations harbored in a patient. The following overview gives recommendations for monitoring patients on the basis of their mutational status.

Coexisting JAK2V617F and CALR Exon 9 Mutations in Myeloproliferative Neoplasms - Do They Designate a New Subtype?

  • Ahmed, Rifat Zubair;Rashid, Munazza;Ahmed, Nuzhat;Nadeem, Muhammad;Shamsi, Tahir Sultan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.923-926
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    • 2016
  • The classic BCR-ABL1-negative myeloproliferative neoplasm is an operational sub-category of MPNs that includes polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). The JAK2V617F mutation is found in ~ 95% of PV and 50-60% of ET or PMF. In most of the remaining JAK2V617F-negative PV cases, JAK2 exon 12 mutations are present. Amongst the JAK2V617F-negative ET or PMF 5-10% of patients carry mutations in the MPL gene. Prior to 2013, there was no specific molecular marker described in the remaining 30-40% ET and PMF. In December 2013, two research groups independently reported mutations in the gene CALR found specifically in ET (67-71%) and PMF (56-88%) but not in PV. Initially CALR mutations were reported mutually exclusive with JAK2 or MPL. However, co-occurrence of CALR mutations with JAK2V617F has been reported recently in a few MPN cases. Many studies have reported important diagnostic and prognostic significance of CALR mutations in ET and PMF patients and CALR mutation screening has been proposed to be incorporated into WHO diagnostic criteria for MPN. It is suggestive in diagnostic workup of MPN that CALR mutations should not be studied in MPN patients who carry JAK2 or MPL mutations. However JAK2V617F and CALR positive patients might have a different phenotype and clinical course, distinct from the JAK2-positive or CALR-positive subgroups and identification of the true frequency of these patients may be an important factor for defining the prognosis, risk factors and outcomes for MPN patients.

Development of the Clinical Pathway for the Allogeneic Bone Marrow Transplantation Donor Nursing (동종골수이식 공여자 간호를 위한 표준임상지침서 개발)

  • Seol, Mi-Ee
    • Asian Oncology Nursing
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    • v.4 no.2
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    • pp.110-123
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    • 2004
  • The purpose of this study was to develop a clinical pathway for the allogeneic bone marrow transplantation donor. For this study, a conceptual framework was developed through a review of the literature including six steps which are using in Jones Hopkins Hospital. USA. The researcher reviewed 129 medical re-cords of donor who had bone marrow donation between January 2002 to January 2004, to identify the overall service contents required by these patients and to make a preliminary clinical pathway. A content validity test was done for the preliminary clinical pathway, a professional group screened 51 medical re-cords and adopted with 3 hospitalization days as the clinical pathway framework. In the fifth step, clinical pathway test was also done to 7 donors from April 28th to July, 2004. After these processes the final clinical pathway was developed. The results of this study are as follows: 1. The vertical axis of the clinical pathway Includes the following 9 items: vital signs, nursing assessment, activity, diet, intervention, medication, test, consultation and patient teaching. The duration of the horizontal axis was 3days from admission to discharge 2. Analysis of the 129 medical records indicated that the average length of stay was 3 4 days. The medical performance according to the vertical axis in the preliminary clinical pathway consisted of 51 items After clinical validity test, it steel consisted of 51 items in the final form. 3. Clinical Validity test was done to 7 bone marrow donors. During these process, The first patient was deleted because he was out of the criteria the investigate set and 6 patients were used, finally The result of this study indicated all of 7 donors were discharged on expected day. 4. Clinical pathway enables to improve the quality of care, multidisciplinary team work It also helps nursing bone marrow donor, effective education to donor or medical member. The results of this study suggest that clinical pathway may be able to improve the quality of nursing care for bone marrow transplantation donors.

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Clinical use of Platelet Rich Fibrin(PRF) in Various Hard and Soft Tissue Defect : Case Report (혈소판 유래 섬유소(Platelet Rich Fibrin(PRF))를 이용한 골결손부의 치료 : 증례보고)

  • Chee, Young-Deok;Go, Seo-Wook
    • Journal of Dental Rehabilitation and Applied Science
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    • v.23 no.4
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    • pp.303-312
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    • 2007
  • Recently several studies have been developed not only to apply bone materials to bony defect, but also to use osteogenic and osteoinductive materials to form bone more effectively. In 1998 Mark et al applied gel formation of PRP(platelet-rich plasma) in bony transplantation for mandibular reconstruction as one of the method of stimulating bone formation in maxillofacial area, which is contain of varies growth factors. After he reported that PRP accelerate bone formation, which is used in varies bone transplantation and augmentation with a good result. Especially there are amount of growth factors in PRP, and PRP increase angiogenesis, cell division, and mesenchymal cell growth. Moreover it is capable of osteoconduction, hemostatitis, anti-infection, forming the shape at transplantation, ease of handling, and recipient site stability. So it is known that success rate is high in bone transplantation. However PRP need tissue adhesive to make plasma to solid form. Thrombin and calcium chloride, component of PRP, is extracted from autogenic donor. So it is expensive to extract and there is possibility of hepatitis, AIDS, and hematogenous metastasis. After all, tissue adhesive have the limitation and danger of use. So we are willing to introduce that we had get some idea after using PRF(platelet-rich fibrin) in the various hard and soft tissue bony defect, which is self extracted simply and contain growth factors.