• 제목/요약/키워드: Extramedullary

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Primary Idiopathic Myelofibrosis: Clinico-Epidemiological Profile and Risk Stratification in Pakistani Patients

  • Sultan, Sadia;Irfan, Syed Mohammed
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8629-8631
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    • 2016
  • Background: Primary idiopathic myelofibrosis (PMF) is a clonal Philadelphia chromosome-negative myeloproliferative neoplasm characterized by extramedullary hematopoiesis and marrow fibrosis. It is an uncommon hematopoietic malignancy which primarily affects elderly individuals. The rational of this study was to determine its clinico-epidemiological profile along with risk stratification in Pakistani patients. Materials and Methods: In this retrospective cross sectional study, 20 patients with idiopathic myelofibrosis were enrolled from January 2011 to December 2014. Data were analyzed with SPSS version 22. Results: The mean age was $57.9{\pm}16.5years$ with 70% of patients aged above 50. The male to female ratio was 3:1. Overall only 10% of patients were asymptomatic and the remainder presented with constitutional symptoms. In symptomatic patients, major complaints were weakness (80%), weight loss (75%), abdominal discomfort (60%), night sweats (13%), pruritus (5%) and cardiovascular accidents (5%). Physical examination revealed splenomegaly as a predominant finding detected in 17 patients (85%) with the mean splenic span of $22.2{\pm}2.04cm$. The mean hemoglobin was $9.16{\pm}2.52g/dl$ with the mean MCV of $88.2{\pm}19.7fl$. The total leukocyte count of $17.6{\pm}19.2{\times}10^9/l$ and platelets count were $346.5{\pm}321.9{\times}10^9/l$. Serum lactate dehydrogenase, serum creatinine and uric acid were $731.0{\pm}154.1$, $0.82{\pm}0.22$ and $4.76{\pm}1.33$ respectively. According to risk stratification, 35% were in high risk, 40% in intermediate risk and 25% in low risk groups. Conclusions: The majority of PMF patients were male and presented with constitutional symptoms in our setting. Risk stratification revealed predominance of advanced disease in our series.

Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma

  • Li, Qi-Wen;Niu, Shao-Qing;Wang, Han-Yu;Wen, Ge;Li, Yi-Yang;Xia, Yun-Fei;Zhang, Yu-Jing
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권9호
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    • pp.3741-3745
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    • 2015
  • Background: A moderate dose of radiation is the recommended treatment for solitary plasmacytoma (SP), but there is controversy over the role of surgery. Our study aimed at comparing different treatment modalities in the management of SP. Materials and Methods: Data from 38 consecutive patients with solitary plasmacytoma, including 16 with bone plasmacytoma and 22 with extramedullary plasmacytoma, were retrospectively reviewed. 15 patients received radiotherapy alone; 11 received surgery alone, and 12 received both. The median radiation dose was 50Gy. All operations were performed as radical resections. Local progression-free survival (LPFS), multiple myeloma-free survival (MMFS), progression-free survival (PFS) and overall survival (OS) were calculated and outcomes of different therapies were compared. Results: The median follow-up time was 55 months. 5-year LPFS, MMFS, PFS and OS were 87.0%, 80.9%, 69.8% and 87.4%, respectively. Univariate analysis revealed, compared with surgery alone, radiotherapy alone was associated with significantly higher 5-year LPFS (100% vs 69.3%, p=0.016), MMFS (100% vs 51.4%, p=0.006), PFS (100% vs 33.7%, p=0.0004) and OS (100% vs 70%, p=0.041). Conclusions: Radiotherapy alone can be considered as a more effective treatment for SP over surgery. Whether a combination of radiotherapy and surgery improves outcomes requires further study.

척수 신경초종을 동반한 결핵성 척추염 1례 - 증례보고 - (A Case of Tuberculous Spondylitis Combined with Schwannoma of Spinal Cord - A Case Report -)

  • 박종훈;김규홍;이운기;최정훈;이인창;배상도
    • Journal of Korean Neurosurgical Society
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    • 제30권10호
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    • pp.1241-1244
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    • 2001
  • The authors report a very rare case of tuberculous spondylitis combined with a schwannoma of spinal cord. A 39- year-old man was admitted because of paraparesis(G1/G2). MRI showed severe cord compression at two different levels. One was by the bulged soft tissue and subligamentous abscess extending from T7 to T9 and the other was by an intradural extramedullary cord tumor at the level of T1-2. At first operation, T8 corpectomy and T7-9 plate fixation with autogenous iliac bone graft were performed. After then, Paraparesis was improved(G2/G3) postoperatively. The second operation underwent two weeks later. The tumor was totally removed and shortly after second operation, paraparesis was markedly improved(G3/G4). Histological diagnosis were tuberculous spondylitis and schwannoma, respectively. The authors reviewed this case where good surgical outcome was obtained by two stage operation.

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YHB216의 비글개에서 정맥내 단회 및 4주 반복투여독성시험 (Intravenous Single Dose and Four-week Repented Dose Toxicity Study of YHB216, a Recombinant Human Erythropoietin, in Beagle Dogs)

  • 노용우;장호송;지형진;정은용;신지순;강민정;안경규;최연식;이종욱
    • Biomolecules & Therapeutics
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    • 제10권1호
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    • pp.59-69
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    • 2002
  • Recently, recombinant human erythropoietin (rHu-EPO) has been used to treat various types of anemia. YHB216 is a new rHu-EPO developed by Yuhan Research Institute. In this study, we investigated the single dose and 4-week repeated dose toxicity of YHB216 in Beagle dogs. In the single dose toxicity study, YHB216 was administered intravenously at single dose levels of 0 and 25,000 IU/kg to dogs (2 dogs/sex/group). There were no treament-related changes in survivals, clinical signs, body weight gain, hematological values, blood chemical values, and necropsy finding during experimental period. In the repeated dose toxicity study, YHB216 was administered intravenously to dogs for 4 weeks at the dose levels of 0, 100, 500, and 2,500IU/kg (3 dogs/sex/group). There were no toxicologically significant changes in clinical signs, body weights, food and water consumptions, ophthalmoscopy, urinalysis and blood chemistry. There were increased values of red blood cell, hemoglobin, and hematocrit at all treated groups. Spleen revealed increased weight and extramedullary hematopoiesis at 500 IU/kg or more. These changes are all considered to be Pharmacology-related effects and were recovered after 4-week recovery period. From these results, it is concluded that LD50 value was above 25,000 IU/kg in the single dose toxicity study of YHB216 in dogs and the no observed adverse effect level (NOAEL) was 100 IU/kg day in the repeated dose toxicity study of YHB216 in dogs.

Methylcellulose의 경구 및 정맥내 반복 투여가 SD랫드의 간장, 비장 및 신장에 미치는 독성학적인 영향 (Toxic effects of methylcellulose solution on the liver, spleen and kidney in the Sprague-Dawley(SD) rats following repeated oral or intravenous administration)

  • 송시환;강부현;한상섭;노정구;이창업
    • 대한수의학회지
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    • 제36권1호
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    • pp.221-233
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    • 1996
  • This experiment was carried out to study the toxic effect of solublized methylcellulose (MC). Sprague-Dawley rats were dosed with 1%(w/v) MC in 0.9% saline by gavage at a dose of 10ml/kg b.w/day or by intravenous injection at a dose of 5ml/kg b.w/day for 28 days. Clinical signs were observed once a day. Body weights, water and food consumptions were measured and urinalysis was performed several times during the experiment. Rats were sacrificed on days 3, 7, 15 and 28 for hematology, blood chemistry, organ weights and histopathology. The relative weight of the spleen and foamy cells of the spleen were increased in the gavage group. Body weight gain, food consumptions, the values of RBC, Hb, MCH, Hct, serum proteins, glucose, bilirubin, AST, and ALP were decreased in I.V. treatment group. On the other hand, water consumptions, the values of serum cholesterol, creatinine, and BUN were increased. Microscopic findings were granulomas, distended sinusoids, and hypertrophy of Kupffer cells with vacuoles in the liver. Spleen exhibited granuloma, increased extramedullary hematopoiesis, and congestion. Kidney exhibited foamy cells in the glomeruli, distension of the tubules. The findings appeared more severe when the treatment was extended. In conclusion, MC solution is not a safe vehicle for intravenous administration because of the toxic effects on the liver, kidney and spleen. In addition, a long-term and large dosage of oral administration of MC appears to be unsafe also and needs to be investigated further.

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Clinical Analysis of 21 Cases of Spinal Cord Ependymoma : Positive Clinical Results of Gross Total Resection

  • Kaner, Tuncay;Sasani, Mehdi;Oktenoglu, Tunc;Solmaz, Bilgehan;Sarioglu, Ali Celin;Ozer, Ali Fahir
    • Journal of Korean Neurosurgical Society
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    • 제47권2호
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    • pp.102-106
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    • 2010
  • Objective : To evaluate the clinical results of gross total resection in the surgical approach to spinal ependymoma. Methods : Between June 1995 and May 2009,13 males and 8 females (mean age 34) diagnosed with intramedullary or extramedullary spinal ependymoma were surgically treated at our centre. The neurological and functional state of each patient were evaluated according to the modified McCormick scale. Results : The average follow-up duration was 54 months (ranging from 12 to 168 months). The locations of the lesions were : thoracic region (4, 19%), lumbar region (7, 34%), cervical region (4, 19%), cervicothoracic region (3, 14%) and conus medullaris (3, 14%). Four patients (19%) had deterioration of neurological function in the early postoperative period. The neurological function of three patients was completely recovered at the 6th postoperative month, while that of another patient was recovered at the 14th month. In the last assessment of neurological function, 20 patients (95%) were assessed as McCormick grade 1. No perioperative complications developed in any of our patients. In one patient's 24-month assessment, tumour recurrence was observed. Re-operation was not performed and the patient was taken under observation. Conclusion : Two determinants of good clinical results after spinal ependymoma surgery are a gross total resection of the tumour and a good neurological condition before the operation. Although neurological deficits in the early postoperative period can develop as a result of gross total tumour resection, significant improvement is observed six months after the operation.

다리에 생긴 출혈성 농양과 유사한 과립구성 육종 (Granulocytic Sarcoma in the Leg Mimicking Hemorrhagic Abscess)

  • 조송미;지원희
    • Investigative Magnetic Resonance Imaging
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    • 제13권1호
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    • pp.88-92
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    • 2009
  • 과립세포육종은 골수모세포라 불리는 미성숙 악성 백혈구로 구성된 골수 외 종양이다. 과립세포육종은 보통 급성골수성 백혈병이나 골수이형성 증후군과 동반되나 드물게 급성 골수성 백혈병의 전신 질환 이전에 초기 발현으로 발병하기도 한다. 저자의 증례에서와 같이 급성 골수성 백혈병 확진 이전의 과립세포육종은 영상 소견이 임상적 의심과 함께 이 질환의 진단과 치료에 중요하다. 이 증례에서 출혈성 농양과 오인 가능한 과립세포육종의 자기공명영상 소견을 보고하고자 한다. 저자는 자기공명영상이 급성 골수성 백혈병 환자에서 농양으로부터 과립세포육종을 감별하는데 도움이 된다고 생각한다.

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재조합 사람 적혈구 조혈인자 DA-3585의 랫드에 대한 단회 및 4주반복 정맥투여 독성시험 (Single and Four-week Intravenous Toxicity Studies of DA-3585, a Recombinant Human Erythropoietin, in Rats)

  • 김동환;조현;강경구;백남기;김원배
    • Biomolecules & Therapeutics
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    • 제6권2호
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    • pp.182-190
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    • 1998
  • DA-3585 is a recombinant human erythropoietin produced by Dong-A pharmaceutical Co. Ltd. using recombinant DNA technique. Recently, recombinant human erythropoietin (rHu-EPO) has been used to treat various types of anemia. In this study, we examined acute and subacute toxicity of DA-3585 in rats. DA-3585 was intravenously administered to rats at dose levels of 0, 6,250, 12,500 and 25,000 lU/kg for single dose toxicity study and at dose levels of 0,100,500 and 2,500IU/kg daily for 4 week-repeated dose toxicity study. In the single dose toxicity study, there were no death, clinical signs and changes in body weight gain related to the treatment. Necropsy revealed no evidence of toxicity related to DA-3585, In the repeated dose toxicity study, all the rats survived throughout the study. There were no treatment-related changes in clinical signs, food and water intake, and body weight. Hematological examination showed increases in the number of erythrocytes, hemoglobin concentration, hematocrit value and mean corpuscular volume, and decrease in the number of platelet in 500 and 2,500 lU/kg dosed groups. Extramedullary hematopoiesis in the spleen and erythroid hyperplasia in the bone marrow were noted as treatment-related histological changes. Toxicologically significant changes were not observed in blood biochemistry, urinalysis, organ weights and in any other examinations. The treatment-related changes observed in this study were hematological or histological changes associated with pharmacological effects of DA-3585. On the basis of the results of this study, LD5n value of DA-3585 was above 25,000 lU/kg and the no-observed-adverse-effect-level was estimated to be 100 lU/kg.

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사람 적혈구 조혈인자 DA-3585의 토끼에 대한 단회 및 4주 반복투여 독성시험 (Single and 4-Week Repeated Dose Toxicity Studies of DA-3585, a Recombinant Human Erythropoietin, in Rabbits)

  • 조현;김동환;강경구;백남기;김원배
    • Biomolecules & Therapeutics
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    • 제6권2호
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    • pp.171-181
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    • 1998
  • DA-3585, a biosynthetic recombinant human erythropoietin has been developed as a treatment for anemia associated with chronic renal failure in Dong-A pharmaceutical Co. Ltd. This study was carried out to assess its acute and subacute toxicities in rabbits. DA-3585 was intravenously administered to rabbits at dose levels of 6250, 12500 or 25000 lU/kg for single dose toxicity study and at dose levels of 100, 500 or 2500 lU/kg/day for 4-week repeated dose toxicity study. In the acute toxicity study, dose up to 25000 lU/kg had no adverse effect on the behavior or body weight gain. Pathological examinations revealed no abnormal gross lesions related to DA-3585. In the subacute toxicity study, all animals survived until termination of treatment. DA-3585 had no influence on clinical signs, food and water intake or on body weight changes. Hematological examination showed increases in the number of RBC, hemoglobin contents and hematocrit values with a dose dependent manner in the animals treated with DA-3585. Histopathological examination revealed erythroid hyperplasia in the bone marrow and extramedullary hematopoiesis in the liver. The changes detected in the hematological and histopathological examination presumably represent exaggerated pharmacological effects of erythropoietin. The NOAEL (no-observed-adverse-effect-level) of DA-3585 was estimated to be 100 lU/kg/ day under this study condition.

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골수정을 이용한 대퇴골 전자간 골절의 새로운 치료 경향 (New Approach in the Treatment of Intertrochanteric Fracture Using a Cephalomedullary Nail)

  • 김준영;최기홍;양규현
    • 대한정형외과학회지
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    • 제55권3호
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    • pp.193-199
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    • 2020
  • 골수강 내 금속정(골수정)은 1988년부터 대퇴골 전자간 골절을 치료하는 데 사용되어 왔다. 골수정은 활강고나사와 같은 골수강 외 고정 장치에 비하여 기계적 이점이 있으나 대퇴 전자간 골절 Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 31-A1 및 31-A2 골절 치료에 활강고나사보다 유리한 고정 기구인지에 대해서는 논란이 계속되고 있다. 지난 30년 동안 여러 시행 착오가 극복되었고 새로운 유형의 대퇴 골수정이 개발되어 임상에서 사용되고 있다. 새로 개발된 골수정은 삽입 과정이 쉬워지고 지연나사를 사용한 대퇴 골두의 고정 능력이 향상되어 왔다. 그러나 고정 실패율은 여전히 정형외과 의사의 수술 술기에 달려 있다고 할 수 있다. 이 종설에서 우리는 골수정을 이용하여 대퇴 전자간 골절을 치료하는 동안 내측 지지대 복원의 중요성에 대해 초점을 맞추고 그 기본 원칙에 대하여 논의해 보고자 한다.