• Title/Summary/Keyword: Transplant time

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Developmental Ability of Enucleated Bovine Oocytes Matured In Vitro Following Fusion with a Single Blastomere of Embryos Matured and Fertilized In Vitro (소 체외수정란의 단일분할구와 제핵미수정란 융합배의 초기발생에 관한 연구)

  • 김정익;정희태;박춘근;양부근
    • Korean Journal of Animal Reproduction
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    • v.18 no.2
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    • pp.121-126
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    • 1994
  • This study was conducted to examine the condition of activation of the nuclear transplant bovine embryos. In vitro fertilized(IVF) and nuclear transplant embryos(NTs) were co-cultured with bovine oviduct epithelial tissue(BOET). NTs were treated with cycloheximide(CHXM) for 0 to 6 h after electrofusion to investigate the activation conditin of recipient ooplast. Then, the infljence of the CHXM treatment timing on the cleavage and development of NTs were investigated in relation to the nuclear transplant time. The cleavage rates of NTs were increased with the increasing time of the CHXM treatment from 0 to 6 h (54.7 to 91.3%, P<0.01). Similar trend was shown in the development into the morula or blastocyst stage, but very limitted. Activation of enucleated oocytes prior to fusion enhanced development of NTs compared with that post fustion. This result suggests that the frequency of activation of NTs can be greatly enhanced by treating with CHXM for 6 h. The result also suggests that if blastomeres of unknown cell cycle stage are used, activation of enucleated oocytes prior to fusion enhances development of NTs.

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Joint Modeling of Death Times and Counts Using a Random Effects Model

  • Park, Hee-Chang;Klein, John P.
    • Journal of the Korean Data and Information Science Society
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    • v.16 no.4
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    • pp.1017-1026
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    • 2005
  • We consider the problem of modeling count data where the observation period is determined by the survival time of the individual under study. We assume random effects or frailty model to allow for a possible association between the death times and the counts. We assume that, given a random effect, the death times follow a Weibull distribution with a rate that depends on some covariates. For the counts, given the random effect, a Poisson process is assumed with the intensity depending on time and the covariates. A gamma model is assumed for the random effect. Maximum likelihood estimators of the model parameters are obtained. The model is applied to data set of patients with breast cancer who received a bone marrow transplant. A model for the time to death and the number of supportive transfusions a patient received is constructed and consequences of the model are examined.

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Clinical manifestations of BK virus infection in pediatric kidney transplant patients

  • Kwon, Yiyoung;Kim, Jeong Yeon;Lee, Yeonhee;Cho, Heeyeon
    • Clinical and Experimental Pediatrics
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    • v.62 no.11
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    • pp.422-427
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    • 2019
  • Background: Polyomavirus BK (BKV) infection is an important cause of graft loss in kidney transplant patients. Purpose: The purpose of this study was to evaluate clinical findings and risk factors for BKV in pediatric patients after kidney transplantation. Methods: This retrospective single-center study included 31 pediatric kidney transplant recipients from January 2002 to December 2017. Two patients received 2 transplantations during the study period, and each transplant was analyzed independently. Total number of cases is 33 cases with 31 patients. BKV infection was confirmed from blood samples via periodic quantitative polymerase chain reaction. Results: The mean age at kidney transplantation was 11.0±4.7 years, and the male-to-female ratio was 2.7:1. Three patients had a past medical history of high-dose chemotherapy and autologous stem-cell transplantation for solid tumors. Nine patients (27.3%) developed BKV infection. The median period from kidney transplantation to BKV detection in blood was 5.6 months. There was no statistically significant difference in estimated glomerular filtration rate between patients with and those without BKV infection. Among 9 patients with BKV viremia, 7 were treated by reducing their immunosuppressant dose, and BKV was cleared in 6 of these 7 patients. In the other 2 BKV-positive patients, viremia improved without immunosuppressant reduction. Conclusion: BKV infection is common in children with kidney transplantation and might not have affected short-term renal function in our patient sample due to early immunosuppressant reduction at the time of BKV detection.

The Relationship between the Period of Engraftment and the Nutritional Status in Patients Undergoing Allogenic Bone Marrow Transplantation for Acute Myelogenous Leukemia (동종 골수이식을 받은 급성 골수성 백혈병 환자의 영양상태와 생착일수에 관한 연구)

  • 홍정임;장은재
    • Korean Journal of Community Nutrition
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    • v.7 no.4
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    • pp.578-584
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    • 2002
  • This study was designed to investigate the association between the period of engraftment and the nutritional status of patient s undergoing bone marrow transplantation for acute myelogenous leukemia (AML). Nutritional status was evaluated by body mass index (BMI), percentage of ideal body weight (PIBW), percentage of weight loss, and serum albumin, total protein (T protein), hemoglobin (HGB) and hematocrit (HCT) levels on the day prior to transplantation and on the day of bone marrow transplantation. The periods of engraftment were determined by absolute neutrophil counts (ANC) above $500/mm^3$ from the day of bone marrow transplantation. The study subjects were 80 patients (55 males, 25 females) with acute myelogenous leukemia admitted to the University Hospital in Seoul. The result of this study is as follows : Tie nutritional status values of the majority of patients on the day prior to transplantation were in the normal range except for HGB and HCT ; however, during hospitalization, all of the levels of the nutritional status values were significantly decreased. The periods of engraftment of the abnormal group according to their BMI, PIBW, HGB and HCT levels on the day of bone marrow transplantation showed no difference when compared to the normal group. However, the periods of engraftment of the abnormal group, according to the percentage of weight loss, albumin, and T protein levels were significantly decreased when compared to the normal group. Therefore, the nutritional status of patients at the time of transplant had a noticeable influence on the periods of engraftment. Our results suggested that nutritional status is a critical factor of engraftment in BMT during pre-transplant and post-transplant. Futhermore, we recommend that the process of nutritional preparation for the transplant should initiate immediately after the transplant decision has been made.

Clinical Characteristics of Tuberculosis in Liver or Heart Transplant Recipients (간 또는 심장이식을 시행 받은 환자에서의 결핵의 발생률 및 임상양상)

  • Jung, Hoon;Oh, Yeon-Mok;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Kim, Jae-Joong;Lee, Sung-Gyu;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.440-446
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    • 2006
  • Background: Post-transplant tuberculosis (TB) is a serious complication in solid organ transplant recipients worldwide, However there is little or no data on TB in liver or heart transplant recipients in Korea. Methods: The incidence and clinical characteristics of TB of 730 patients who had undergone a liver transplant in a university hospital in Korea between 1992 and 2004, and 110 heart transplant recipients in the same period, were reviewed retrospectively. Results: The incidence of TB was 1.5%(11/730) and 2.7%(3/110) in the liver and heart transplantation, respectively. The median time from the transplant to the development of TB was 8.4 months(1.0-30.8). and the mean time from the symptoms to the diagnosis of TB was $2.1{\pm}3.6$ months(0.3-13.2). Nine patients (65%) had pulmonary TB and five (35%) had extrapulmonary TB. The leukopenia and positive HbeAg at the baseline, post-transplant diabetes mellitus, and chronic rejection were associated with the development of TB in the liver transplant recipients. Ten patients were treated with a 4-drug standard regimen for a mean duration of $7.8{\pm}3.5$ months. One patients died of TB. Conclusion: The incidence of TB in liver or heart transplant recipients was similar to that reported in other countries with a similar TB-burden.

Clinical Utility of Epstein-Barr Viral Load Assay to Diagnose Posttransplant Lymphoproliferative Disorders in Pediatric Heart Transplant Recipients (소아 심장이식 후 림프증식성 질환의 진단을 위한 Epstein-Barr Virus 정량 검사의 유용성)

  • Kim, Joonil;Lee, Jina;Kim, Young-Hwue
    • Pediatric Infection and Vaccine
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    • v.24 no.1
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    • pp.44-53
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    • 2017
  • Purpose: The aim of this study was to investigate the risk factors for posttransplant lymphoproliferative disorder (PTLD) and to evaluate the association between Epstein-Barr viral load and the development of PTLD in pediatric heart transplant recipients. Methods: We reviewed children aged <18 years who underwent heart transplantation and quantitative analysis of blood Epstein-Barr virus (EBV) viremia at our institute from January 2006 to March 2015. Clinical characteristics and EBV viral loads were compared according to the presence of PTLD. Results: Over 9 consecutive years, a total of 40 heart transplant recipients, were included. Among 28 children with available EBV viral load measurements, seven patients (25%) had EBV viremia only defined as at least one time of ${\geq}457copies/mL$. PTLD occurred in three recipients (7.5%) 4.3, 6.3, and 17.0 months after transplant and all PTLD cases had preceding EBV viremia. The median age at transplant was 5.3 years (range, 0.5 to 6.0 years) in the PTLD group, compared with 11.9 years (range, 0.3 to 17.8 years) in the non-PTLD group (P=0.021). The median values of the peak EBV levels in the PTLD group were 3,452,170 copies/mL (range, 46,750 to 7,622,910 copies/mL); the peak EBV levels in the non-PTLD group were 3,112 copies/mL (range, 2,250 to 103,000 copies/mL). Conclusions: Younger age at transplant and presence of EBV viremia were associated with the development of PTLD in pediatric heart transplant recipients. A prospective study will be required to determine the blood EBV load for predicting the development of PTLD in these patients.

Recipient Management before Lung Transplantation

  • Kim, Hyoung Soo;Park, Sunghoon
    • Journal of Chest Surgery
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    • v.55 no.4
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    • pp.265-273
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    • 2022
  • Lung transplantation is considered a viable treatment option for patients with end-stage lung disease. Recent decades have seen a gradual increase in the number of lung transplantation patients worldwide, and in South Korea, the case number has increased at least 3-fold during the last decade. Furthermore, the waiting list time is becoming longer, and more elderly patients (>65 years) are undergoing lung transplantation; that is, the patients placed on the waiting list are older and sicker than in the past. Hence, proper management during the pre-transplantation period, as well as careful selection of candidates, is a key factor for transplant success and patient survival. Although referring and transplant centers should address many issues, the main areas of focus should be the timing of referral, nutrition, pulmonary rehabilitation, critical care (including mechanical ventilation and extracorporeal membrane oxygenation), psychological support, and the management of preexisting comorbid conditions (coronary artery disease, diabetes mellitus, gastroesophageal reflux disease, osteoporosis, malignancy, viral infections, and chronic infections). In this context, the present article reviews and summarizes the pre-transplantation management strategies for adult patients listed for lung transplantation.

Immune reconstitution after allogeneic hematopoietic stem cell transplantation in children: a single institution study of 59 patients

  • Kim, Hyun O;Oh, Hyun Jin;Lee, Jae Wook;Jang, Pil-Sang;Chung, Nack-Gyun;Cho, Bin;Kim, Hack-Ki
    • Clinical and Experimental Pediatrics
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    • v.56 no.1
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    • pp.26-31
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    • 2013
  • Purpose: Lymphocyte subset recovery is an important factor that determines the success of hematopoietic stem cell transplantation (HSCT). Temporal differences in the recovery of lymphocyte subsets and the factors influencing this recovery are important variables that affect a patient's posttransplant immune reconstitution, and therefore require investigation. Methods: The time taken to achieve lymphocyte subset recovery and the factors influencing this recovery were investigated in 59 children who had undergone HSCT at the Department of Pediatrics, The Catholic University of Korea Seoul St. Mary's Hospital, and who had an uneventful follow-up period of at least 1 year. Analyses were carried out at 3 and 12 months post-transplant. An additional study was performed 1 month post-transplant to evaluate natural killer (NK) cell recovery. The impact of pre- and post-transplant variables, including diagnosis of Epstein-Barr virus (EBV) DNAemia posttransplant, on lymphocyte recovery was evaluated. Results: The lymphocyte subsets recovered in the following order: NK cells, cytotoxic T cells, B cells, and helper T cells. At 1 month post-transplant, acute graft-versus-host disease was found to contribute significantly to the delay of $CD16^+/56^+$ cell recovery. Younger patients showed delayed recovery of both $CD3^+/CD8^+$ and $CD19^+$ cells. EBV DNAemia had a deleterious impact on the recovery of both $CD3^+$ and $CD3^+/CD4^+$ lymphocytes at 1 year post-transplant. Conclusion: In our pediatric allogeneic HSCT cohort, helper T cells were the last subset to recover. Younger age and EBV DNAemia had a negative impact on the post-transplant recovery of T cells and B cells.

Efficacy of Sorafenib for the Treatment of Post-Transplant Hepatocellular Carcinoma Recurrence

  • Kang, Seong Hee;Cho, Hyeki;Cho, Eun Ju;Lee, Jeong-Hoon;Yu, Su Jong;Kim, Yoon Jun;Yi, Nam-Joon;Lee, Kwang-Woong;Suh, Kyung-Suk;Yoon, Jung-Hwan
    • Journal of Korean Medical Science
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    • v.33 no.45
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    • pp.283.1-283.10
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    • 2018
  • Background: The role of sorafenib in patients with hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) has been rarely studied. The aim of this study was to evaluate the efficacy of sorafenib in post-LT era. Methods: Consecutive patients with post-transplant HCC recurrence not eligible to resection or locoregional therapy were included. Patients receiving best supportive care (BSC) until 2007 were compared with those treated by sorafenib thereafter. Results: Of a total of 65 patients, 20 patients received BSC and 45 received sorafenib. Clinical characteristics were similar between two groups except that sorafenib group received tacrolimus and mammalian target-of-rapamycin inhibitors more frequently than BSC group. Treatment with sorafenib conferred a survival advantage as compared with BSC for survival after recurrence (median, 14.2 vs. 6.8 months; P = 0.01). In multivariate analyses, high serum ${\alpha}$-fetoprotein level, synchronous intrahepatic recurrence and distant metastasis at the time of recurrence, and BSC were independently associated with poorer survival after recurrence. Sorafenib treatment was associated with better survival after recurrence as compared with BSC (hazard ratio, 0.25; 95% confidence interval, 0.10-0.62; P = 0.002). In addition, sorafenib group showed tolerable toxicity in the post-transplant setting. Conclusion: Sorafenib may be beneficial in patients with post-transplant HCC recurrence.

Joint Modeling of Death Times and Counts Considering a Marginal Frailty Model (공변량을 포함한 사망시간과 치료횟수의 모형화를 위한 주변환경효과모형의 적용)

  • Park, Hee-Chang;Park, Jin-Pyo
    • Journal of the Korean Data and Information Science Society
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    • v.9 no.2
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    • pp.311-322
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    • 1998
  • In this paper the problem of modeling count data where the observation period is determined by the survival time of the individual under study is considered. We assume marginal frailty model in the counts. We assume that the death times follow a Weibull distribution with a rate that depends on some covariates. For the counts, given a frailty, a Poisson process is assumed with the intensity depending on time and the covariates. A gamma model is assumed for the frailty. Maximum likelihood estimators of the model parameters are obtained. The model is applied to data set of patients with breast cancer who received a bone marrow transplant. A model for the time to death and the number of supportive transfusions a patient received is constructed and consequences of the model are examined.

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