Total body irradiation (TBI) is included in the conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT), with unique advantages such as uniform distribution over the whole body and decreased exposure to cytotoxic chemotherapeutic agents. For individuals who lack matched sibling or matched unrelated donors, the use of haploidentical donors has been increasing despite challenges such as graft rejection and graft-versus-host disease (GVHD). Although a limited number of studies have been performed to assess the clinical role of TBI in haploidentical HSCT, TBI-based conditioning showed comparable results in terms of survival outcomes, rate of relapse, and GVHD in diverse hematologic malignancies such as leukemia, lymphoma, and multiple myeloma. Advances in supportive care, along with recent technical improvements such as restriction of maximum tolerated dose, appropriate fractionation, and organ shielding, help to overcome diverse adverse events related to TBI. Post-transplantation cyclophosphamide was used in most studies to reduce the risk of GVHD. Additionally, it was found that post-transplantation rituximab may improve outcomes in TBI-based haploidentical HSCT, especially in patients with B-cell lymphoma. Along with the advances of techniques and strategies, the expansion of age restriction would be another important issue for TBI-based haploidentical HSCT considering the current tendency toward increasing age limitation and lack of matched donors. This review article summarizes the current use and future perspectives of TBI in haploidentical HSCT.

Total body irradiation (TBI) is included in the conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT), with unique advantages such as uniform distribution over the whole body and decreased exposure to cytotoxic chemotherapeutic agents. For individuals who lack matched sibling or matched unrelated donors, the use of haploidentical donors has been increasing despite challenges such as graft rejection and graft-versus-host disease (GVHD). Although a limited number of studies have been performed to assess the clinical role of TBI in haploidentical HSCT, TBI-based conditioning showed comparable results in terms of survival outcomes, rate of relapse, and GVHD in diverse hematologic malignancies such as leukemia, lymphoma, and multiple myeloma. Advances in supportive care, along with recent technical improvements such as restriction of maximum tolerated dose, appropriate fractionation, and organ shielding, help to overcome diverse adverse events related to TBI. Post-transplantation cyclophosphamide was used in most studies to reduce the risk of GVHD. Additionally, it was found that post-transplantation rituximab may improve outcomes in TBI-based haploidentical HSCT, especially in patients with B-cell lymphoma. Along with the advances of techniques and strategies, the expansion of age restriction would be another important issue for TBI-based haploidentical HSCT considering the current tendency toward increasing age limitation and lack of matched donors. This review article summarizes the current use and future perspectives of TBI in haploidentical HSCT.

Purpose: This study investigated the incidence of secondary malignancy in multiple myeloma (MM) patients compared with that in the general population using a population-based database covering all residents in Korea. Materials and Methods: Based on the national health insurance system in Korea, all people primarily diagnosed with MM between January 1, 2010 to December 31, 2018 were identified. A total of 9,985 MM patients aged ≥ 20 years in Korea were included. Results: Among them, 237 (2.4%) developed secondary malignancies by 2018. The standardized incidence rates (SIRs) of all secondary malignancies in MM patients were 0.87 (95% confidence interval [CI], 0.76 to 0.98), with a higher incidence of hematologic malignancies than in the general population with an SIR of 3.80 (95% CI, 2.61 to 5.00). The incidence rates of both lymphoid malignancy (SIR, 3.56; 95% CI, 2.31 to 4.82) and myeloid malignancy (SIR, 3.78; 95% CI, 1.16 to 6.39) were higher in MM patients than in the general population. In contrast, a lower incidence of solid cancer was observed in MM patients than in the general population (SIR, 0.76, 95% CI, 0.65 to 0.86). There was no significant difference in survival in MM patients without secondary malignancies, with hematologic malignancy, and with solid cancer (p=0.413). Conclusion MM patients had a greater risk of secondary malignancies, especially hematologic malignancies, than the general population. Future studies with a focus on analyzing patients’ history, treatment details, and genetic information in various stages of MM patients are needed to better understand the mechanism behind this increased risk.

BACKGROUND: Granulocyte transfusion therapy has been used as supportive care for patients with prolonged neutropenia after intensive chemotherapy or peripheral blood stem cell transplantation (PBSCT). Here, we investigated clinical factors of granulocyte transfusion therapy for neutropenic patients with infection to evaluate its efficacy and safety. METHODS: A retrospective analysis of 25 neutropenic patients treated with 99 granulocyte collection and granulocyte transfusion therapy from October 2011 to April 2016 at the National Cancer Center was conducted. Two groups, a count recovery group with a cut off of >1,000/µL and a no recovery group were compared and symptoms related with granulocyte transfusion were analyzed. RESULTS: Granulocyte collection and transfusions were performed in 99 procedures. After granulocyte transfusion therapy, 21 patients (84%) showed count recovery, whereas 4 patients (16%) had no response. Significant differences in pre-absolute neutrophil count (29/µL vs. 0/µL, P=0.048), duration of neutropenia before granulocyte transfusion (11 days vs. 26 days, P=0.011), and total number of granulocyte transfusion (2 times vs. 11 times, P=0.049) were observed between groups. Temporary symptoms related granulocyte transfusion were observed in seven patients (28%); however, all patients showed clinical improvement. The median of the single transfusion volume was 220 mL (200 to 397 mL) and the mean total granulocyte content was 4.92×10¹⁰. CONCLUSION: Granulocyte transfusion therapy is safe and effective for patient with life threatening neutropenia and infection, also considerable for early onset trial for granulocyte transfusion.
Drug Therapy ; Granulocytes* ; Humans ; Leukocyte Transfusion ; Neutropenia* ; Neutrophils ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies

In this study, the effect of soil ameliorators on ectomycorrhizal (ECM) fungal communities in coal mine spoils was investigated. Organic fertilizers and slaked lime were applied as soil ameliorators in 3 abandoned coal mine spoils. One year after the initial treatment, roots of Pinus densiflora seedlings were collected and the number of ECM species, colonization rate, and species diversity were assessed. The results showed that the soil ameliorators significantly increased ECM colonization on the roots of P. densiflora. The results suggest that soil ameliorators can have a positive effect on ECM fungi in terms of growth of host plants and show the potential use of soil ameliorator treatment for revegetation with ECM-colonized pine seedlings in the coal mine spoils.
Calcium Compounds ; Coal ; Colon ; Fertilizers ; Fungi ; Oxides ; Pinus ; Seedlings ; Soil

PURPOSE: Parenting stress could be different among mothers of children with brain tumors. The aim of this study was to explore subtypes of children with brain tumor based on their intellectual and psychological characteristics and to compare the parenting stress of their mothers among the subtypes. METHODS: Latent profile analysis was conducted on the Verbal IQ, Performance IQ, and the scores of Social Problem, Internalization Behavior Problem, and Externalization Behavior Problem in a total of 90 children with brain tumors. Furthermore, the mothers' parenting stress was compared among the explored subtypes. RESULTS: Four-categorization appeared the best way to describe the intellectual and psychological presentation of the children with brain tumors and they are as follows; (1) Borderline Intelligence-Socially Maladjusted (B-SM: 24.4%), (2) Average Intelligence-Internalization Behavior Problem (A-I: 44.4%), (3) Average Intelligence-Normal Behavior (A-N: 18.9%), and (4) Retarded Intelligence-Global Maladjusted (R-GM: 12.2%). Mothers of R-GM group reported higher levels of stress on total domain and the subfactors of distractibility and adaptability of Korean Parenting Stress Index compared to mothers of A-N group, and the highest level of stress on spouse subfactor among the mothers of all subtypes. Mothers of subtypes with either intellectual or psychological problems showed higher level of stress on demandingness subfactor compared to mothers of A-N group. CONCLUSION: Eighty percents of children with brain tumor showed intellectual or psychological problems and the mothers of the children with both problems reported the highest parenting stress. The tailored services are needed to manage the parenting stress of mothers of children with brain tumors.
Brain ; Brain Neoplasms ; Child ; Cognition ; Humans ; Mothers ; Parenting ; Parents ; Social Problems ; Spouses

Patients with hyperthyroidism can develop left ventricular dysfunction and heart failure, but severe pulmonary hypertension association with hyperthyroidism is rarely seen. Herein, we describe the case of a 27-year-old female who presented with abdominal distension accompanied by pulmonary arterial hypertension and Graves' disease. Her pulmonary arterial hypertension was improved by treating the hyperthyroidism and pulmonary artery hypertension. Additionally, the patient's symptoms of right-side heart failure improved after pulmonary arterial pressure was reduced. Hyperthyroidism should be regarded as a reversible cause of associated pulmonary arterial hypertension.
Adult ; Arterial Pressure ; Ascites ; Female ; Graves Disease ; Heart Failure ; Humans ; Hypertension ; Hypertension, Pulmonary ; Hyperthyroidism ; Pulmonary Artery ; Ventricular Dysfunction, Left

Pancreatic tissue is maintained by a simple proliferation of the preexisting cells in adulthood, whereas, they are dynamically derived from precursor/ stem cells from ductal epithelia during prenatal life. It has been known that tissue regeneration rarely occurs in the normal adult pancreas, particularly in the human pancreas. However, regeneration can be experimentally induced in the adult pancreas in response to various tissue injuries such as partial resection, pancreatitis by obstruction of the duct, and chemical insults. Regenerating pancreatic tissue shares a common morphogenic feature of "neogenic regeneration" in all regenerating animal models. Neogenic regeneration occurs at the site of tissue injury by forming small tubular structures with elongated epithelial cells (ductules) which grow to form pancreatic ducts and acini. The endocrine cells, including insulin secreting beta cells, are also derived from these ductules. As a sequential process of neogenesis, the regenerating tissue becomes heterogeneous in composition. Some areas were composed by tubules and ductules in surrounding loose connective tissue while others were denser with differentiating acini derived from tubules or ductules. Such neogenic regeneration mimics tissue development during fetal pancreatic organogenesis. In the process of pancreatic neogenesis, we found unique expressions of bioactive proteins such as nestin and clusterin as morphogenic factors. It is likely that the stem/precursor cells could be recapitulated and regenerated to functional cells, including endocrine and exocrine pancreatic cells with acinar and ductal cells during neogenic regeneration of the pancreas.
Adult ; Candidiasis, Cutaneous ; Clusterin ; Connective Tissue ; Endocrine Cells* ; Epithelial Cells ; Humans ; Insulin ; Models, Animal ; Nestin ; Organogenesis ; Pancreas ; Pancreatic Ducts ; Pancreatitis ; Regeneration* ; Social Change ; Stem Cells ; Tinea

Four cases of sudden unexpected death during hospitalization are described where autopsy examination showed lobar pneumonia. As widely accepted, sudden death is defined as a natural unexpected death within 1 hour of symptoms and it is well known that pneumonia can be a cause of sudden death. Although pneumonia is a common finding in autopsy, it is not usual that pneumonia is a direct cause of death, especially in medicolegal autopsy cases. In the present study about 4 cases, pneumonia was primary illness and direct cause of death. 4 victims were all male(39~74 years) and found dead on the bed or corridor couch during their admission. The authors describe the autopsy findings, clinical features and courses, and predisposing factors, with literature review.
Autopsy* ; Causality ; Cause of Death ; Death, Sudden ; Hospitalization ; Humans ; Pneumonia*

No abstract available.
Base Sequence ; Benzamides/therapeutic use ; Bone Marrow/pathology ; Female ; Fusion Proteins, bcr-abl/*genetics ; Humans ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy/*genetics ; Middle Aged ; Philadelphia Chromosome ; Piperazines/therapeutic use ; Protein Kinase Inhibitors/therapeutic use ; Pyrimidines/therapeutic use ; Sequence Analysis, DNA ; Thiazoles/therapeutic use ; Translocation, Genetic