1.Pulmonary Thromboembolectomy for Acute Pulmonary Thromboembolism.
Inho YI ; Joo Chul PARK ; Kyu Seok CHO ; Bum Shik KIM ; Soo Cheol KIM ; Dae Hyun KIM ; Jung Heon KIM ; Hyo Chul YOUN
The Korean Journal of Thoracic and Cardiovascular Surgery 2011;44(5):343-347
BACKGROUND: Acute pulmonary thromboembolism is fatal because of abruptly occurring hypoxemia and right ventricular failure. There are several treatment modalities, including anticoagulation, thrombolytics, ECMO (extracorporeal membrane oxygenator), and thromboembolectomy, for managing acute pulmonary thromboembolism. MATERIALS AND METHODS: Medical records from January 1999 to December 2004 at our institution were retrospectively reviewed for pulmonary thromboembolectomy. There were 7 patients (4 men and 3 women), who underwent a total of 8 operations because one patient had post-operative recurrent emboli and underwent reoperation. Surgery was indicatedfor mild hypoxemia and performed with CPB (cardiopulmonary bypass) in a beating heart state. RESULTS: The patients had several symptoms, such as dyspnea, chest discomfort, and palpitation. Four patients had deep vein thromboembolisms and 3 had psychotic problems, specifically schizophrenia. Post-operative complications included hemothorax, pleural effusion, and pericardial effusion. There were two hospital deaths, one each by brain death and right heart failure. CONCLUSION: Emergency operation should be performed when medical treatments are no longer effective.
Anoxia
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Brain Death
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Dyspnea
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Emergencies
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Extracorporeal Membrane Oxygenation
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Heart
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Hemothorax
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Humans
;
Male
;
Medical Records
;
Membranes
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Pericardial Effusion
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Pleural Effusion
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Pulmonary Embolism
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Reoperation
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Retrospective Studies
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Schizophrenia
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Thorax
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Thromboembolism
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Veins
2.Allogeneic clonal mesenchymal stem cell therapy for refractory graft-versus-host disease to standard treatment: a phase I study.
Hyeon Gyu YI ; Seung Ah YAHNG ; Inho KIM ; Je Hwan LEE ; Chang Ki MIN ; Jun Hyung KIM ; Chul Soo KIM ; Sun U SONG
The Korean Journal of Physiology and Pharmacology 2016;20(1):63-67
Severe graft-versus-host disease (GVHD) is an often lethal complication of allogeneic hematopoietic stem cell transplantation (HSCT). The safety of clinical-grade mesenchymal stem cells (MSCs) has been validated, but mixed results have been obtained due to heterogeneity of the MSCs. In this phase I study, the safety of bone marrow-derived homogeneous clonal MSCs (cMSCs) isolated by a new subfractionation culturing method was evaluated. cMSCs were produced in a GMP facility and intravenously administered to patients who had refractory GVHD to standard treatment resulting after allogeneic HSCT for hematologic malignancies. After administration of a single dose (1x10(6) cells/kg), 11 patients were evaluated for cMSC treatment safety and efficacy. During the trial, nine patients had 85 total adverse events and the rate of serious adverse events was 27.3% (3/11 patients). The only one adverse drug reaction related to cMSC administration was grade 2 myalgia in one patient. Treatment response was observed in four patients: one with acute GVHD (partial response) and three with chronic GVHD. The other chronic patients maintained stable disease during the observation period. This study demonstrates single cMSC infusion to have an acceptable safety profile and promising efficacy, suggesting that we can proceed with the next stage of the clinical trial.
Bone Marrow
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Drug-Related Side Effects and Adverse Reactions
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Graft vs Host Disease*
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Hematologic Neoplasms
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Hematopoietic Stem Cell Transplantation
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Humans
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Mesenchymal Stromal Cells*
;
Myalgia
;
Population Characteristics
3.Central Pontine Myelinolysis in a Patient with Acute Lymphoblastic Leukemia after Hematopoietic Stem Cell Transplantation: A Case Report.
Kyu Hyoung LIM ; Sunyoung KIM ; Yoon Su LEE ; Ki Hwan KIM ; Jinwon KIM ; Ji Young RHEE ; Hye Jin KIM ; Hyeon Gyu YI ; So Yeon OH ; Joo Han LIM ; Sae Won HAN ; Sangyoon LEE ; Inho KIM ; Sung Soo YOON ; Seonyang PARK ; Byoung Kook KIM
Journal of Korean Medical Science 2008;23(2):324-327
We describe a 37-yr-old man who developed central pontine myelinolysis (CPM) after allogeneic hematopoietic stem cell transplantation (HSCT) for acute lymphoblastic leukemia. After HSCT, desquamation developed on the whole body accompanied by hyperbilirubinemia. The liver biopsy of the patient indicated graft-versus-host disease- related liver disease, and the dose of methylprednisolone was increased. Then, the patient developed altered mentality with eye ball deviation to the left, for which electroencephalogram and magnetic resonance imaging (MRI) scans were done. Brain MRI scan demonstrated the imaging findings consistent with central pontine myelinolysis and extrapontine myelinolysis. He did not have any hyponatremia episode during hospitalization prior to the MRI scan. To the best of our knowledge, presentation of CPM after allogeneic HSCT is extremely rare in cases where patients have not exhibited any episodes of significant hyponatremia. We report a rare case in which hepatic dysfunction due to graft-versus-host disease has a strong association with CPM after HSCT.
Adult
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Biopsy
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Brain/pathology
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Electroencephalography
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Graft vs Host Disease
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Hematopoietic Stem Cell Transplantation/*adverse effects
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Humans
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Hyperbilirubinemia/etiology
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Liver/pathology
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Magnetic Resonance Imaging
;
Male
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Myelinolysis, Central Pontine/complications/*etiology
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Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications/*therapy
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Time Factors
;
Treatment Outcome