1.Current Perspectives on Emerging CAR-Treg Cell Therapy: Based on Treg Cell Therapy in Clinical Trials and the Recent Approval of CAR-T Cell Therapy.
Koeun KANG ; Junho CHUNG ; Jaeseok YANG ; Hyori KIM
The Journal of the Korean Society for Transplantation 2017;31(4):157-169
Regulatory T cells (Treg) naturally rein in immune attacks, and they can inhibit rejection of transplanted organs and even reverse the progression of autoimmune diseases in mice. The initial safety trials of Treg against graft-versus-host disease (GVHD) provided evidence that the adoptive transfer of Treg is safe and capable of limiting disease progression. Supported by such evidence, numerous clinical trials have been actively investigating the efficacy of Treg targeting autoimmune diseases, type I diabetes, and organ transplant rejection, including kidney and liver. The limited quantity of Treg cells harvested from peripheral blood and subsequent in vitro culture have posed a great challenge to large-scale clinical application of Treg; nevertheless, the concept of CAR (chimeric antigen receptor)-Treg has emerged as a potential resolution to the problem. Recently, two CAR-T therapies, tisagenlecleucel and axicabtagene ciloleucel, were approved by the US FDA for the treatment of refractory or recurrent acute lymhoblastic leukemia. This approval could serve as a guideline for the production protocols for other genetically engineered T cells for clinical use as well. The phase I and II clinical trials of these agents has demonstrated that genetically engineered and antigen-targeting T cells are safe and efficacious in humans. In conclusion, both the promising results of Treg cell therapy from the clinical studies and the recent FDA approval of CAR-T therapies are paving the way for CAR-Treg therapy in clinical use.
Adoptive Transfer
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Animals
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Autoimmune Diseases
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Cell- and Tissue-Based Therapy*
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Disease Progression
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Graft vs Host Disease
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Humans
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In Vitro Techniques
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Kidney
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Leukemia
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Liver
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Mice
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T-Lymphocytes
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T-Lymphocytes, Regulatory*
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Transplantation
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Transplants
2.Study of Functional Appliance for Treatments of Children and Adolescents with Class II Malocclusion
Himchan KANG ; Koeun LEE ; Misun KIM ; Okhyung NAM ; Hyo-seol LEE ; Kwangchul KIM ; Sungchul CHOI
Journal of Korean Academy of Pediatric Dentistry 2020;47(3):235-247
The purpose of this study was to evaluate the skeletal and dentoalveolar effects and optimal timing for treatment of class II malocclusion with functional appliances in children and adolescents. A group of 30 patients with class II malocclusion were divided into 3 groups according to their use of functional appliance: Twin block, Activator, Fränkel appliance. The group was also divided into 2 groups according to the cervical vertebrae maturation method. Lateral cephalometric radiographs were analyzed pretreatment (T0) and osttreatment(T1). Among the functional appliances, treatment with Twin block and Activator showed significant increase in the length of the mandible (Co-Gn) and the lower anterior facial height (ANS to Me), whereas the overjet and overbite were significantly reduced. Treatment with Fränkel appliance showed significant improvement in the relationship of maxilla and mandible. In addition, if the functional appliance was used during the period of pubertal growth peak, there was a significant increase in mandibular length, improvement in the relationship of maxilla and mandible, labial inclination of lower incisors and decrease in overjet compared to the treatment before pubertal growth peak. Therefore, this studyindicates that using functional appliances for patients with class II malocclusion is effective and the optimal timing for using functional appliances is during pubertal growth peak.
3.Long-Term Outcome of Reattached Tooth Fragment in Permanent Anterior Teeth of Children and Adolescents
Hoyeon KANG ; Yongkwon CHAE ; Koeun LEE ; Hyo-seol LEE ; Sungchul CHOI ; Okhyung NAM
Journal of Korean Academy of Pediatric Dentistry 2021;48(1):42-49
This study aimed to evaluate the long-term outcomes of teeth treated with reattachment technique in children and adolescents. Twenty seven permanent anterior teeth from 21 patients treated with fragment reattachment were evaluated. Clinical photos and medical records were used to assess treatment outcomes. Effect of pulp treatment and the ratio of fragment on success rate were statistically analyzed. Detachment of fragment was observed in 17 teeth, and their duration of retention was 21.41 ± 23.39 months. Repeated trauma was found to be the most frequent causes of failure. Pulp treatment before reattachment did not affect the success rate (p > 0.05). The mean ratio of fragment was 0.482 ± 0.147, and the success rate was affected by the ratio of fragment (p = 0.018). The median retention time of the teeth was 72 months if the ratio was under 0.5, and 8 months for that of the others. A significant correlation was found between the ratio of fragment and retention time (p = 0.003). Reattachment can be a predictable treatment option for crown fracture in anterior teeth in children and adolescents when a fracture involves less than 50% of the clinical crown.
4.Predicting Vascularized Bone Graft Viability Using 1-Week Postoperative Bone SPECT/CT After Maxillofacial Reconstructive Surgery
Hyunji KIM ; Koeun LEE ; Sejin HA ; Eonwoo SHIN ; Kang-Min AHN ; Jee-Ho LEE ; Jin-Sook RYU
Nuclear Medicine and Molecular Imaging 2020;54(6):292-298
Purpose:
We aimed to evaluate the performance of hybrid bone single-photon emission computed tomography (SPECT)/computed tomography (CT) in predicting bone graft viability after maxillary or mandibular reconstructive surgery with vascularized bone grafts.
Methods:
We retrospectively reviewed 46 bone planar scintigraphy and SPECT/CT images of 45 adult patients taken at 1 week (5–8 days) after maxillary or mandibular reconstructive surgery with vascularized bone grafts. By visual analysis, two nuclear medicine physicians scored the uptake degrees of each bone graft segment compared with the calvarium uptake on planar bone scintigraphy and SPECT/CT, respectively (0 = absence of uptake, 1 = less uptake, 2 = similar uptake, and 3 = more uptake). The imaging results were compared with clinical follow-up for assessing bone graft viability.
Results:
During follow-up, five bone graft segments were surgically removed and confirmed as nonviable—one had a score of 0, although the other four had a score of 1–3 on planar bone scintigraphy. All five bone graft segments were scored 0 on SPECT/CT and eventually confirmed as nonviable. All other graft segments with a score of > 1 on SPECT/CT were viable and uneventful.The anatomical CT information on SPECT/CT images was helpful in discriminating bone graft uptake from adjacent bone or soft tissue uptake.
Conclusions
The absence of tracer uptake by the vascularized bone graft on bone SPECT/CT at 1 week after maxillary or mandibular reconstructive surgery can predict graft failure. Bone SPECT/CT can be used to predict vascularized bone graft viability postoperatively.