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Biomedical subjects

T Kim

Publications and source records attributed to T Kim.

At least 271 records · Page 15Linked to original sources
PubMed1983

Thyroid neoplasm after high-dose radiotherapy.

A female patient is described who developed papillary-follicular carcinoma of the thyroid 8 years after receiving high-dose external radiotherapy to the head and neck. This malignant neoplasm developed while she was taking suppressive doses of thyroid medication. Although it has long been thought that high-dose radiotherapy is not associated with the occurrence of thyroid tumor, it is becoming increasingly apparent that this concept is not necessarily true. Clinicians should be aware of the possible sequelae of neoplastic thyroid disease after any amount of external radiotherapy to the head and neck. Careful periodic follow-up of patients who have received such treatment is strongly advised.

Adenocarcinoma↗
PubMed1982

Fractionated total lymphoid irradiation as preparative immunosuppression in high risk renal transplantation: clinical and immunological studies.

Twenty-two patients at high risk to reject renal allografts have been treated with fractionated total lymphoid irradiation (FTLI) prior to transplantation of primary (2), secondary (16) or teritary (4) renal allografts. All patients undergoing retransplantation had rapidly rejected previous grafts. At 24 months following transplantation, 72% of grafts were functioning in the TLI group compared with a 38% graft function in an historical control group of recipients receiving secondary or tertiary grafts and treated with conventional immunosuppression. Important variables in determining success of transplantation following fractionated TLI include the dose of TLI, the interval from radiation to transplantation, and maintenance, post-transplant immunosuppressive therapy. Optimal results were achieved with 2500 rads delivered in 100 rad fractions followed by transplantation within two weeks, and a tapering prednisone schedule and maintenance azathioprine post-transplantation. Seventeen patients had significant complications of the radiation treatment and there was one death, prior to transplantation, associated with pneumonitis. In vitro assessment of immune function demonstrated marked peripheral T cell depletion and loss of in vitro responsiveness to mitogen and allogeneic stimulation following FTLI. The administration of donor bone marrow at the time of transplantation did not produce chimerism. The results suggest that when properly utilized FTLI can produce effective adjunctive immunosuppression for clinical transplantation.

Adolescent↗
PubMed1982

Allogeneic bone marrow transplantation in acute nonlymphocytic leukemia: a pilot study.

The objective of the current study, initiated in 1976, was to improve upon the high relapse rate and subsequent mortality in children and young adults with acute nonlymphocytic leukemia (ANLL). Seventeen patients, ages 6--28, with ANLL in first bone marrow remission, received cyclophosphamide and total body irradiation using a radiation scheme of 750 rad (7.5 Gy) total dose, delivered at a dose rate of 26 rad (26 cGy) per minute. Allogeneic marrow from HLA-matched sibling donors was followed by prophylactic therapy or graft-versus-host disease (GVHD). Median follow-up of the entire group is 20+ mo; survivors have been followed for a minimum of 14+ mo. Interstitial pneumonitis was observed in 6% of patients, and GVHD was observed in 29%. Seventy percent of patients are alive and in complete continuous remission. Two patients have relapsed (at 7 and 24 mo). Actuarial relapse-free survival is 76% at 1 yr and 64% at 5 yr. Quality of life in this disease-free survivors is excellent; all patients are free of active GVHD, receive no maintenance chemotherapy, and have high Karnofsky performances scores. High dose rate total body irradiation plus cyclophosphamide followed by allogeneic BMT may provide an opportunity for long-term complication-free survival in a substantial proportion of children and young adults with ANLL.

Acute Disease↗
PubMed1981

Effect of x-irradiation on immunocompetency of T-lymphocytes.

Effect of x-irradiation on various aspects of cell-mediated immune reactions is studied. The irradiated splenic lymphocytes could transform to blast cells upon stimulation with PHA, but could not divide into small lymphocytes. It was concluded that irradiation at doses higher than 500 rads inhibits the differentiation of lymphocytes to effector cells upon stimulation with antigens. The irradiated immune lymphocytes were able to kill target tumor cells when the cytotoxicity was tested immediately after irradiation with doses as high as 500 rads. The cytotoxicity of immune lymphocytes diminished, however, 7--10 hours after irradiation. The splenic lymphocytes irradiated with doses as high as 200 rads could stimulate allogeneic lymphocytes 2 days after the irradiation. It thus appeared that irradiation cannot immediately abolish the antigenicity of lymphocytes to stimulate allogeneic lymphocytes. The combined effect of irradiation and T-cell-mediated immune reaction to reduce clonogenecity of target tumor cells in vitro is simple additive.

Autoradiography↗
PubMed1981

Cytogenetic conversion following allogeneic bone marrow transplantation for advanced chronic myelogenous leukemia.

We performed a pilot study to test the effectiveness of allogeneic bone marrow transplantation in the treatment of chronic myelogenous leukemia. Five patients in the advanced stages of chronic myelogenous leukemia (four in blast crisis, one in accelerated phase) with abnormal chromosomes underwent matched-sibling allogeneic bone marrow transplantation after preparation with busulfan, vincristine, cyclophosphamide, and fractionated total body irradiation. Engraftment and conversion to normal chromosome patterns after transplantation occurred in all five patients. None of the patients reverted to an abnormal chromosome pattern of demonstrated clinical or hematologic evidence of recurrent disease during the course of this study; however, longest survival from transplant was 248 days. Allogeneic bone marrow transplantation can eradicate the abnormal clone even in far advanced chronic myelogenous leukemia and can provide normal hematopoiesis. We suggest that clinical complications of chemotherapeutic toxicity and infection were responsible for the short survival in this group of patients, and that these complications could be decreased by performing transplantation in the chronic phase or early accelerated phase of the disease.

Adult↗
PubMed1980

Radiation therapy for advanced head and neck squamous-cell carcinoma using twice-a-day fractionation.

Fifteen patients with massive advanced squamous-cell carcioma of the head and neck received radiation therapy under the twice-a-day fractionation regimen. The purpose was to increase the therapeutic ratio by minimizing sublethal radiation damage to normal tissue while allowing reoxygenation of radioresistant hypoxic tumor cells. Results demonstrated better local control than can be achieved through once-a-day fractionation, with 53% of the patients showing no evidence of primary tumor at the end of therapy, and 60% showing complete regression of cervical lymphadenopathy.

Carcinoma, Squamous Cell↗
PubMed1980

Total lymphoid irradiation and cyclophosphamide as preparation for bone marrow transplantation in severe aplastic anemia.

A new combination of total lymphoid irradiation and cyclophosphamide was used prior to bone marrow transplantation in an attempt to achieve decreased rejection rates and graft-versus-host disease. Nine previously transfused patients with severe aplastic anemia received marrow from an HLA-identical, MLC-compatible sibling following this preparative regimen. There were no episodes of graft rejection, and only one patient developed graft-versus-host disease. Of the 9 patients, 7 (78%) are surviving with a median follow-up of 400 days. The excellent results of this pretransplant combination of total lymphoid irradiation and cyclophosphamide warrants application of this regimen to a larger series of patients.

Adolescent↗