• Clinical and Experimental Pediatrics
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• 제50권10호
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• pp.982-986
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• 2007

목 적 : 특발성혈소판감소성자반증의 치료로 정주용 면역 글로불린을 사용한 후 절대 중성구치의 변화에 대하여 조사하였다. 방 법 : 내원 당시 발열이나 CRP 증가, 스테로이드 사용 등 백혈구수치에 영향을 받을 수 있는 인자를 가지지 않은 특발성혈소판감소성자반증 환아 26례를 대상으로 사용된 정주용 면역 글로불린의 용량과 사용중 발열 여부 등에 따라 정주용 면역 글로불린을 1일간 사용한 전후의 절대 중성구 수치의 변화를 후향적으로 관찰하였다. 결 과 : 특발성혈소판감소성자반증의 치료로 면역 글로불린을 사용한 후 1일이 지났을 때 절대 호중구 수치는 감소되었던 경우가 많았고 절대 호중구 수치의 감소 정도는 면역 글로불린의 용량과 관계가 있었다. 면역 글로불린 사용 후 절대 호중구 수치가 증가되었던 경우는 면역 글로불린 사용 중 발열을 동반하거나 저용량의 면역 글로불린을 사용하였던 경우들이었다. 절대 호중구 수치가 감소된 경우에도 감염성 합병증이 있었다고 기술되었던 경우는 찾을 수 없었다. 결 론 : 특발성혈소판감소성자반증의 치료에 면역 글로불린을 사용하고 1일 후 절대 호중구 수치가 감소되는 현상을 관찰할 수 있었다. 심각한 감염성 합병증이 있었다는 기록은 찾기 어려웠으나 이러한 현상이 환자에게 어떤 영향을 미치는지에 대해서는 앞으로 계속 관찰할 필요가 있겠다.

• 대한임상검사과학회지
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• 제36권1호
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• pp.27-32
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• 2004

Bone marrow transplantation(BMT) is widely used as curative means of various malignant and nonmalignant hematologic disorders, and early and accurate determination of engraftment is very important for critical management decisions. Reticulocyte counts performed by automated flow cytometric methods is a good indicator of erythropoietic activity and its evaluation has been proposed as an early predictor of bone marrow regeneration. Some reports highlighted the usefulness of the percentage of highly fluorescent reticulocytes and the sum of highly and medium fluorescent reticulocytes(immature reticulocyte fraction, IRF). In Asan Medical Center, the criteria for engraftment following BMT or PBSCT was defined as the first day of a 3-day trend of absolute neutrophil count(ANC)${\geq}500/uL$ and platelet count${\geq}30{\times}10^3/uL$. In 1999, Grotto et al proposed an indidator of bone marrow recovery as the first day on which the IRF was twice the minimum value after bone marrow transplantation. To compare the both criterias, we got consecutive datas of immature reticulocyte fraction, absolute neutrophil count(ANC), WBC count, platelet count and reticulocyte count by XE-2100 automated hematology analyzer(Sysmex Co. Japan) from 33 patients daily after BMT. When compared to standard neutrophil engraftment(10-30 days, $16.2{\pm}4.6days$), IRF engraftment (5-21 days, $11.0{\pm}3.9days$) occured significantly earlier in 87.9% of patients(P<0.05). The mean engraftment day for WBC count(11-29 days, $16.4{\pm}4.3days$) was similar to ANC, but platelet count and reticulocyte count revealed more delayed data (10-49 days, $19.1{\pm}7.4days$ vs 17-64 days, $31.4{\pm}14.1days$). In conclusion, our results confirm that an increase in the immature reticulocyte population is the earliest sign of the hematopoietic recovery after BMT and that automated reticulocyte quantification including immature fraction may be integrated into clinical protocols to evaluate bone marrow reconstitution.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2523-2526
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• 2012

Introduction: Febrile neutropenia is a relatively frequent event in cancer patients treated with chemotherapy and improvement in absolute neutrophil count (ANC) has been linked directly to improved outcome. Evaluation of granulocyte colony stimulating factors (GCSFs) for treatment has shown reduced incidences of episodes of prolonged neutropenia and protracted hospitalization. To determine absolute neutrophil counts with GCSF in febrile neutropenic cancer patients admitted to a tertiary care centre and to co-relate the improvement in ANC with mortality and hospital discharge. Methods: A prospective cross sectional study was carried at an oncology ward at Aga Khan University hospital from January 2010 to June 2011. All adult patients who were admitted and treated with GCSF for chemotherapy induced febrile neutropenia were included. Multivariable regression was conducted to identify the factors related with poor outcomes. Results: A total of 131 patients with febrile neutropenia were identified with mean age of 43.2 (18-85) years, 79 (60%) being ${\leq}50$. Seventy-five (57%) had solid tumors and 56 (43%) hematological malignancies, including lymphoma. Fifty seven (43.5%) had an ANC less 100 cells/$mm^3$, 34 (26%) one between 100-300 cells/$mm^3$ and 40 (31%) an ANC greater than 300 cells/$mm^3$. Thirty (23%) patients showed ANC recovery in 1-3 days, and 74(56%) within 4-7 days. Thirteen (10%) patients showed no recovery. The overall mortality was 18 (13.7%) patients. The mean time for ANC recovery seen in hematological malignancies was 6.34 days whereas for solid tumors it was 4.88 days. Patients with ANC <100 cells/$mm^3$ were more likely to die than patients with ANC >300 cells/$mm^3$ by a factor of 4.3. Similarly patients >50 years of age were 2.7 times more likely to die than younger patients. Conclusion: Our study demonstrated that use of GCSF, in addition to intravenous antibiotics, in treatment of patients with chemotherapy induced febrile neutropenia accelerates neutrophil recovery, and shortens antibiotic therapy and hospitalization. We propose to risk classify the patients at the time of admission to evaluate the cost effectiveness of this approach in a resource constrained setup.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.422-430
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• 2010

Purpose: The aim of this study is that we evaluate the change of the White Blood Cell(WBC) count, Absolute Neutrophil Count (ANC), Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP) values, and try to make standardization for postoperative sequels before and after the oral cancer resection and reconstructive surgery. Materials and Methods: The study was comprised of 34 patients (male 15, female 19) who were diagnosed as an oral cancer and had performed ablation and reconstructive surgery at Dankook university dental hos-pital. Each blood specimen was collected from patients and estimated WBC count, Neutrophil count, ESR, CRP on first, third, fifth, seventh day efore and after surgery and analyzing inter relationship between each value. Classifying Group I (resection with reconstructive surgery patients) and Group II (resection without reconstructive surgery patients). Also classifying group A (below 4 hours of operation time), Group B (4 to 8 hours of operation time), Group C (above 8 hours of operation time), each group was analyzed and compared. The Following results were induced. Results: (1) In coefficient of correlation, the CRP and WBC has highest value except WBC count and Neutrophil count. (2) There was no significant difference any lapse in the progress between Group I and II of WBC count, Neutrophil count, but the CRP shows statistically higher level in group I than group II at immediate postoperative day, and 1 to 5 days after surgery. (3) There is no significant difference any lapse in the progress between Group A, B, C of WBC count, Neutrophil count, but CRP shows statistically significant difference in 1 day, 3 days after surgery Conclusion: It should be suggested that, determination of CRP is most valuable parameter for postopera-tive management and determination of postoperative clinical changes than other parameter such as WBC count, neutrophil count, and ESR values in oral cancer patient after resection and reconstructive surgery, based on the results of this study.

• 동의생리병리학회지
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• 제29권1호
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• pp.85-89
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• 2015

The purpose of this study is to report two patients with neutropenia caused by chemotherapy who prescribed Samul-tanggagambang. Samul-tanggagambang was prescribed three times a day to two patients with chemotherapy induced neutropenia. Complete blood cell count is measured before and after prescription. Absolute Neutrophil Count (ANC) was gradually increased after administration of Samul-tanggagambang to the cancer patients. Significantly, no related adverse events were found. Samul-tanggagambang has shown benefit in improving chemotherapy induced neutropenia. It is expected to be a promising treatment for improving chemotherapy induced neutropenia and more clinical research will be required for evidence based using.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권1호
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• pp.39-47
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• 2015

Purpose: To determine clinically useful biochemical markers reflecting disease activity and/or gastrointestinal (GI) tract involvement in Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP). Methods: A total of 185 children with HSP and 130 controls were included. Laboratory data indicating inflammation, standard coagulation, and activated coagulation were analyzed for the HSP patients, including measurements of the hemoglobin level, white blood cell (WBC) count, absolute neutrophil count (ANC), platelet count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, prothrombin time, activated partial thromboplastin time, and fibrinogen, D-dimer, and fibrin degradation product (FDP) levels. The clinical scores of the skin, joints, abdomen, and kidneys were assessed during the acute and convalescence phases of HSP. Results: The WBC count, ANC, ESR, and CRP, fibrinogen, D-dimer, and FDP levels were significantly higher in the acute phase compared with the convalescent phase of HSP (p<0.05). The total clinical scores were more strongly correlated with the D-dimer (r=0.371, p<0.001) and FDP (r=0.369, p<0.001) levels than with inflammatory markers, such as the WBC count (r=0.241, p=0.001), ANC (r=0.261, p<0.001), and CRP (r=0.260, p<0.001) levels. The patients with GI symptoms had significantly higher ANC (median [interquartile range], 7,138.0 [4,446.4-9,470.0] vs. 5,534.1 [3,263.0-8,153.5], p<0.05) and CRP (0.49 [0.15-1.38] vs. 0.23 [0.01-0.67], p<0.05), D-dimer (2.63 [1.20-4.09] vs. 1.75 [0.62-3.39]), and FDP (7.10 [0.01-13.65] vs. 0.10 [0.01-7.90], p<0.05) levels than those without GI symptoms. Conclusion: D-dimer and FDPs are more strongly associated with disease activity and more consistently reflect GI involvement than inflammatory markers during the acute phase of HSP.

• Journal of Yeungnam Medical Science
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• 제40권3호
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• pp.283-288
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• 2023

Severe chronic neutropenia is classified as severe congenital, cyclic, autoimmune, or idiopathic. However, there is a lot of uncertainty regarding the diagnosis of severe congenital neutropenia (SCN) and chronic idiopathic neutropenia, and this uncertainty affects further evaluations and treatments. A 20-year-old man presented with fever and knee abrasions after a bicycle accident. On admission, his initial absolute neutrophil count (ANC) was 30/µL. He had no medical history of persistent severe neutropenia with periodic oscillation of ANC. Although his fever resolved after appropriate antibiotic therapy, ANC remained at 80/µL. Bone marrow (BM) aspiration and biopsy were performed, and a BM smear showed myeloid maturation arrest. Moreover, genetic mutation test results showed a heterozygous missense variant in exon 4 of the neutrophil elastase ELANE: c597+1G>C (pV190-F199del). The patient was diagnosed with SCN. After discharge, we routinely checked his ANC level and monitored any signs of infection with minimum use of granulocyte colony-stimulating factor (G-CSF), considering its potential risk of leukemic transformation. Considering that SCN can be fatal, timely diagnosis and appropriate management with G-CSF are essential. We report the case of a patient with SCN caused by ELANE mutation who had atypical clinical manifestations. For a more accurate diagnosis and treatment of severe chronic neutropenia, further studies are needed to elucidate the various clinical features of ELANE.

• Clinical and Experimental Pediatrics
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• 제49권11호
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• pp.1167-1173
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• 2006

목 적 : 신생아 패혈증을 진단하기 위해 단독 그리고 복합적인 다양한 선별검사를 분석하기 위해 일신기독병원의 신생아집중치료실에서 2001년 4월 1일부터 2005년 12월 31일까지 68개월 동안 시행했다. 방 법 : 패혈증의 임상증상이 있는 100명의 신생아와 증상이 없는 정상 신생아를 대상으로 연구를 시행했다. 신생아 패혈증의 진단을 위해 CRP, 총 백혈구 수, 총 호중구 수, 미숙호중구/총호중구 비(I/T비), 혈소판 수, 호중구의 변성, 다형 핵 백혈구에 대한 GAC를 사용했다. 결 과 : CRP는 A군에서는 50례 중 40례에서(86%) 양성이었고 B군에서는 50례 중 37례에서(74%) 양성이었으며 특이도는 94%였다. 총 호중구 수는 민감도와 특이도가 각각 A군에서는 72%와 86%였고 B군에서는 62%와 86%로 단일 검사상 민감도가 두 번째로 높았다. A군에서 GAC와 혈소판 수에 대한 각각의 민감도는 74%와 64%였다. A군과 B군에 대해 검사를 개별적으로 시행했을 경우와 함께 시행했을 경우에 대한 민감도, 특이도, 그리고 예측도를 계산했다. 결 론 : CRP, 총 백혈구 수, 총 호중구 수, 혈소판 수, 호중구의 변성과 다형 핵 백혈구에 대한 GAC는 신생아 패혈증이 없는 배양 검사 상 음성인 경우를 알아내는데 높은 민감도를 나타냈다. 더욱이 3가지 검사를 함께 시행할 경우에 민감도가 증가했다.

• Clinical and Experimental Pediatrics
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• 제51권2호
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• pp.204-208
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• 2008

목 적 : 본 연구는 소아 급성 ITP에서 IVIG 치료 후 호중구 감소의 빈도와 정도 및 경과 등을 알아보기 위하여 시행되었다. 방 법 : 2001년 1월부터 2006년 6월까지 부산대학교병원에서 급성 ITP로 진단받은 소아 환자 총 54례를 대상으로 하였다. 이중 IVIG를 투여한 군이 42례, Anti-D Ig을 투여한 군이 12례이었으며, 각각의 투여 후에 백혈구 및 호중구 수를 비교하였다. 또한 IVIG의 투여 방법 및 투여 횟수에 따른 백혈구 및 호중구 수도 비교하였다. 결 과 : IVIG 투여 군과 Anti-D Ig 투여 군에서 투여 직전의 백혈구 및 호중구 수의 차이는 없었으나, 투여 후에는 IVIG 투여군에서 42례 중 32례(76.2%)가 투여 전에 비해 호중구 수가 50% 이상 감소하였고, 투여 종료 후 1일째에 호중구수가 최저로 감소하였다. 한편 Anti-D Ig 투여군에서는 12례 중 2례(16.7 %)만이 투여 전 호중구 수에 비해 50% 이상으로 감소하였다. 첫 번째 IVIG 투여군(42례)과 재투여군(7례)에서 호중구 수의 감소는 통계학적인 차이가 없었다. IVIG 투여 방법에 따른 호중구 수의 감소는 5일간 투여군과 2일간 투여군 사이에 통계학적인 차이가 없었다. 면역글로불린 투여 후에 발생한 호중구 감소는 평균 투여 종료 7일 후에 39례 중 38례(97%)에서 자연적으로 회복되었다. 결 론 : 소아 ITP 환자에서 IVIG 투여 후에 호중구 감소가 비교적 흔하게 발생되며, 이는 일시적인 현상으로 대부분 자연적으로 회복되는 것으로 생각된다.

• 대한암한의학회지
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• 제16권2호
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• pp.9-17
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• 2011

Objectives : Contradictions for Oncology acupuncture were searched and reviewed to establish fundamentals for the appropriate contraindication guideline. Methods : In order to search contraindications for oncology acupuncture, domestic journals, books and online database of Pubmed were searched using the terms, cancer, tumor, acupuncture, safety, contraindications and guideline were below. Results : We found 7 papers and 1 book by the above methods. We reviewed and suggested the contraindications. Contraindications for oncology acupuncture are neutropenia (absolute neutrophil count : ANC less than $500/mm^3$), thrombocytopenia (platelets less than $50,000/mm^3$), anticoagulant use, spinal instability, tumour nodule, lymphedema, prosthesis, intracranial deficits, confused patients, significant arrhythmia, patient refusal to treatment, severe neurotic patients and intracardiac defribillator. Contraindications for using semi-permanent needles are neutropenia (ANC less than $500/mm^3$), splenectomy, valvular heart disease, B, C hepatitis and keloids. Conclusions : Acupuncture for cancer patients pose significant risks but these guidelines are proposed in the hopes of providing certain boundaries in practicing oncology acupuncture. A more systematic and rigorous research is needed to establish a more reliable oncology acupuncture guidelines.