• Title/Summary/Keyword: Aplastic anemia

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Central Venous Access for Chemoterapy in Patients with Malignant Disease (항암 화학요법을 받는 환자들에서의 중심정맥삽관술)

  • Kim, Uk-Seong;Kim, Gi-Bong
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.483-487
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    • 1993
  • From July 1990 to August 1992,78 Hickman catheters and 22 chemoports were inserted in 98 patients for chemotherapy.We analyzed the clinical data of these patients. The results were as follows: 1]Mean age of patients was 42.8$\pm$1.6[SE] years 2]Male to female ratio was 1.09:1 3]The diseases of the cases were leukemia[66] ,lymphoma[8], stomach cancer[8],uterine cervix cancer[5],ovarian cancer[4],lung cancer[3],aplastic anemia[2],maxillary gland cancer[1],pancreas cancer[1],malignant mesothelioma[1] and multiple myeloma[1] 4]Mean values of preoperative WBC counts,platelet counts,PT and APTT were 31,500$\pm$ 8,132[SE]/mm,104,000$\pm$ 12,200 [SE]/mm,82$\pm$ 1.9[SE]% and 32$\pm$ 0.8[SE] sec,respectively. 5]The average duration of catheter uses was 121.7$\pm$ 17.3[SE]days. 6]The complications were subcutaneous tunnel bleeding or hematoma[2],exit site or subcutaneous tunnel infection[2] and catheter related septicemia[1]. 7]The causes of catheter removal were patient`s death or hopeless discharge[22],completion of treatment[6],subcutaneus hematoma or bleeding[2],exit site or subcutaneous tunnel infection[2] and catheter related septicemia[1].So,we concluded that Hickman catheter and chemoport were useful vascular access for chemotherapy in patients with malignant diseases, with low rate of complication and longterm duration.

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The Clinical Observation on 3 Cases of Hemifacial Spasm (침술요법과 부항요법을 사용한 안면경련 치험 3례 -근막동통증후군(Myofascial syndrome: MPS)을 위주로 하여 치료함-)

  • Park, Ho-soon;Kim, Yoon-bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.16 no.3
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    • pp.242-251
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    • 2003
  • In the treatment of hemifacial spasm, the operative methods, such as neurovascular decompression, rhizotomy etc. are the most efficacious therapy on its control. But, due to some side effects and complication, pharmacotherapy has been the first attempted by first intention of hemifacial spasm. The carbamazepine is the most commonly used agent, however it is often inefficacious in some cases, and attenuates as the time passes, engages in some symptoms, such as dizziness, nausea, vomiting, and causes an aplastic anemia, it has many deficiencies in becoming the first intention. Acupuncture is a simple, effective and conservative spasm control modality. It is so simple to use in hemifacial spasm. We had observed 3 cases of hemifacial spasm which were treated by acupuncture in Oriental clinic recently. We reported these cases and reviewed related literatures briefly. The results of treatment are as follows; The clinical conditions of spasm intensity was improved after the therapy. These results suggest that acupuncture and negative therapy be effective as the first intention in healing hemifacial spasm.

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In vitro Metabolism of Stanozolol to 3'-Hydroxystanozolol in the Liver S-9 Fraction of Polychlorinated Biphenyl-treated Rats (Polychlorinated biphenyl 전처리한 횐쥐 간장의 S-9 분획에서 Stanozolol의 Hydroxylation 대사체의 생성)

  • 권오승;류재천
    • YAKHAK HOEJI
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    • v.44 no.5
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    • pp.379-383
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    • 2000
  • Stanozolol (STZ, 17$\alpha$-methyl-17$\beta$-hydroxy-5$\alpha$-androstano-(3,2-c) pyrazole), an anabolic steroid, is an abused drug by body-builders or atheletes, as well as medicine for treatment of aplastic anemia and vascular thrombosis. In human volunteers, the major urinary metabolite of STZ was reported to be 3'-hydroxystanozolol that was identified by gas chromatography-mass selective detector (GC/MSD). The objective of this experiment is to investigate the in vitro metabolism of STZ in liver S-9 faction of polychlorinated biphenyl-induced rats. Reaction mixture including STZ as substrate and the S-9 faction was extracted with diethyl ether and quantified by the selected ion monitoring mode of GC/MSD. The selected concentration of substrate STZ is 100 nmole and the selected time for incubation in the reaction mixture was determined to 60 min. The amount of 3'-hydroxystanozolol produced was increased by about 6-fold in the reaction medium including the liver S-9 fraction of polychlorinated biphenyl-induced rats, compared to that of untreated rats. Inhibitors of cytochrome P450, SKF-525A and 7,8-benzoflavone, decreased the production of 3'-hydroxystanozolol by about 89~100% and 65~75%, respectively; In conclusion, hydroxylation of STZ into 3'-hydroxystanozolol is confirmed by GC/MSD and is catalyzed by cytochrome P450.

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Review of pediatric cerebrovascular accident in terms of insurance medicine (소아뇌졸중의 보험의학적 고찰)

  • Ahn, Gye-Hoon
    • The Journal of the Korean life insurance medical association
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    • v.29 no.2
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    • pp.29-32
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    • 2010
  • Moyamoya disease (MMD) is a progressive occlusive disease of the cerebral vasculature with particular involvement of the circle of Willis and the arteries that feed it. MMD is one of cerebrovacular accident,which is treated with sugical maeuver in pediatic neurosurgery. Moyamoya (ie, Japanese for "puff of smoke") characterizes the appearance on angiography of abnormal vascular collateral networks that develop adjacent to the stenotic vessels. The steno-occlusive areas are usually bilateral, but unilateral involvement does not exclude the diagnosis. The exact etiology of moyamoya disease is unknown. Some genetic predisposition is apparent because it is familial 10% of the time. The disease may be hereditary and multifactorial. It may occur by itself in a previously healthy individual. However, many disease states have been reported in association with moyamoya disease, including the following: 1) Immunological - Graves disease/thyrotoxicosis 2) Infections - Leptospirosis and tuberculosis 3) Hematologic disorders - Aplastic anemia, Fanconi anemia, sickle cell anemia, and lupus 4) Congenital syndromes - Apert syndrome, Down syndrome, Marfan syndrome, tuberous sclerosis, Turner syndrome, von Recklinghausen disease, and Hirschsprung disease 5) Vascular diseases - Atherosclerotic disease, coarctation of the aorta and fibromuscular dysplasia, 6)cranial trauma, radiation injury, parasellar tumors, and hypertension etc. These associations may not necessarily be causative but do warrant consideration due to impact on treatment.(Mainly neurosurgical operation.) The incidence of moyamoya disease is highest in Japan. The prevalence of MMD is 1 person per 100,000 population. The prevalence and incidence of moyamoya disease in Japan has been reported to be 3.16 cases and 0.35 case per 100,000 people, respectively. With regard to sex, the female-to-male ratio is 1.4:1. A bimodal peak of incidence is noted, with symptoms occurring either in the first decade(5-10yr) or in the third and fourth decades (30-40yr)of life. Mortality rates of moyamoya disease are approximately 10% in adults and 4.3% in children. Death is usually from hemorrhage. In aspect of life insurance, MR is 1700%, EDR is 16 per 1000 persons. Children and adults with moyamoya disease (MMD) may have different clinical presentations. The symptoms and clinical course vary widely from asymptomatic to transient events to severe neurologic deficits. Adults experience hemorrhage more commonly; cerebral ischemic events are more common in children. Children may have hemiparesis, monoparesis, sensory impairment, involuntary movements, headaches, dizziness, or seizures. Mental retardation or persistent neurologic deficits may be present. Adults may have symptoms and signs similar to those in children, but intraventricular, subarachnoid, or intracerebral hemorrhage of sudden onset is more common in adults. Recently increasing diagnosis of MMD with MRI, followed by surgical operation is noted. MMD needs to be considered as the "CI" state now in life insurance fields.

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A Case of Pure Red Cell Aplasia with Thymoma (흉선종을 동반한 적혈구 무형성증)

  • 노중기
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.306-311
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    • 1980
  • Pure red cell aplasia is unusual cause of anemia and a selective aplastic disorder that affects the erythroid series of the bone marrow. Fifty percent of all patients with red cell aplasia will have a thymoma. Twenty-five to 30% of those who undergo thymectomy will be cured. A 57-years-old man was admitted to the medical department of Korea University hospital with complaints. Physical examination reveals a sick looking man with a pale lip, anemic conjunctiva and subicteric sclera. On auscultation, coarse breathing sound and moist rale was heard on the right lung field. Neither the liver nor spleen was palpable. A blood count showed the erythrocytes to number 2,640,000/mm3 and hemoglobin to be 7.0gm/dl. A white blood cell count was 5,000/mm3 and a platelet count was 328,000/mm3 Reticulocyte count was 0.7%. Examination of the peripheral blood smear showed the red cell, to be normocytic and normochromic. Urine sugar was three positive and GTT was positive. The anterior-posterior and lateral view of Chest X-ray was suggestive of an anterior mediastinal mass. A bone marrow biopsy reveals absence of red cell precursors and a normal myeloid series and megakaryocytes. At thoracotomy in May 1980 an encapsulated, lobulated, benign thymoma, which measured 5x7x5 cm was removed, microscopic examination showed it was of the spindle cell type. The postoperative course was uneventful, but the patient never had a return of hemoglobin to the blood. The patient was discharged on the postoperative] 3 days. At postoperative 1 month, the patient was readmitted for bone marrow study and had no return of red cells to bone marrow. At now, patient has been treated with steroid and the further follow up study will be needed.

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Clinical Study of Hematology Patients in Intensive Care Units (혈액종양 중환자실 환자의 임상적 고찰)

  • Lim, Jung In;Kim, Hyoung Soon;Ryu, Ri Ar;Kim, Eun Hee;Kong, Hyo Young
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.384-394
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    • 2014
  • Purpose: To improve professional intensive care by analyzing admission causes, causes of death, disease conditions, and treatment processes in patients with hematological malignancies admitted to intensive care units (ICUs) in South Korea. Methods: This was a retrospective study approved by IRB, and conducted on admission with 559 adults, in the hematology ICU of a hospital located in Seoul. The study was carried out from April 2009 to March 2012. Data were analyzed using SAS. Results: Pneumonia was the most frequent cause of ICU admission and death, followed by sepsis. The condition at discharge was death (53.6%), recovery (39.9%), or hopeless (5.1%). Mortality of patients in states of incomplete remission was higher than that of patients with complete remission and of patients with multiple myeloma, severe aplastic anemia, and lymphoma. Conclusion: Results show that pneumonia and sepsis are the most frequent causes of ICU admission and for the death of patients with hematological malignancies. The most frequent status at discharge of patients with hematological malignancies was death (53.6%), with mortality of patients at Incomplete Remission status, of mechanically ventilated patients, and of patients on continuous renal replacement therapy (CRRT) being higher than others.

Study on Clinical Diseases of Yang Deficiency Pattern (양허증(陽虛證)의 임상적 질환 범위에 대한 고찰)

  • Park, Mi Sun;Ki, Yeong Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.2
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    • pp.153-166
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    • 2013
  • Yang deficiency pattern is a representative syndrome differentiation. This article is a study on to which categories of modern diseases yang deficiency is assigned by reference to modern clinical papers and the meaning of yang deficiency interpreted with a perspective of Korean Medicine and a modern perspective. Yang deficiency, yang qi deficiency, lack of yang qi and yang qi debilitation are the words found in "Nei Ching" and yang qi can be interpreted as something to warm, drive and arouse. Zhangzhongjing considered recovery or loss of Yang as the key to life in "Shanghanlun". Danxi proposed "Yang being liable to hyperactivity, Yin being insufficient" and emphasized pathological ministerial fire of Yang exuberance rather than physiological ministerial fire of Yang deficiency. Zhangjingyue proposed "Yang not being in excess, Yin being often deficient" and understood growth and decline of yin qi are all led by yang qi and put emphasis on true yin in addition to yang qi. Diseases of yang deficiency pattern are related with decline of metabolic level, hypofunction of internal secretion, disorder of immune function, disorder of automatic nerve system, sympathetic nerve inhibition, metabolic disorder of microelements, increase of cGMP, change of microcirculation, low speed of blood stream, kidney malfunction. Diseases related with kidney are sterility, polycystic ovary syndrome, spinal stenosis, edema, renal failure, IgA nephropathy, erectile dysfunction, nephritis, prostatitis, benign prostatic hyperplasia, decrease of adrenal cortical hormone by nephrotic syndrome, myelodysplastic syndrome. Disease related with heart are heart failure, arrhythmia, cardiomyopathy, atherosclerosis heart disease, hypertension, hyperlipidemia, pulmonary heart disease. Diseases related with spleen are irritable bowel syndrome, ulcerative colitis. Diseases related with liver are hypothyroidism, liver cirrhosis ascites, hepatitis B, chronic hepatitis, hepatic diabetes. Diseases related with lung are allergic rhinitis, cough variant asthma, bronchial asthma, pulmonary emphysema. And diabetes mellitus, metabolic syndrome, aplastic anemia, headache, encephalatrophy, Alzheimer's disease are also related with yang deficiency.

Effect of Ethanol Extracts of Raw and Boiled Bracken on Blood Pressure in Cats (고사리 (Pteridium aquilinum) Ethanol 추출액(抽出液)에 의한 혈압강하작용(血壓降下作用))

  • Koh, Sang-Don;Kim, Kee-Soon
    • The Korean Journal of Physiology
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    • v.18 no.2
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    • pp.171-180
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    • 1984
  • The death of cattle from acute bracken poisoning has been recognized for many years. Acute bracken poisoning is characterized by mucoidal nasal and anal hemorrhage, severe anorexia. pyrexia, gastric ulcer and myocardial damage. In 1958 Evans first suggested that clinical picture of bracken poisoning was very much similar to that of radiation injuries such as aplastic anemia, leucopenia, thrombocytopenia and increased capillary fragility. Bracken has been clearly demonstrated to contain a carcinogen as well as thiaminase. However, the nature of carcinogen in bracken has not definetely elucidated. Also it was warned by several workers that bracken could be a causative factor for stomach cancer in Korean and Japanese. It appears that little is known on the e(feet of bracken on the function of cardiovascular system. Therefore the present study was designed to explore effects of ethanol extract of raw and toiled bracken (RBEE:BBEE) on blood pressure in cats. Also studied was the mechanism underlying changed in blood pressure of cats by bracken. The result obtained were as follows; 1) Mean arterial blood pressure was invariably decreased following administration of either RBEE or BBEE. Tn general depressor responses to RBEE persisted longer than that to BBEE. Generally, depressor responses were proportional to debases of RBEE and BBEE administered. 2) After administration of 60 mg/kg RBEB and BBEE, blood Pressure decreased by $62.1{\pm}1.7mmHg$ and $68.0{\pm}3.0mmHg$, respectively. No change was observed between depressor responses to RBEE and that to BBEE. 3) Depressor responses to BBEE and RBEE were not affected by vagotomy, propranolol and regitine. 4) In atropinized animal depressor responses to BBEE and RBEE were reduced by 30-40% showing part of depressor response was resulted from cholinergic effect of bracken.

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Effects of clarithromycin treatment in scrub typhus in children: comparison with chloramphenicol and azithromycin

  • Lee, Min;Kim, June;Jo, Dae Sun
    • Clinical and Experimental Pediatrics
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    • v.60 no.4
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    • pp.124-127
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    • 2017
  • Purpose: Chloramphenicol and tetracycline are not recommended for treating scrub typhus in pediatric patients because of potential side effects, such as aplastic anemia or tooth discoloration. While clarithromycin has recently been used in adults, few reports have been published on its effects in pediatric patients. We report the clinical profiles of pediatric scrub typhus and the effects of clarithromycin on scrub typhus in children. Methods: We retrospectively analyzed medical records of 56 children with scrub typhus who were admitted between 2004 and 2013 to Chonbuk National University Hospital, Jeonju, Korea. Cases were divided into 3 groups based on the treatment drug (chloramphenicol, azithromycin, and clarithromycin). We compared their clinical manifestations and laboratory findings. Results: All patients exhibited fever and rash. Other common clinical manifestations were eschars (66%), lymphadenopathy (48%), upper respiratory symptoms (42%), abdominal pain (32%), and hepatosplenomegaly (14%). Elevated levels of C-reactive protein, erythrocyte sedimentation rates, aspartate transaminase, and alanine transaminase were detected in 95%, 96%, 84%, and 77% of patients, respectively. Additionally, decreased platelet and white blood cell levels were observed in 43% and 36% of patients, respectively. There were no statistical differences between the treatment groups in mean age (P=0.114) or sex (P=0.507). However, time to defervescence after the treatments differed significantly, being the shortest in the clarithromycin group (P=0.019). All patients recovered without complications related to the disease or drugs. Conclusion: Clarithromycin was as effective as chloramphenicol and azithromycin in pediatric scrub typhus patients and may be used as a first-line treatment drug.

Cases Series of Malignant Lymphohematopoietic Disorder in Korean Semiconductor Industry

  • Kim, Eun-A;Lee, Hye-Eun;Ryu, Hyung-Woo;Park, Seung-Hyun;Kang, Seong-Kyu
    • Safety and Health at Work
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    • v.2 no.2
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    • pp.122-134
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    • 2011
  • Objectives: Seven cases of malignant lymphohematopoietic (LHP) disorder were claimed to have developed from occupational exposure at two plants of a semiconductor company from 2007 to 2010. This study evaluated the possibility of exposure to carcinogenic agents for the cases. Methods: Clinical courses were reviewed with assessing possible exposure to carcinogenic agents related to LHP cancers. Chemicals used at six major semiconductor companies in Korea were reviewed. Airborne monitoring for chemicals, including benzene, was conducted and the ionizing radiation dose was measured from 2008 to 2010. Results: The latency of seven cases (five leukemiae, a Non-Hodgkin's lymphoma, and an aplastic anemia) ranged from 16 months to 15 years and 5 months. Most chemical measurements were at levels of less than 10% of the Korean Occupational Exposure Limit value. No carcinogens related to LHP cancers were used or detected. Complete-shielded radiation-generating devices were used, but the ionizing radiation doses were 0.20-0.22 uSv/hr (background level: 0.21 ${\mu}Sv/hr$). Airborne benzene was detected at 0.31 ppb when the detection limit was lowered as low as possible. Ethylene oxide and formaldehyde were not found in the cases' processes, while these two were determined to be among the 263 chemicals in the list that was used at the six semiconductor companies at levels lower than 0.1%. Exposures occurring before 2002 could not be assessed because of the lack of information. Conclusion: Considering the possibility of exposure to carcinogenic agents, we could not find any convincing evidence for occupational exposure in all investigated cases. However, further study is needed because the semiconductor industry is a newly developing one.