• Applied Microscopy
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• v.33 no.1
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• pp.41-48
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• 2003

The hemopoiesis in human fetal spleen was studied with transmission electron microscope. There were undifferentiated proerythroblast, basophilic erythroblast, polychromatophilic erythroblast, and acidophilic erythroblast. Besides, enucleated nuclei and mitoses were present. Groups of erythroblastic cells were surrounded by certain cell. The structure was identical to erythropoietic island found in fetal liver. So, erythropoisis in spleen was developing in a pattern similar to fetal liver. Megakaryobalst were found in spleen, but there was no mature cells, cells in mitosis nor platelet formation. It was not clear whether megakaryoblast in circulation was trapped in spleen or participated in megakaryopoiesis. In summary, erythropoiesis took place in fetal spleen in a pattern similar to fetal liver and bone marrow. But it was not certain whether megakaryopoiesis took place in fetal spleen.

• Korean Journal of Community Nutrition
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• v.5 no.3
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• pp.493-501
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• 2000

The purpose of this study was to assess the nutritional status of iron of the elderly residing in the Jeonju area. The anthropometric parameters, nutrient intake and biochemical status of iron, were measured for 60 korean elderly(23 elderly men and 37 elderly women aged 60 - 79 years old). The level of hemoglobin(Hb), hematocrint(Hct), serum iron(Fe), total iron binding capacity(TIBC) and serum ferritin(Ferritin) were measured and transferrin saturation(TFsaturation) was calculated. Mean values of Hb, Hct, Fe, TIBC, TFsaturation and Ferritin were 14.49$\pm$0.93g/이, 42.47$\pm$2.59%, 125.48$\pm$52,.46$\mu\textrm{g}$/dl, 338.13$\pm$45.92$\mu\textrm{g}$/dl, 193.00$\pm$125.03$\mu\textrm{g}$/l in elderly men and 12.82$\pm$0.99$\mu\textrm{g}$/dl, 37.66$\pm$2.90%, 100.08$\pm$42.82$\mu\textrm{g}$/dl, 356.41$\pm$54.65$\mu\textrm{g}$/dl, and 99.35$\pm$117.22$\mu\textrm{g}$/l in elderly women, respectively. Prevalence of iron deficiency varied greatly with biochemical indices of iron. It was 13.0% when judged by Fe(60 $\mu\textrm{g}$/dl) and TFsaturation(15%) whereas 34.78% by Hct(41%) in elderly men. However 13.5% of the elderly women showed iron depletion(Ferritin<20$\mu\textrm{g}$/l) and 43.2% showed suppressed erythropoiesis with iron deficiency(TIBC>360$\mu\textrm{g}$/dl). The anemic subjects assessed with TFsaturation(<15%) represented 13.5% of the elderly women, whereas 18.9% of the subjects possessed less than 12g/dl of Hb. The Hb concentration was positively correlated with Hct(r=0.980, p<0.001), Fe(r=0.384, p<0.01) and TFsaturation(r=0.349, p<0.01). On the other hand, Ferritin concentration showed a significantly negative correlation with TIBC(r=0.349, p<0.05) and a positive correlation with TFsaturation(r=0.362, p<0.01). Major food groups of iron intake in the elderly were vegetables, cereals, and fish. The mean daily intake of iron was not significantly different between elderly men and women(12.82mg vs 10.35mg). Intake of heme iron however, was significantly higher(p<0.01) in elderly men(1.03mg) than women(0.42mg). Total absorbable iron caculated by the method of Monsen was 0.55mg, 0.40mg in elderly men and women, respectively and bioavailability of dietary iron 4.29% and 3.87%.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.654-659
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• 1995

Background: Tuberculosis has commonly been associated with various hematologic changes. A difference between the changes found in pulmonary tuberculosis and those found in miliary tuberculosis has been discussed. Up to now some worker were investigated hematological changes associated with pulmonary tuberculosis but was not investigated those associated with miliary tuberculosis in korea. Therefore we examimed the peripheral blood and bone marrow findings in miliary tuberculosis patients to determine hematologic changes. Methods: We performed blood sample at admission and bone marrow biopsy within 7days after admission. For evaluation of the hematologic findings, full blood counts and marrow differential counts were defined by the criteria outlined by Dacie and Lewis. Results: 1) Peripheral blood findings: Pancytopenia in 10% of patients, anemia in all patients, leukocytosis in 10% of patients, leukopenia in 20% of patients, thrombocytopenia in 30% of patients, lymphocytopenia in 90% of patients, monocytosis in 40% of patients and neutrophilia in 10% of patients were found at peripheral blood. 2) Bone marrow findings: Lymphocytopenia in 30% of patients, lymphocytosis in 20% of patients, plasmacytosis in 40% of patients, monocytosis in 100% of patients, and hypocellularity in 30% of patients were found at bone marrow. Erythropoiesis was decreased in 30% of patients. Granulopoiesis was decreased in 20% of patients and increased in 20% of patients. Bone morrow granuloma occured in 25% of patients. Conclusion: Hematologic changes of miliary tuberculosis were seen tendency of cytopenic pattern but monocyte was increased at peripheral blood and bone morrow. This findings would provide additional information for the differential diagnosis of miliary tuberculosis.

• Clinical and Experimental Pediatrics
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• v.52 no.4
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• pp.435-440
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• 2009

Purpose : The concentration of soluble transferrin receptor (sTfR) is estimated as an iron parameter to evaluate erythropoiesis and iron status. The aim of our study is to evaluate the correlation between sTfR concentration and inflammatory parameters and to distinguish iron deficiency anemia from anemia of inflammation. Methods : One hundred and forty-four infants younger than two years of age who visited Gyeongsang University Hospital for 7 years from 2000 to 2006 were enrolled. Patients who had hemoglobin (Hb) <11 g/dL and ferritin <12 mg/L were excluded. Routine hematologic lab, serum ferritin, sTfR, and inflammatory markers [C-reactive protein(CRP), interleukin-6(IL-6), and absolute neutrophil count (ANC)] were investigated. Results : In all patients, the sTfR concentration showed a correlation with Hb, ferritin, MCV, and ANC, but not with CRP and IL-6. In multiple regression models, positive correlations were found between sTfR concentration and IL-6 (r=0.078, P=0.043), and negative correlations were found between sTfR concentration and ANC (r=-0.117, P=0.033) and MCV (r=-0.027, P=0.009). Conclusion : sTfR concentration was influenced by inflammatory parameters. Therefore, sTfR does not appear to be a useful parameter for discriminating between iron deficiency anemia and anemia of inflammation in infants.

• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.167-175
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• 2009

Purpose : This study has been conducted to analyze whether the biochemical nutrition indexes might be useful and effective for evaluating the nutrition states of children. Methods : We evaluated 269 children, aged 3-9 years old, who had visited Gangneung Asan Hospital for elective surgery from January 2006 to December 2007, and examined their anthropometric and preoperative laboratory data with retrospective analysis. The children were classified into underweight, normal weight, overweight, and obese groups according to body mass index (BMI). The biochemical nutrition indexes (total lymphocyte count (TLC), hemoglobin, hematocrit, serum albumin, cholesterol, et al) of each group were then analyzed statistically. Results : None of the groups showed statistically significant differences in TLC. Serum albumin decreased significantly in the underweight group. Red blood cell (RBC) count, hemoglobin, hematocrit, and serum total cholesterol in the obese group were higher than in the normal weight group. None of the groups showed statistically significant increase in mean corpuscular volume or mean corpuscular hemoglobin, and it seems that the increase of hemoglobin and RBC count in the overweight and obese groups is due to the enhancement of erythropoiesis rather than iron metabolism. However, in females, almost all nutrition indexes except albumin were statistically significantly poor. Conclusion : Serum albumin, total cholesterol, RBC count, hemoglobin, and hematocrit were useful as nutrition indexes. However, except for albumin, these indexes were significantly poor for females. More control studies are needed to confirm the effectiveness of biochemical indexes for evaluating the nutritional state of children.

• Tuberculosis and Respiratory Diseases
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• v.66 no.2
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• pp.104-109
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• 2009

Background: Anemia is quite common in lung cancer patients and known to decrease the quality of life. Darbepoetin alfa is an erythropoiesis-stimulating protein approved for administration to cancer patients. This study examined the efficacy and safety of darbepoetin alfa in lung cancer patients with a hemoglobin concentration <10 g/dl during chemotherapy. Methods: Lung cancer patients (n=178) received darbepoetin alfa at doses of 1.91 ${\mu}g/kg$ per week until the hemoglobin concentration increased to >10 g/dl. The efficacy and safety were measured by comparing the hemoglobin concentration and assessing the adverse events. Results: After chemotherapy, the hemoglobin concentration decreased to 9.03${\pm}$0.64 g/dl. With the darbepoetin alfa treatment, the hemoglobin concentration increased to 10.09${\pm}$1.17 g/dl after 4 weeks reaching a peak hemoglobin concentration of 10.45${\pm}$1.18 g/dl. The changes in hemoglobin after 4 and 8 weeks with treatment were 1.08${\pm}$1.24 g/dl and 1.38${\pm}$1.59 g/dl (p<0.01). At least a 1 g/dl or more increase in hemoglobin was observed in 62.4% of patients. There were no serious adverse effects except for some mild reactions. Conclusion: Darbepoetin alfa administered to lung cancer patients appears to be an effective, well-tolerated treatment for chemotherapy induced anemia.

• Journal of Nutrition and Health
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• v.43 no.2
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• pp.114-122
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• 2010

Se and Fe are trace minerals acting as antioxidant scavenging free radicals. Iron deficiency is the most frequently reported nutritional deficiency in females. Body iron status are known to be dependent not only upon dietary iron intake, but also upon micro-mineral nutrition and obesity. Antioxidants such as selenium are reported to play an important role on the regulation of erythropoiesis by protecting RBC membrane from antioxidative damage. In this study, iron status in young females and its relationships with selenium status and physique were examined. Serum selenium and iron concentrations were measured by HANARO research reactor using neutron activation analysis method (NAA-method). The proportion with iron deficiency and anemia were 27.1% and 8.6%, respectively in young females, but the proportion with iron deficient anemia was 1.4%. The mean serum selenium level was $12.0\;{\mu}g/dL$ and in normal range in the young women. The study participants were tertiled according to BMI and serum selenium levels. Serum ferritin and iron levels inclined with increasing BMI tertiles. Serum iron and RBC count were higher in middle selenium group than low selenium group. Individuals had significantly lower hematocrit level in the lowest tertile for their serum selenium levels compared with the highest tertile. The serum ferritin level was predicted 25% by BMI and RBC count 26.2% by the serum selenium level and body fat%. In conclusion, this study shows that body iron status in young adult females are influenced by obesity and body selenium status.

• 한국체육학회지인문사회과학편
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• v.54 no.1
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• pp.553-566
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• 2015

This study was performed to identify the effects of different intensities of regular aerobic exercise on erythropoietin (EPO) and BDNF levels, and cognitive function and working memory in middle-aged women. Women aged 40 to 60 years residing in G-gu, Y-si, Gyeonggi-do were divided into 3 groups: control group, moderate-intensity aerobic exercise group and high-intensity aerobic exercise. All groups were asked to exercise at the given intensities, twice a week for a total of 12 weeks. Blood samples were collected from participants on week 0 (before exercising), week 6 and week 12, and then cognitive function and working memory tests were followed to measure erythropoietin (EPO) and BDNF levels, cognitive function and working memory. Repeated measures ANOVA, univariate analysis and follow-up test were performed on all data to compare the group, period and interaction through a SPSS. As a result, a significant difference over time was observed in EPO, BDNF, cognitive function and working memory; therefore, a follow-up one-way ANOVA analysis was performed on each group. As a result of analysis, a significant increase in erythrocyte, hematocrit, BDNF level and working memory was observed in moderate-intensity aerobic exercise group while erythrocyte and working memory were significantly increased inhigh-intensity aerobic exercise group. When comparing the results between the groups, the level of hematocrit was shown to be significantly higher in both moderate-and high-intensity aerobic group than the control group and also the higher level of hemoglobin was observed in both moderate-and high-intensity aerobic group comparing to control group. Considering the results of this study, therefore, a 12-week long aerobic exercise at moderate to high intensity positively affected EPO and BDNF levels, cognitive function and working memory in middle-aged women.

• Journal of Nutrition and Health
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• v.7 no.3
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• pp.1-13
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• 1974

The relative state of human iron storage may be ascertained more reliably through determination of the serum iron, iron binding capacity, transferrin saturation and absorption of radioactive iron in conjunction with studies of red cell morphology than from the study of red cell morphology alone. Recent investigations have shown that there is an increase in red cell protoporphyrin concentration in iron deficiency anemia. The significance of the red cell protoporphyrin has been discussed greatly during the years since its discovery. Two of the main factors which appear to influence the amaunt of protoporphyrin are increased erythropoiesis and factors interfering with the utilization of iron in the synthesis of hemoglobin, and iron deficiency. Recently Heller et al. have described a simplified method for blood protoporphyrin assay and this technique could be used assess nutritional iron status, wherein even minor insufficiencies are detectable as increased protoporphyrin concentrations. Based on the evaluation of the relationship between nutritional iron status and red cell protoporphyrin as an index suitable for the detection of the iron deficiency is described in this paper. RESULTS 1. Hemoglobin Concentrations and Anthropometric Measurements. The mean and standard deviations of the various anthropometric measurements of different age and sex groups are shown in table 1. There measurements have been compared with the Korean Standard. In the absence of local standards for arm circumference and skin-fold thickness over triceps, they have been compared with the standard from Jelliffe. Table 2,3, and 4 give anthropometric measurements and frequency (%) of anemia in children surveyed. The mean height of the children studid was 10 to 20 percent; below the Korean Standard. The distribution of height below 80 percent of the Standard was 21.2 percent, however, among anemic group this percentage was 27.7 percent. In general, the mean weight of the children was 10 to 15 percent below the Korean Standard. The percentage of children with weight less than 80 percent of the Standard was about 35 percent. But in the anemic group of the children, this percentage was 44 percent. The mean arm circumference was about 15 percent lower than the Jelliffe's standard. 61.2 percent of the children had values of arm circumference below 80 percent of the standard. Children with low hemoglobin levels, this percentage was 80 percent. The mean skinfold thickness over the triceps of the children studied was about 25 Percent lower than the Jelliffe's standard and 61.2 percent of the children had the value less than 80 percent of the standard. Among anemic children, this percentage was 70.8%. As may be seen from table 5, the mean hemoglobin concentration of the total group was 11.3g/100ml. Hemoglobin concentration was less than 11.0g/100ml. in 65(36.5%) of the 178 children. The degree of anemia in most of these children was mild with a hemoglobin level of less than 8.0g/100ml. found in only one child. In general, the prevalence of anemia was high in female children than male and decreased its frequency with increasing age. Relatively close relationship was observed between hemoglobin level and anthrophometric measurements especially high between arm circumference and skinfold thickness and hemoglobin but very low in height and low in weight and hemoglobin level, estimated by chi-square value. II. Serum iron, Transferrin saturation (1) Serum iron, and transferrin saturation Serum iron, transferrin saturation and red cell protoporphyrin concentrations were estimated in sub-sample of 84 children from 1 to 6 years and 24 older children between 7 and 13 years of age. The findings are presented in table 6. The mean serum iron concentration of the total group was 59ug/100ml. However, the level incrased with age from 36.6ug/100ml. (1-3years) to 80.8ug/100ml. (7-13 years). 60 percent of these children had a serum iron level less than 50ug/10ml. in the 1-3 years age group and 31.4 percent for 4-6 years group. These contrast with the finding of 12.5 percent anemic children in the 7-13 years age group. The mean transferrin saturation for the total group was 18.1 percent and frequency of anemia by transferrin saturation was observed same pattern as serum iron concentration. (2) Red cell protoporphyrin concentrations. (a) Red cell protoporphrin levels of children: Red cell protoporphyrin and other biochemical data are shown in table 4. The mean concentration in red cell of all children was fround 46.3ug/100ml. RBC. and differences with age groups were observed; in the age group 1-3 years, the mean concentration was $59.5{\pm}32.14$ ug/100ml. RBC; 4-6 years $44.1{\pm}22.57$ ug/100ml. RBC. and 7-13 years, $39.0{\pm}13.56$ ug/100ml. RBC. (b) Normal protoporphyrin values in adults: It was observed that in 10 normal adult males studied here the level of protoporphyrin in red cell ranged from 18 to 54 ug/100ml. RBC. and the mean concentration was $47.5{\sim}14.47$ ug/100ml. RBC. Other biochemical determination made on the same subjects are presented in table 8. (c) Red tell protoporphyrin concentration of occupational blood donors: The results of analyses for red cell protoporphyrin as well as serum iron, transferrin saturation and hemoglobin in the 76 blood donors are presented in table 7 and 8. In this experiment, donors were selected at random, however, most of them bled repeatedly because of poor economic situation, I doubt. Table 9 shows the distribution of red cell protoporphyrin concentration and hemoglobin concentration of occupational donors. The mean hemoglobin value for the total was 11.9 g/100 ml. When iron deficiency anemia is defined as a transferrin saturation below 15%, prevalence of anemia was 47.4 percent and the mean serum iron was 27.1ug/100ml. and red cell protoporphyrin, 168.3ug/100ml. RBC. However, mean serum iron and protoporphyrin concentration of above 15% transferrin saturation were 11.6 ug/100 ml. and 58.8 ug/100 ml. RBC. respectively. The mean Protoporphyrin concentration of non-anemic (above 15% transferrin saturation) donors was slightly higher than the results of normal adult males.

• Journal of Yeungnam Medical Science
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• v.14 no.2
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• pp.399-414
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• 1997

There are several factors concerning to anemia in chronic renal failure patients. But when rHuEPO is used, most of these factors can be overcome, and the levels of hemoglobin are increased. However, about 10% of the renal failure patients represent rHuEPO-resistant anemia eventhough high dosage of rHuEPO. For these cases, desferrioxamine can be applied to correct rHuEPO resistnacy, and many mechanism of DFO are arguing. So we are going to know whether DFO can be applied to correct anemia of the such patients, how long its effect can be continued. The seven pateients as experimental group(DFO+EPO) who represent refractoriness to rHuEPO and the other seven patients as control group(EPO) were included. Experimental group had lower than 9 g/dL of hemoglobin levels despite high rHuEPO dosage (more than 4000U/Wk) and showed normocytic normochromic anemia. There were no definitve causes of anemia such as hemorrhage or iron deficiency. Control group patients had similar characteristics in age, mean dialysis duration but showed adequate response to rHuEPO. DFO was administered to experimental group for 8 weeks along with rHuEPO(the rHuEPO individual mean dosage had been determined by mean dosage of the previous 6 months. Total mean dosage; 123.5 U/Kg/Wk). After 8 weeks of DFO administration, the hemoglobin and rHuEPO dosage levels were checked for 15 consecutive months. It should be noted that the patients determined their own rHuEPO dosage levels according to hemoglobin levels and economic status. In conrol group, rHuEPO was administered by the same method used in experimental group without DFO through the same period. Fifteen months of observation period after DFO trial were divided as Time I(7 months after DFO trial) and Time II(8 months after Time I). The results are as follows: Before DFO trial, mean hemoglobin level of experimental group was 7.8 g/dL, which is similar level(p>0.05) to control group(mean Hb; 8.2 g/dL). But in experimental group, significantly(p<0.05) higher dosages of rHuEPO(mean; 123.5 U/Kg/Wk) than control group (mean; 41.6 U/Kg/Wk) had been used. It means resistancy to rHuEPO of experimental group. But after DFO trial, the hemoglobin levels of the experimental group were increased significantly(p<0.05), and these effect were continued to Time II.(Time I; mean 8.6g/dL, Time II; mean 8.6g/dL) The effects of DFO to hemoglobin were continued for 15 months after DFO trial with similar degree through Time I, Time II. Also, rHuEPO dosages used in the experimental group were decreased to similar levels of the control group after DFO trial and these effect were also continued for 15 months(Time I; mean 48.1 U/Kg/Wk. Time II; mean 51.8 U/Kg/Wk). In the same period, hemoglobin levels and rHuEPO dosages used in the control group were not changed significantly. Notibly, hemoglobin increment and rHuEPO usage decrement in experimental group were showed maxilly in the 1st month after DFO trial. That is, after the use of DFO, erythopoiesis was enhanced with a reduced rHuEPO dosage. So we think rHuEPO reisistancy can be overcome by DFO therapy. In conclusion, the DFO can improve the anemia caused by chronic renal failure at least over 1 year, and hence, can reduce the dosage of rHuEPO for anemia correction. Additional studies in order to determine the mechanism of DFO on erythropoiesis and careful attention to potential side effects of DFO will be needed.