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Platelet count change by vincristine in maintenance phase of acute lymphoblastic leukemia chemotherapy (급성 림프구성 백혈병의 항암 유지요법 중 vincristine과 관련된 혈소판수의 변화)

  • Lee, Sung Moon;Ham, Soon Shik;Jeon, In-sang
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.181-186
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    • 2006
  • Purpose : The hematologic change during the treatment of acute lymphoblastic leukemia(ALL) is critical as a prognostic determinant and a variable to determine the dose of chemotherapeutic agents. It is known that the dose of vincristine used in the maintenance phase of ALL is small enough to increase the count of platelet. To investigate the change of platelet count according to the vincristine administration in maintenance phase of ALL chemotherapy, we performed this study. Methods : Eleven patients eligible under the criteria of Children's Cancer Study Group(CCG)-1882 and who had completed chemotherapy were enrolled in this study. The count of platelets before vincristine administration was compared with those of vincristine administration 1, 2 and 3 weeks after the early and last periods of maintenance phases. The platelet count before vincristine administration was defined as 100 percent and that after vincristine were compared. In addition, we tentatively defined an enhancing effect of vincristine as positive when the relative count was more than 120 percent. Results : Platelet count did not differ according to the early and last periods of maintenance phase. Platelet count at first week after vincristine administration increased more significantly than that before vincristine in early and last periods. There was an enhancing effect in 10(90.9 percent) of 11 patients after 1 week vincristine administration both in the early and last periods of the maintenance phase. Conclusion : Vincristine, used in ALL maintenance phases as a low dose, increased platelet count 1 week after administration. The increased platelet count resumed to the previous level 2-3 weeks later. However, the thrombocytosis observed in the maintenance phase by vincristine was not high enough to induce thrombosis. In addition, vincristine is known to reduce the activity of platelets. Therefore, the risk of thrombosis in the maintenance phase of ALL chemotherapy would be low.

Caregivers' adherence factors affecting maintenance treatment in children with well-controlled asthma : A qualitative analysis through in-depth interview (천식 조절 상태 환아의 유지 치료에 대한 보호자 순응 요인: 심층 면담을 통한 질적 분석)

  • Choi, Ic Sun;Cho, Saeng Koo;La, Kyong Suk;Byeon, Jung Hye;Song, Dae Jin;Yoo, Young;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.364-372
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    • 2010
  • Purpose : Good adherence of caregivers is essential for successful health outcomes in the treatment of childhood asthma. The purpose of this study was to identify the factors contributing to good adherence of maintenance treatment in children with well-controlled asthma. Methods : Children with well-controlled asthma being treated with a daily controller for at least 3 months in Korea University Anam Hospital were selected. Their caregivers who had good adherence to maintenance treatment were recruited. Qualitative study through in-depth interviews was conducted with 18 caregivers who agreed to the study. Results : The 18 caregivers (mean age, 40.0 years) consisted of 15 mothers, 2 grandmothers, and 1 father. The resulting consensus were identified and grouped into 2 domains: the caregiver/patient aspect with 8 theme factors and the treatment aspect with 4 theme factors. The main theme factors in the caregiver/patient aspect were enabling participation in physical activities and exercise (77.8%), perceptions regarding asthma and the need for long-term treatment (50.0%), and perceived value of the medications outweighing the risk of side effects (38.9%). The main theme factors in the treatment aspect were trust in the physician (77.8%), general satisfaction with the manner and attitude of the physician (77.8%) and verification of the necessity of further treatment by performing tests (38.9%). Conclusion : Efforts to improve caregivers' adherence to the treatment of childhood asthma must include a range of factors related to both caregiver/patient aspects and treatment aspects. Among all of these factors, it may be most important to establish a physician-caregiver partnership.

Monitoring of Polycyclic Aromatic Hydrocarbon Residues in Environmental Samples in Korea (국내 PAHs 오염 우려지역의 환경 시료 중 PAHs 잔류량 모니터링)

  • Lim, Jong-Soo;Kim, Seong-Soo;Park, Dong-Sik;Joo, Jin-Ho;Lim, Chun-Keun;Hur, Jang-Hyun
    • The Korean Journal of Pesticide Science
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    • v.11 no.2
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    • pp.95-105
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    • 2007
  • The aim of this study was to determine the residual amounts of PAHs in environmental samples such as crop, soil and water collected from paddy, upland fields and forestlands near industrial zone and/or a thermal power plant in South Korea. All of the samples were analyzed by GC-mass spectrometer. The average contents of total PAHs in soil samples were 140.2 ${\mu}g\;kg^{-1}$ and the range was from 4.3 to $662.9{\mu}g\;kg^{-1}$. The detection of benzo(a)anthracene, chrysene, benzo(b)fluoranthene, benzo(k)fluoranthene, benzo(a)pyrene and dibenzo(a,h) anthracene which have strong carcinogenecity was ranged from 14.2 to 167.8 ${\mu}g\;kg^{-1}$. The residual amounts and detection frequency of PAHs in soil samples from the iron and heavy industrial areas near Pohang and Busan were 3-folds more than those of the other areas. Amounts of PAHs in upland soil samples was 1.5 folds higher than those of paddy soil samples, suggesting that it may be related to the content of organic matter in soil. The average contents of total PAHs in crop samples were 9.7 ${\mu}g\;kg^{-1}$ which ranged from 4.5 to 52.2 ${\mu}g\;kg^{-1}$. However, the residual amounts of PAHs in water samples were not detected. These results showed that soils and crops were slightly contaminated with PAHs. Therefore, the investigation should be continued for evaluating a safety or risk assessment through expansion of regions and crops.

The Influence of the Restrictions in Chinese economic growth on Korean commercial environment (중국 경제성장의 제약요인이 한국 통상환경에 미치는 영향)

  • Shong, Il-Ho;Lee, Gye-Young
    • International Commerce and Information Review
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    • v.15 no.4
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    • pp.457-479
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    • 2013
  • Through a Chinese rise, Chinese dream is actualizing as the world's great power. According to outlook of World Bank and IMF, Around 2030 China will be a great power bigger than America's economic power. The rise of China will give a huge impact to the whole world. China expands her influence through a global manufacturing base and a global market. To actualize 'Peaceful Rise' Strategy, China has many constraints. Chinese society is facing many difficult social problem due to side effects of a rapid development. Such as the spread of corruption, the severity of wealth gap, environmental degradation and energy shortage. Internationally there are containment from hegemon so-called 'China threat' dispute, Taiwan issue and territorial disputes. Western countries are hostile to China for two reasons. Based on expectations, one is China's socialist system and the other is the rising China which will compete for supremacy with Europe and America. Recent emergence of Chinese nationalism and the containment of the neighboring countries are also serious limiting factors. Domestically they have the rampant corruption in the bureaucracy, weakened capacity of Communist rule, wealth disparity due to the discriminatory economic development strategy, seriousness of rural problem, social instability, lack of social security systems and the development gap between the eastern coastal areas and western inland areas, ethnic minorities problems, the constraint of sustainable development issues due to lack of resources, environmental pollution and energy constraints. Like the former Soviet Union, China may face a dismantlement. After the rise, China may encounter possibilities of a war between great powers or a collapse of Chinese society caused by deepening internal conflict. Serious economic polarization would make peasants and urban workers, who are social vulnerable people, to turn their back to communist party and threaten the justification and the appropriateness of the ruling communist party. Chinese government will think internal system security threat is more formidable risk factor than a system security threat from the hegemon. The decline of great country comes from internal reasons rather than external reasons. To achieve peaceful rise, unification with Taiwan is an essential prerequisite. Taiwan issues are complex problems which equipped with international and domestic factors. Lack of energy resources, environmental pollution in China will bring economic crisis to Korean enterprises. Important influence to Korean economy will be a changeover of the method in economic development. It will turn the balance of investment and consumption, GDP-centered growth to consumption and environment-centered growth. Services industries including finance, environment, culture, education, health care and social welfare will grow. Change in China's growth model will give a great challenge upon the intermediate goods industry in Korea. Korea should reduce the portion of machinery, automotive, semiconductor, steel and chemical-centered export industry to China, and should increase the proportion of the service industry.

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The Diagnosis for Educational Behavioral Strategies of Community Health Nurse-Community Health Worker for Control of Hypertensive Urban Young Black Men in America (간호사-지역사회건강상담자팀의 미국 도시지역 젊은 흑인 남자 집단의 고혈압 관리를 위한 전략 활동의 교육-행위진단)

  • Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.80-99
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    • 1996
  • Young black men(YBM) have the most severs levels of high blood pressure(HBP) and, in all reports but one, the lowest of HBP control of any age /sex /race group. To increase entry into care, remaining in care, and BP control for young(18-49 years) Black men, It is needed to review socio-demographic, medical characteristics, and behaviors(importance of and difficulty with HBP control behaviors, or worry about mdication) for experimental intervention study(educational- behavior strategies) of hypertensive urban young black men. The 204 participants had an average age of 38.8+7.0 years and an average educational level of $11.0{\pm}2.4$ years; only 23.1% were employed full- or part-time while 26% were on disability ; and 6% were married. Only 35.3% had an MD for HBP care and 37.3% had some form of health insurance. The average BP of those men currently being in care on medication(35.3%) was $148.2/95.1{\pm}19.5/11.3$ compared to those men not taking HBP care $153.7/99.1{\pm}14.0/9.8(p<.05)$. The average creatinine level was 1.3(excluding 3 marked elevations of 15.9, 9.6, and 7.7) for the 163 men consenting to have their blood drawn. Self-reported co-morbidity induded heart disease 7.8%, diabetes 8.9%, high cholesterol 18.2%, CVA 3.4%, alcohol and drug related problems 27.9% and 22.5% respectively. The kidney disease of those men currently being in care & on medication was 9.7 compared to those men not taking HBP care 0.8(p<.05). The problems of with sex life, physicl activity and dearly thinking of those men currently being in care & on medication was higher compared to those men not taking HBP care(p<.05). Questions of 'during the past month, on how many days did you have 5 or more drinks (bottles) of any alcoholic beverag?' and smoking of those men currently being in care & on medication was 18.1% and 72.2% compared to those men not taking HBP care 27.3 and 82.6%, respectively. HBP control behaviors was assessed with 1-5 point Likert subscales(5=extreme, 1-none at all), In general, th men reportd low levels of perceived psychological barrier to HBP care and control behaviors; importance of and difficulty with HBP control behaviors, or worry about mdication. For example, on a five point scale(1=none at all, 5=extreme), average ratings for perceived important and difficulty with BP care and behaviors were 2.8(SD=1.2) and 2.5(SD=1.1). Average ratings for perceived benefit with BP care and behaviors worry about medication of those men currently being in care on medication was 4.0(SD=0.9) and 2.2(SD=1.1) compared to those men not taking HBP care 3.6(SD=0.8), 2.8 (SD=1.6) respectively(p<.05). These data support the need for educational-behavioral strategies of community health nurse to improve high blood pressure control in this high risk group through perceived barriers to treatment, health care skills and use of resources, and social support.

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Delayed Diagnosis of Primary Lung Cancer (원발성 폐암의 지연진단에 관한 임상적 고찰)

  • Kim, Sun-Young;Cho, Hae-Jeong;Kim, Geun-Hwa;Ko, Dong-Seok;Suh, Jae-Chul;Shin, Kyoung-Sang;Jeong, Seong-Su;Kim, Ju-Ock
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.754-759
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    • 1998
  • Background : Lung cancer is an important public health problem because of rapidly increasing malignancy in both sexes in relation with high smoking rate in Korea. Despite advances in therapeutic modalities and supportive cares, 5-year survival rate has improved only marginally during the past 2 decades. Therefore, the early detection of lung cancer is strongly needed for better prognosis and we conducted this study to review the clinical factors resulting in delayed diagnosis of lung cancer. Method: The clinical data such as presenting symptoms, duration for diagnosis, disease entities causing misdiagnosis or delayed diagnosis, were analyzed retrospectively in 154 patients with primary lung cancer diagnosed at Chungnam National university hospital from January to December in 1995. Results : 63 patients(40.9%) out of 154 patients were delayed diagnosed with the duration of 6.3 months compared with 3.6 months in patients diagnosed without delay. In delayed diagnosed group, Cough & sputum and dyspnea as presenting symptom were more critical than hemoptysis and chest pain, and doctor's delay was more critical than patient's delay. Tuberculosis(30/63) was most frequent disease entity causing delayed diagnosis, followed by pneumorua(9/63), COPD(6/63), heart diseases(5/63), etc.. Conclusion: It should be emphasized that any respiratory symptom be checked with chest X-ray to differentiate lung cancer and periodic check of chest X-ray be also needed for the longterm patients with any disease, especially with high risk group.

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Clinical Characteristics of Pulmonary Tuberculosis Presenting Prolonged Fever Despite Primary Short-Course Anti-tuberculosis Treatment (1차 항결핵약제 치료 후에도 지속적으로 발열을 보인 폐결핵 환자의 임상상)

  • Kim, Eun-Kyung;Hwang, Jung-Hwa;Song, Kun-Sick;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.169-178
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    • 2000
  • Background : Usually fever subsides within one week in over 90% of pulmonary tuberculosis (TBp) patients after the start of short-course anti-tuberculosis therapy, but occasionally it persists over two weeks after treatment. When the fever persists, drug resistance, combined infection, or drug fever, and so on, are considered as an etiology and, in some cases, drugs are changed. But inadvertent discontinuation of a short-course regimen inevitably will extend the duration of treatment, and the treatment completion may be delayed. This study was performed to investigate the causes of prolonged fever (PF) and to identify the predictors of PF in drug-susceptible TBp patients in Korea. Method : Five hundred-ninety-eight patients, who were admitted to Asan Medical Center from January 1996 to March 1999, diagnosed with TBp and prescribed short-course, anti-tuberculosis treatment, were reviewed. PF was defined as having fever over two weeks despite treatment. The causes of PF were analyzed. Drug-sus-ceptible TBp patients who presented no causes for PF, except turberculosis itself, were selected(n=22), and they were compared with those who had no fever at diagnosis (n=22) and those who had fever at diagnosis, which had subsided within two weeks after treatment (n=22). Clinical, laboratory, and radiological parameters were compared among the three groups. Results : Twenty-eight (4.8%) of 598 patients showed PF over two weeks despite short-course treatment. The causes of PF were drug fever (n=2), multi-drug resistant tuberculosis (n=3), disseminated Mycobacterium kansasii infection (n=1), and drug-susceptible tuberculosis itself (n=22). The patients with PF had more risk factors for tuberculosis, long duration of symptoms before treatment, night sweats, weight long, numerous acid fast bacilli on sputum smear, anemia, hyponatremia, hypoalbuminemia, over three lung cavity numbers and extensive infiltration, indicating that they had prolonged and extensive lung diseases. Conclusion : The main cause of PF in TBp despite short-course regimen seems to be drug-susceptible but extensive disease in Korea. Any changes to the drug regiment provided for TBp patients with prolonged fever despite treatment should be carefully considered.

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Antihyperlipidemic Effect of Diet Containing Portulaca oleracea L. Ethanol Extract in High Fat Diet-Induced Obese Mice (고지방식이로 유도된 비만 Mice에서 쇠비름 에탄올 추출물의 고지혈증 개선효과)

  • Won, Hyang-Rye;Kim, Soo-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.4
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    • pp.538-543
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    • 2011
  • This study was conducted for the antihyperlipidemic effect of ethanol extract from Portulaca oleracea in high fat diet-induced obese mice after having injected the ethanol extract from Portulaca oleracea to the obese mice with high fat diet. The 30 six-week-old male C57BL/6J mice were divided into 3 groups of 10 and fed for 5 weeks to be obese with high fat diet. Thereafter, for 4 weeks, ethanol extract from Portulaca oleracea was provided through oral injection to the 3 groups: control group (HFD), group injected with 75 mg/kg of ethanol extract from Portulaca oleracea (HFD+POE 75) and the group injected with 125 mg/kg of ethanol extract from Portulaca oleracea (HFD+POE 125). The serum and liver lipid and the alanine transaminase (ALT) and aspartate transaminase (AST) activity were measured. The result showed that there was no significant difference in weight gain and feed intake, and the feed efficiency ratio was significantly low in the group provided with ethanol extract from Portulaca oleracea. Serum total cholesterol was significantly low in the group of ethanol extract from Portulaca oleracea (HFD+POE 125). It appeared that all the groups provided with ethanol extract from Portulaca loeracea reduced plasma triglyceride significantly according to the ethanol extract from Portulaca oleracea dose. There was no dose dependency of HDL-cholesterol to the dose of ethanol extract of Portulaca oleracea. LDL-cholesterol was low in the group dosed with high ethanol extract from Portulaca oleracea (HFD+POE 125). There was difference of total cholesterol, triglyceride and total lipid contents in liver. AI (atherogenic index) and CRF (cardiac risk factor) were significantly low in the group with high dose of ethanol extract from Portulaca oleracea (HFD+POE 125). There was no difference of serum AST activity, however, serum ALT activity was significantly low in the group with high dose of ethanol extract from Portulaca oleracea (HFD+POE 125).

The Changes of Dietary Reference Intakes for Koreans and Its Application to the New Text Book (한국인 영양섭취기준에 대한 이해 및 새 교과서에의 적용 방안)

  • Kim, Jung-Hyun;Lee, Min-June
    • Journal of Korean Home Economics Education Association
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    • v.20 no.2
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    • pp.75-94
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    • 2008
  • The purposes of this paper are to describe the newly established reference values of nutrient intakes: to apply the changed dietary reference intakes to the new text book based on the revised curriculum: and to contrive substantial contents in the domain of dietary life(foods & nutrition) of new text book. Dietary Reference Intakes for Koreans(KDRIs) is newly established reference values of nutrient intakes that are considered necessary to maintain the health of Koreans at the optimal state and to prevent chronic diseases and overnutrition. Unlike previously used Recommended Dietary Allowances for Koreas(KRDA), which presented a single reference value for intake of each nutrient, multiple values are set at levels for nutrients to reduce risk of chronic diseases and toxicity as well as prevention of nutrient deficiency. The new KDRIs include the Estimated Average Requirement(EAR), Recommended Intake(RI), Adequate Intake(AI), and Tolerable Upper Intake Level(UL). The EAR is the daily nutrient intake estimated to meet the requirement of the half of the apparently healthy individuals in a target group and thus is set at the median of the distribution of requirements. The RI is set at two standard deviations above the EAR. The AI is established for nutrients for which existing body of knowledge are inadequate to establish the EAR and RI. The UL is the highest level of daily nutrient intake which is not likely to cause adverse effects for the human health. Age and gender subgroups are established in consideration of physiological characteristics and developmental stages: infancy, toddler, childhood, adolescence, adulthood and old age. Pregnancy and lactation periods were considered separately and gender is divided after early childhood. Reference heights and weights are from the Korean Agency for Technology and Standards, Ministry of Commerce, Industry and Energy. The practical application of DRIs to the new books based on the revision in the 7th curriculum is to assess the dietary and nutrient intake as well as to plan a meal. It can be utilized to set an appropriate nutrient goal for the diet as usually eaten and to develop a plan that the individual will consume using a nutrient based food guidance system in the new books based on the revision in the 7th curriculum.

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Design and Analysis of Online Advertising Expenditure Model based on Coupon Download (쿠폰 다운로드를 기준으로 하는 온라인 광고비 모델의 설계 및 분석)

  • Jun, Jung-Ho;Lee, Kyoung-Jun
    • Journal of Intelligence and Information Systems
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    • v.16 no.4
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    • pp.1-19
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    • 2010
  • In offline environment, unlike traditional advertising model through TV, newspaper, and radio, online advertising model draws instantaneous responses from potential consumers and it is convenient to assess. This kind of characteristics of Internet advertising model has driven the growth of advertising model among various Internet business models. There are, conventionally classified, CPM (Cost Per Mile), CPC (Cost Per Click), and CPS (Cost Per Sales) models as Internet advertising expenditure model. These can be examined in manners regarding risks that stakeholders should stand and degree of responsibility. CPM model that is based on number of advertisement exposure is mechanically exposed to users but not actually recognized by users resulting in risk of wasted expenditure by advertisers without any advertising effect. While on aspect of media, CPS model that is based on conversion action is the most risky model because of the conversion action such as product purchase is determined by capability of advertisers not that of media. In this regard, while there are issue of CPM and CPS models disadvantageously affecting only one side of Internet advertising business model value network, CPC model has been evaluated as reasonable both to advertisers and media, and occupied the largest segment of Internet advertising market. However, CPC model also can cause fraudulent behavior such as click fraud because of the competition or dishonest amount of advertising expenditure. On the user aspect, unintentionally accessed advertisements can lead to more inappropriate expenditure from advertisers. In this paper, we suggest "CPCD"(Cost Per Coupon Download) model. This goes beyond simple clicking of advertisements and advertising expenditure is exerted when users download a coupon from advertisers, which is a concept in between CPC and CPS models. To achieve the purpose, we describe the scenario of advertiser perspective, processes, participants and their benefits of CPCD model. Especially, we suggest the new value in online coupon; "possibility of storage" and "complement for delivery to the target group". We also analyze the working condition for advertiser by a comparison of CPC and CPCD models through advertising expenditure simulation. The result of simulation implies that the CPCD model suits more properly to advertisers with medium-low price products rather than that of high priced goods. This denotes that since most of advertisers in CPC model are dealing with medium-low priced products, the result is very interesting. At last, we contemplate applicability of CPCD model in ubiquitous environment.