• Journal of Yeungnam Medical Science
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• 제28권1호
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• pp.99-104
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• 2011

Essential thrombocythemia (ET), a subcategory of chronic myeloproliferative disorder, is characterized by absolute thrombocytosis due to excessive clonal proliferation of platelets, hyperaggregability of platelets, and increased incidence of thrombosis and hemorrhage. We consider a diagnosis of ET when an unexplained and persistent thrombocytosis is observed. It is difficult to consider ET first when we meet a patient with esophageal varix bleeding or unusual multiple thromboses like mesenteric vein, splenic vein, and portal vein. This article reports a patient who presented initially with esophageal varix bleeding and unusual multiple thromboses, thereafter, she was diagnosed with ET after testing positive for the Janus Tyrosine Kinase 2 (JAK2) V617F mutation. In conclusion, in patients with varix bleeding and unusual multiple thromboses, myeloproliferative disorders like essential thrombocythemia should be considered as a potential cause and testing for the JAK2 mutation is warranted.

• 대한수의학회지
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• 제33권2호
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• pp.327-336
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• 1993

Present experiments were undertaken in order to clarify the effect of splenectomy on the hematology and marrow megakaryocyte picture and to know the genesis of postsplenectomy thrombocytosis in dogs. Six mongrel dogs weighing 8.5~18㎏ were used, of which three were splenectomized and the other three were laparotomized for comparison. Erythrocyte count, total and differential leukocyte counts, thrombocyte count and packed cell volume measurement were made using the blood samples. In addition, bone marrow samples obtained from the femur at 7th and 23rd day of the operation were examined for the number per low-power field, the diameter, and the distribution frequency of the megakaryocyte. From these experiments, following results were obtained : Erythrocyte count and packed cell volume showed significant decrease beginning on the 15th day of splenectomy. Total and differential leukocyte counts showed marked increase for the first 2 days of postsplenectomy. The thrombocyte count of splenectomized dogs increased from the 2nd day of the operation, reached to the peak count on the 15th day, and returned to the preoperation count by the 28th day. The megakaryocyte count per low-power field of the biopsied preparation increased in according to the increase in thrombocyte count. The megakaryocyte diameter of splenectomized dog showed no increase on the 7th or 23rd day of the operation. However, the distribution frequency of the larger megakaryocyte was higher in the splenectomized dogs than in the laparotomized dogs. The total plasma protein concentration showed no significant change after splenectomy or laparotomy. From these results, it may be concluded that the postsplenectomy thrombocytosis results from the increased megakaryocytopoesis or the activated thrombocytopoesis of the marrow megakaryocytes.

• Journal of Medicine and Life Science
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• 제20권2호
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• pp.99-102
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• 2023

Patients with essential thrombocythemia (ET) can undergo laparoscopy without international precautions. This case report describes an ET with a mild increase in the platelet count that developed after laparoscopic surgery and prolonged intraperitoneal bleeding. The patient underwent intensive postoperative medical and surgical treatments until cured. Patients with ET should provide informed consent for post-laparoscopic bleeding. Surgeons should perform optimal hemostasis. Further studies are required to provide clear guidelines for both medical and surgical interventions aimed at preventing thrombo-hemorrhagic complications associated with ET. A preoperative study of platelet function and the selection of the best cytotoxic drug for the perioperative period are mandatory.

• Clinical and Experimental Pediatrics
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• 제49권6호
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• pp.672-676
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• 2006

목 적 : 가와사끼병에서 급성기 항염치료 후 회복기에 항혈전 요법으로 저용량 아스피린을 사용한다. 대개 6-8주간 투여하고 종료 시기에 혈소판 치를 포함한 각종 혈액검사와 관상동맥 이상 유무를 알기 위한 심초음파 검사를 시행하기도 한다. 발병 6주째에 시행하는 각종 추적검사가 임상적으로 얼마나 유용한지 알아보고자 본 조사를 시행하였다. 방 법 : 1997년 1월부터 2004년 12월까지 만 8년간 원광대학교병원 소아과에 입원하여 가와사끼병으로 치료받았던 282명의 환자를 대상으로 후향적으로 조사하였다. 입원 당시와 6주째에 백혈구수와 혈소판수, ASO, ESR, CRP, AST, ALT, 소변검사, 심초음파 검사를 시행하였다. 6주째에 혈소판이 증가했던 군과 대조군을 각종 검사 척도로 비교하였고, 나이와 성별, 재치료 여부, 발열-입원 기간, 치료-해열 기간, 관상동맥 이상 등이 6주째의 혈소판 증가에 영향을 미치는지 비교 분석하였다. 통계적 비교는 paired t-test와 Fisher's exact test, logistic 회귀분석으로 하였다. 결 과 : 입원 시에 증가를 보였던 ESR과 CRP는 6주째 시행한 검사상 각각 35명(12.4%), 12명(4.3%)을 제외하고 정상화되었고, 무균성 농뇨는 전례에서 모두 정상화되었다. 혈소판 증가는 36명(12.8%), 백혈구 이상 15명(5.3%), 관상동맥 이상 6명(2.1%), AST 상승 22명(7.8%), ALT 상승 3명(1.1%), AST/ALT 동시 상승은 3명(1.1%)에서 관찰되었다. 관상동맥 이상은 발병 초기에 이상을 보였던 경우에서만 관찰되었다. 6주째의 혈소판 증가군에서 대조군에 비해 성별과 재치료, 입원 시의 백혈구 이상, 농뇨, AST/ALT의 동시상승, 관상동맥 이상 빈도의 비교에서 모두 유의한 차이가 없었다. 6주째의 혈소판 증가에 영향을 주는 인자로는 어린 나이와 발병초기의 혈소판 증가증이었다. 발열-입원 기간과 치료-해열 기간, 입원 시의 ESR, CRP, AST, ALT치는 영향을 주지 않았다. 입원 시와 6주째의 혈소판 증가는 관상동맥 이상에 영향을 주지 않았다. 결 론 : 가와사끼병에서 6주째에 시행하는 각종 추적검사에서 소변 검사는 생략해도 될 것으로 보이며, 심초음파 검사는 발병 초기에 이상이 있었던 군에서만 선택적으로 시행해도 될 가능성을 시사했지만 이에 대한 연구가 더 필요하다고 판단된다. 혈소판 수는 계속적인 항혈전 치료와 관련이 있으므로 6주째의 검사가 필요하나, 백혈구수와 AST, ALT, ESR, CRP 검사의 임상적 의의는 크지 않다고 판단된다.

• Tuberculosis and Respiratory Diseases
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• 제67권4호
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• pp.351-355
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• 2009

The incidence of pulmonary thromboembolism increases with age. The risk factors of pulmonary thromboembolism include surgery, malignancy, obesity, lupus anticoagulants, and vascular conditions such as deep vein thrombosis. Thromboembolism in younger patients or in unusual locations, the possibility of primary thrombophilic conditions should be considered. Primary thrombophilic states include myeloproliferative disorders (MPD). JAK2 V617F mutation is found commonly in patients diagnosed with MPD, in 90~95% of polycythemia vera (PV) and in 50~60% of essential thrombocytosis (ET) patients. Sometimes the JAK2 V617F mutation is found in cases without MPD. The relationship between JAK2 V617F mutation and thrombosis has not been defined. Recently, clinical evidence suggests that this mutation may be variably associated with thrombosis. We present one case of pulmonary thromboembolism in a young patient, who was positive for the JAK2 V617F mutation and did not have MPD.

• 한국임상수의학회지
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• 제32권5호
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• pp.473-475
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• 2015

시골에 사는 12년령의 중성화 안한 수컷 말라뮤트가 회음부위의 염증과 통증을 주호소로 내원하였다. 회음부 신체검사에서 구더기와 구멍이 있는 피부 병변이 존재하였다. 혈액검사에서는 미약한 빈혈과 혈소판 증가증 이외에 특이소견은 보이지 않았으며 진단은 임상증상 및 구더기의 존재에 의해 쉽게 되었다. 즉시 삭모 및 소독을 실시하였으며 삭모 중 진드기가 발견되어 SNAP 4DX (IDEXX Laboratories, Westbrook, ME, USA)를 이용해 진드기 및 관련 병원체의 감염유무를 평가하였고 검사결과는 모두 음성이었다. 치료는 이버멕틴(300 mcg/kg)을 피하 주사로 한번 주사하였으며 2차 감염을 예방하기 위해 항생제를 처방하였다. 이 후 구더기증과 상처부위는 2주 이내에 치료되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7497-7500
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• 2013

Background: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms. Materials and Methods: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis. Results: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, $9.5{\pm}4.3cm$, was larger than non palpable masses, $5.3{\pm}2.7cm$ (p<0.001). Conclusions: This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8235-8238
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• 2016

Background: Lung cancer is one of the most common types of cancer causing high morbidity and mortality worldwide. An increasing incidence of lung cancer has been observed in India. Objectives:To evaluate the clinicpathological profile and haematological abnormalities associated with lung cancer in Bangalore, India. Materials and Methods: This prospective study was carried out over a period of 2 years. A total of 96 newly diagnosed and histopathologically confirmed cases of lung cancer were included in the study. Results: Our lung cancer cases had a male to female ratio of 3:1. Distribution of age varied from 40 to 90 years, with a major contribution in the age group between 61 and 80 years (55.2%). Smoking was the commonest risk factor found in 69.7% of patients. The most frequent symptom was cough (86.4%) followed by loss of weight and appetite (65.6%) and dyspnea (64.5%). The most common radiological presentation was a mass lesion (55%). The most common histopathological type was squamous cell carcinoma (47.9%), followed by adenocarcinoma (28.1%) and small cell carcinoma (12.5%). Distant metastasis at presentation was seen in 53.1% patients. Among the haematological abnormalities, anaemia was seen in 61.4% of patients, leucocytosis in 36.4%, thrombocytosis in 14.5% and eosinophilia in 19.7% of patients. Haematological abnormalities were more commonly seen in non small cell lung cancer. Conclusions: Squamous cell carcinoma was found to be the most common histopathological type and smoking still remains the major risk factor for lung cancer. Haematological abnormalities are frequently observed in lung cancer patients, anaemia being the commonest of all.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7659-7661
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• 2015

Background: Essential thrombocythemia (ET) is a Philadelphia chromosome-negative myeloproliferative neoplasm characterized by sustained thrombocytosis and megakaryocytic hyperplasia. It is an uncommon hematological malignancy which primarily affects elderly individuals. The rational of this study was to determine its clinico-hematological profile along with risk stratification in Pakistan patients. Materials and Methods: In this retrospective cross sectional study, 21 patients with ET were enrolled from January 2011 to December 2014. Data was analyzed with SPSS version 21. Results: The mean age was $56.7{\pm}19.0years$ (range 18-87) and the male to female ratio was 1:1.1. Of the total, 62% of patients were above 50 years of age. Overall 61.9% were diagnosed incidentally and were asymptomatic. In symptomatic patients, major complaints were weakness (19%); erythromelalgia (14.2%), transit ischemic attack (9.5%) and gastrointestinal bleed (4.7%). The mean hemoglobin count was $11.7{\pm}2.4g/dl$ with a total leukocyte count of $13.3{\pm}8.1{\times}10^9/l$ and platelets count of $1188.8{\pm}522.2{\times}10^9/l$. Serum lactate dehydrogenase, serum creatinine and uric acid were $454.3{\pm}127.8$, $1.2{\pm}0.5$ and $7.4{\pm}3.4$ respectively. According to risk stratification, 57.1% were in high risk; 23.8% in intermediate risk while 19.1% in low risk group. Conclusions: ET in our patients in Pakistan, unlike in the West, is seen in a relatively young population. Primarily patients were asymptomatic and risk stratification revealed predominance of high risk disease in our setting.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권1호
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• pp.47-55
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• 2000

Purpose: The aim of this research is to examine the abnormal liver function complicated with Kawasaki disease (KD) and to analyze its clinical characteristics and complications. Methods: Ninty eight cases were diagnosed as having KD, among which thirty four cases had abnormal alanine aminotransferase (ALT) (>30 IU/L). These abnormal ALT cases were evaluated in terms of age and sex distribution, major symptoms, complications, laboratory and histopathologic findings. Results: Male to female ratio was 2.4:1 and most patients (91.2%) were under 5 years of age. Cervical lymphadenopathy was observed in 3 cases (8.8%); and recurred cases were two (5.8%). Average fever duration was 8 days; average length of hospitalization was 9 days; and average recovery period was 13 days. Immediately after admission, positive CRP was observed in 31 cases (91.2%), leukocytosis (> $10,000/mm^3$) in 26 cases (76.0%), thrombocytosis (> $450,000/mm^3$) in 7 cases (20.6%), and anemia (<10 gm/dl) in 7 cases (20.6%), respectively. GB hydrops or cholecystitis were noted in 3 cases (8.8%), abnormal ECG finding in 1 case (2.9%), coronary dilatation or aneurysm in 2 cases (5.9%). Liver biopsy was done in four cases and revealed mild infiltration of lymphocytes on the portal area and mild bile duct proliferations. Conclusion: The abnormal liver function was noted in 34.7% of KD patients, and subsided all within one month. But the liver function test should be checked closely in patients of the abnormal liver function test complicated with KD despite of its good prognosis.