• 제목/요약/키워드: iron-deficiency anemia

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철 결핍성 빈혈: 복합 열성경련과 열성경련의 재발의 가능한 위험인자 (Iron Deficiency Anemia: The Possible Risk Factor of Complex Febrile Seizure and Recurrence of Febrile Seizure)

  • 이찬영;이나미;이대용;윤신원;임인석;채수안
    • 대한소아신경학회지
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    • 제26권4호
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    • pp.210-214
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    • 2018
  • 목적: 열성경련과 철 결핍성 빈혈간의 상관관계는 몇몇 연구에서 밝혀져 왔다. 하지만 단순 열성경련과 복합 열성경련에서 철 결핍성 빈혈의 역할을 확인한 연구는 적으며 열성경련 재발의 위험인자가 될 수 있는지 확인한 연구는 없었다. 본 연구의 목표는 단순 열성경련과 복합 열성경련에서 철 결핍성 빈혈의 역할을 알아보고 철 결핍성 빈혈이 열성경련의 재발에 미치는 영향을 확인하는 것이다. 방법: 2011년 1월부터 2018년 4월까지 중앙대병원에서 열성경련으로 진단받고 2년이상 추적관찰을 받았던 166명의 소아에 대해 연구를 진행하였다. 환자들은 다음과 같은 군으로 나뉘어 분석되었다: 단순 열성경련과 복합 열성경련, 재발이 있었던 환자와 없었던 환자. 각 그룹에서 발병시의 나이를 비교하였고 빈혈 여부를 확인하기 위한 진단검사 결과들을 비교하였다. 결과: 단순 열성경련과 복합 열성경련 군에서 철 결핍성 빈혈과 관련된 진단검사 결과는 두 군 간에 유의한 차이가 없었다. 발병 시 나이는 두 군 간에 유의한 차이를 보였고 복합 열성경련 군에서 낮은 경향을 보였다(24.00과 16.49개월) (P=0.004). 남성과 여성의 비율은 두 군 간에 차이가 없었다. 재발한 군과 재발이 없던 군을 비교할 때 평균 적혈구 용적이 유의한 차이를 보였고(P=0.043) 재발이 있던 군에서 유의하게 더 낮았다(78.92와 77.48 fl). 발병 시 나이는 재발이 있던 군에서 더 어렸다 (26.02와 19.68 개월). 결론: 본 연구에서 발병 시 나이가 복합 열성경련의 위험인자가 될 수 있음을 확인하였고 철 결핍성 빈혈이 복합 열성경련의 위험도를 올리지 않을 수 있다는 것을 알 수 있었다. 하지만 철 결핍성 빈혈은 열성경련의 재발과 연관이 있는 것으로 보인다.

구충증(鉤蟲症)에 관(關)한 연구(硏究) 제1편(第1篇) 구충(鉤蟲)의 감염(感染) 및 구충성빈혈(鉤蟲性貧血)에 관(關)한 고찰(考奈) (Studies on Ancylostomiasis I. An Experimental Study on Hookworm Infection and Anemia)

  • 이문호;김동집;이장규;서병설;이순형
    • 대한핵의학회지
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    • 제1권1호
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    • pp.55-66
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    • 1967
  • In view of its prevalence in the Far East area, a more detailed knowledge on the hookworm infection is one of the very important medical problems. The present study was aimed to; determine the infectivity of the artificially hatched ancylostoma duodenale larvae in man after its oral administration, evaluate the clinical symptomatology of such infection, determine the date of first appearance of the ova in the stool, calculate the blood loss per worm per day, assess the relation-ships between the ova count, infectivity(worm load), blood loss and severity of anemia. An erythrokinetic study was also done to analyse the characteristics of hookworm anemia by means of $^{59}Fe\;and\;^{51}Cr$. Materials and Methods Ten healthy male volunteers(doctors, medical students and laboratory technicians) with the ages ranging from 21 to 40 years were selected as the experimental materials. They had no history of hookworm infection for preceding several years, and care was taken not to be exposed to reinfection. A baseline study including a through physical examinations and laboratory investigations such as complete blood counts, stool examination and estimation of the serum iron levels was done, and a vermifuge, bephenium hydroxynaphoate, was given 10 days prior to the main experiment. The ancylostoma duodenale filariform larvae were obtained in the following manner; The pure ancylostoma duodenale ova were obtained from the hookworm anemia patients and a modified filter paper method was adopted to harvest larger number of infective larvae, which were washed several times with saline. The actively moving mature larvae were put into the gelatine capsules, 150 in each, and were given to the volunteers in the fasting state with 300ml. of water. The volunteers were previously treated with intramuscular injection of 15mg. of chlorpromazine in order to prevent the eventual nausea and vomiting after the larvae intake. The clinical symptoms and signs mainly of the respiratory and gastrointestinal tracts, appearance of the ova and occult blood in the stool etc. were checked every day for the first 20 days and then twice weekly until the end of the experiment, which usually lasted for about 3 months. Roentgenological survey of the lungs was also done. The hematological changes such as the red blood cell, white blood cell and eosinophil cell counts, hemoglobin content and serum iron levels were studied. The appearance of the ova in the stool was examined by the formalin ether method and the ova were counted in triplicate on two successive days using the Stoll's dilution method. The ferrokinetic data were calculated by the modified Huff's method and the apparent half survival time of the red blood cells by the modified Gray's method. The isotopes were simultaneously tagged and injected intravenously, and then the stool and blood samples were collected as was described by Roche et al., namely, three separate 4-day stool samples with the blood sample drawing before each 4-day stool collection. The radio-activities of the stools ashfied and the blood were separately measured by the pulse-height analyser. The daily blood loss was calculated with the following formula; daily blood loss in $ml.=\frac{cpm/g\;stool{\times}weight\;in\;g\;of\;4-day\;stool}{cpm/ml\;blood{\times}4}$ The average of these three 4-day periods was given as the daily blood loss in each patient. The blood loss per day per worm was calculated by simply dividing the daily blood loss by the number of the hookworm recovered after the vermifuge given twice a week at the termination of the experiment. The iron loss in mg. through the gastrointestinal tract was estimated with the daily iron loss in $mg=\frac{g\;Hgb/100ml{\times}ml\;daily\;blood\;loss{\times}3.40}{100}$ 3.40=mg of iron per g Hgb following formula; Results 1. The respiratory symptoms such as cough and sputum were noted in almost all cases within a week after the infection, which lasted about 2 weeks. The roentgenological findings of the chest were essentially normal. A moderate degree of febril reaction appeared within 2 weeks with a duration of 3 or 4 days. 2. The gastrointestinal symptoms such as nausea, epigastric fullness, abdominal pain and loose bowel appeared in all cases immediately after the larvae intake. 3. The reduction of the red blood cell count was not remarkable, however, the hemoglobin content and especially the serum iron level showed the steady decreases until the end of the experiment. 4. The white blood cells and eosinophil cells, on the contrary, showed increases in parallel and reached peaks in 20 to 30 days after the infection. A small secondary rise was noted in 2 months. 5. The ova first appeared in the stool in 40. 1 days after the infection, ranging from 29 to 51 days, during which the occult blood reaction of the stool became also positive in almost cases. 6. The number of ova recovered per day was 164, 320 on the average, ranging from 89,500 to 253,800. The number of the worm evacuated by vermifuge was in rough correlation with the number of ova recovered. 7. The infectivity of ancylostoma duodenale was 14% on the average, ranging from 7.3 to 20.0%, which is relatively lower than those reported by other workers. 8. The mean fecal blood loss was 5.78ml. per day, with a range of from 2.6 to 11.7ml., and the mean blood loss per worm per day was 0.30ml., with a range of from 0.13 to 0.73ml., which is in rough coincidence with those reported by other authors. There appeared to exist, however, no correlation between the blood loss and the number of ova recovered. 9. The mean fecal iron loss was 2.02mg. per day, with a range of from 1.20 to 3.89mg., which is less than those appeared in the literature. 10. The mean plasma iron disappearance rate was 0.80hr., with a range of from 0.62 to 0.95hr., namely, a slight accerelation. 11. The hookworm anemia appeared to be iron deficiency in origin caused by continuous intestinal blood loss.

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여대생의 체질량지수에 따른 식품 및 영양섭취 상태 분석 연구 (A Study on the Nutrtional Ststus according to Body Mass Index in Korean College Women)

  • 유춘희;이정숙
    • Journal of Nutrition and Health
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    • 제37권10호
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    • pp.899-907
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    • 2004
  • This study was performed to investigate dietary habits and nutritional intake according to body mass index (BMI) of female college students. The subjects were 1361 students with a mean age of 20.4 years residing in Seoul and Kyonggui area. BMI (kg/) between $\geq$ 18.5 to $\leq$ 23 was considered as nonnal, < 18.5 as underweight and > 23 as overweight. The subjects had a mean BMI of 20.0 kg/$m^2$ and 25% of them were classified as underweight group, 67% as normal group and 8% as overweight group. Dietary intake was assessed by food frequency method and consumption of foods and nutrients was analyzed. Frequency of meal skipping was higher in the overweight group, 16.1 % of the overweight group skipped dinner. Also, the frequency of snack intake was lowest in the overweight group. The overweight group consumed less meat and fish than the normal and underweight groups. The total number of foods consumed in a day was also significantly lower than that of the underweight and normal group. The overweight group consumed less energy, protein, fat, phosphorus and niacin than the underweight and normal groups. The overweight group took iron and sodium intake lower than the normal group. Mean intakes of nutrients except clacium and iron in all three groups were over Korea RDA. The NAR (nutrient adequacy ratio) value of all nutrients, except calcium, was lower in the overweight group when compared to the normal and underweight groups, and the MAR (mean adequacy ratio) of the overweight group was 0.89, which was lower than 0.92 of the underweight and 0.93 of the normal group. The above results indicated that the deficiency of major nutrients such as calcium and iron could be inducde by less kinds of consumed foods and frequent meal skipping including dinner in the overweighted group. Therefore, balanced nutrient intake is required to maintain skeletal health and prevent anemia in overweighted female college students aged twenties.

Nutrient intakes of infants with atopic dermatitis and relationship with feeding type

  • Han, Youngshin;Lee, Youngmi;Park, Haeryun;Park, Sunyoung;Song, Kyunghee
    • Nutrition Research and Practice
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    • 제9권1호
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    • pp.57-62
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    • 2015
  • BACKGROUND/OBJECTIVES: The prevalence of atopic dermatitis in infants is increasing worldwide. However, the nutrient intake status of infants with atopic dermatitis has not been studied properly. This study was conducted to compare the nutrient intake status of infants in the weaning period with atopic dermatitis by feeding type. MATERIALS/METHODS: Feeding types, nutrient intake status and growth status of 98 infants with atopic dermatitis from age 6 to 12 months were investigated. Feeding types were surveyed using questionnaires, and daily intakes were recorded by mothers using the 24-hour recall method. Growth and iron status were also measured. RESULTS: The result showed that breastfed infants consumed less energy and 13 nutrients compared to formula-fed or mixed-fed infants (P < 0.001). The breastfed group showed a significantly lower intake rate to the Dietary Reference Intakes for Koreans than the other two groups (P < 0.001). In addition, they consumed less than 75% of the recommended intakes in all nutrients, except for protein and vitamin A, and in particular, iron intake was very low, showing just 18.7% of the recommended intake. There was no significant difference in growth by feeding type, but breastfed infants showed a significantly higher rate of iron deficiency anemia (P < 0.001). CONCLUSIONS: Continuous management programs should be prepared for breastfed infants with atopic dermatitis, who are in a period when rapid growth takes place and proper nutrient intake is essential.

일부 여대생의 체성분, 식이 섭취실태 및 혈액 임상조사 (Body Composition, Food Intake and Clinical Blood Indices of Female College Students)

  • 김정희;안혜준;이상은
    • 대한지역사회영양학회지
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    • 제8권6호
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    • pp.977-985
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    • 2003
  • This study was done to evaluate the health and nutritional status of female college students in Seoul. The subjects were 63 healthy college students aged 20 to 29 years. Their body composition, dietary intakes, clinical blood indices were investigated. Their body composition was determined by means of a multifreqency bioelectrical impedance analysis. Their dietary intake was determined using 3-day record method and their nutrient intake was analyzed by Computer Aided Nutritional analysis program for professional (CAN-pro). Their hemoglobin, hematocrit, red blood cell (RBC), white blood cell (WBC) and mean corpuscular volume (MCV) were determined by semi-automated microcell counter (F-520). Their plasma total cholesterol, TG, and HDL-cholesterol levels were measured using test kits. All data were statistically analyzed by SAS PC package program. Their average consumption of calcium, iron vitamin A, vitamin B2 and niacin were 63.3%, 65.0%, 85.2%, 89.2% and 95.2% of RDA, respectively. The overall mean values of the hematological indices in the female college students were within the normal range. However anemic subjects with hemoglobin (< 12 g/dl) and hematocrit (<36%) accounted for about 20% of the subjects. The mean levels of total cholesterol, HDL-cholesterol and TG were 188.4mg/dl, 69.9mg/dl and 67.4mg/dl, respectively. The percentages of the subjects with plasma total cholesterol level (> 200mg/dl) and LDL-cholesterol (>130mg/dl) were about 41% and 30.4%, respectively. The data showed a significantly positive correlation between either body fat (%) or BMI and TG. However. there was a significantly negative correlation between either body fat (%) or BMI and HDL-cholesterol. These overall results suggest that it is necessary for college women to be educated regarding consuming more iron and vitamin C and less fat, in order to prevent iron deficiency anemia and/or cardiovascular diseases in later life.

광주지역 저소득층 노인의 성별, 연령별 영양상태 (Gender and Age Differences in the Nutritional Status of the Low Income Elderly Living in Gwangju)

  • 노희경;오근애
    • 대한지역사회영양학회지
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    • 제8권3호
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    • pp.302-310
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    • 2003
  • This study was undertaken to assess nutritional status of the low income elderly residing in Gwangju. Anthropometric data showed that mean height of the subjects was lower than that of Korean Standard Growth data but weight was similar to that standard value. As the subjects became older, their heights and weights were decreased. Body mass index (BMI) in males and females were 22.9 and 24.4 respectively. However, BMI distribution showed that 56% of the elderly females under 75 were underweight. Advancing age conoibutes significant difference in triceps skinfold thickness in females (p < 0.001). Total cholesterol level was higher in the elderly females than the males. It was found that a considerable number of subjects had anemia determined by hemoglobin and hematocrit level, which indicated un iron deficiency. Twenty-four hour dietary recall revealed that, except for phosphorus and vitamin C, all the nutrient intakes of the subjects were below 75% of Korean RDA. Surprisingly, vitamin A and riboflavin intakes of the elderly were below 50% of Korean RDA. Energy intakes of the elderly males and females were 58.7% and 59.6% of Korean RDA respectively. Unbalanced energy ratios of carbohydrate, protein and fat were noted in both genders. Nutrient intakes of females' were lower than those of males'. Thus, there was a significant gender difference in nutrient intakes. It might be further suggested that an appropriate nutritional program should be developed and implemented to improve the Poor nutritional status of the low income elderly living in cities.

Peutz-Jeghers 증후군: 증례보고와 문헌고찰 (Peutz-Jeghers Syndrome: A Case Report and Review of Literature)

  • 김현수;김성민;최진영;명훈;이석근;이종호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권5호
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    • pp.363-366
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    • 2012
  • Peutz-Jeghers syndrome is a rare syndrome with characteristic features of multiple hamartomatous polyps and mucocutaneous pigmentation. This syndrome is an autosomal dominant disease, and has complications related with polyps of the gastrointestinal tract, such as small bowel obstruction, iron deficiency anemia associated with bleeding, and intussusceptions. Many studies have reported about higher cancer risk of patients with this syndrome than those with no syndrome in the gastrointestinal tract, including gastric, duodenal, jejunal and the extragastrointestinal organs, such as gallbladder, breast and reproductive system. There are guidelines for periodic test for early detection and treatment for higher risk organs. We report a case of Peutz-Jeghers syndrome patient in the emphasis of Oral and Maxillofacial surgeon's role with review of the literature.

Newly Diagnosed Klippel-Trenaunay Syndrome Presenting with Rectal Polyposis in a Male Pediatric Patient: A Case Report

  • Jeong, Seong Hee;Joo, Donghoon;Lim, Taek Jin;Lee, Yeoun Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권1호
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    • pp.115-120
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    • 2020
  • Klippel-Trenaunay syndrome (KTS) is a rare disorder characterized by a triad of abnormal bone and soft tissue growth, the presence of a port-wine stain, and venous malformations. Gastrointestinal (GI) manifestations of KTS are relatively common and generally do not cause significant problems. However, persistence can lead to chronic GI blood loss or even massive bleeding in rare cases. The majority of the severe GI manifestations associated with KTS present as vascular malformations around the GI tract and exposed vessels can lead to serious bleeding into the GI tract. Herein, we report a case of a 16-year-old boy with severe iron deficiency anemia who was previously misdiagnosed as hemorrhoid due to small amount of chronic bleeding. The actual cause of chronic GI bleeding was from an uncommon GI manifestation of KTS as rectal polyposis.

Updates on the Diagnosis of Helicobacter pylori Infection in Children: What Are the Differences between Adults and Children?

  • Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제19권2호
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    • pp.96-103
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    • 2016
  • Helicobacter pylori infection is acquired mainly during childhood and causes various diseases such as gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue (MALT) lymphoma, and iron deficiency anemia. Although H. pylori infection in children differs from adults in many ways, this is often overlooked in clinical practice. Unlike adults, nodular gastritis may be a pathognomonic endoscopic finding of childhood H. pylori infection. Histopathological findings of gastric tissues are also different in children due to predominance of lymphocytes and plasma cells and the formation of gastric MALT. Although endoscopy is recommended for the initial diagnosis of H. pylori infection, several non-invasive diagnostic tests such as the urea breath test (UBT) and the H. pylori stool antigen test (HpSA) are available and well validated even in children. According to recent data, both the $^{13}C$-UBT and HpSA using enzyme-linked immunosorbent assay are reliable non-invasive tests to determine H. pylori status after eradication therapy, although children younger than 6 years are known to have high false positives. When invasive or noninvasive tests are applied to children to detect H. pylori infection, it should be noted that there are differences between children and adults in diagnosing H. pylori infection.

Plummer-Vinson Syndrome과 동반된 진행성 위암 1예 (Gastric Cancer Occurring in a Patient with Plummer- Vinson Syndrome -A case report-)

  • 이성근;이태무;권육;김기한;김민찬;정갑중
    • Journal of Gastric Cancer
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    • 제4권2호
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    • pp.131-133
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    • 2004
  • Plummer-Vinson syndrome (sideropenic dysphagia) is characterized by dysphagia due to an upper esophageal or a hypopharyngeal web in a patient with chronic iron deficiency anemia. The main cause of dysphagia is the web of the cervical esophagus, and an abnormal motility of the pharynx or the esophagus is found to play a significant role in the above cause. Patients with this syndrome are thought to be precancerous because squamous cell carcinomas of the hypopharynx, oral cavity, or esophagus take place in $10\%$ of those patients. However, for Plummer-Vinson syndrome to be combined with gastric cancer is most unusual. We report the case of a 43-year-old woman who was first found to have stomach cancer under a diagnosis of Plummer-Vinson syndrome and who recovered after surgery.

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