• Title/Summary/Keyword: iron-deficiency anemia

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Long-term Effect of Desferrioxamine to rHuEPO Resistant Anemia in Hemodialysis Patients (혈액 투석 환자에서 나타나는 rHuEPO 저항성 빈혈에 대한 Desferrioxamine의 장기 효과)

  • Lim, Sang-Woo;Jung, Hang-Jae;Bae, Sung-Wha;Do, Jun-Young;Yoon, Kyung-Woo
    • 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.

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Impact of Feeding Multiple Probiotics on Performance and Intestinal Microflora in Broiler Chicks (혼합 미생물제의 수준별 급여가 육계의 생산성 및 장내 미생물에 미치는 영향)

  • 류경선;신원집;박재홍;류명선;김종설;김상호;리홍룡
    • Korean Journal of Poultry Science
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    • v.30 no.3
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    • pp.197-202
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    • 2003
  • Feeding probiotics in broiler chicks still critical in several aspects. Thus, this study was conducted to investigate the impact of feeding multiple probiotics on performance, intestinal microflora, blood cholesterol and ND antibody vaccine titer in broiler chicks. Three hundred twenty one day old male broiler chicks(cobb ${\times}$ cobb) were divided into four levels of multiple probiotics(0, 0.1, 0.2, 0.3%) with five replicates for 35 days. Basal diets contained 21.5, 19.0% CP and 3,100 kcal/kg ME for starting and finishing period, respectively. Weight gain, feed intake and feed conversion were measured weekly. The number of Salmonella, E. coli, Lactobacillus, and yeast were examined from ileum and cecum at the end of experiment. ND vaccine titer, cholesterol were detected from sera. Weight gain of birds fed probiotics were 669.33, 679.75 at the level of 0.1 and 0.2% supplemental groups for starting period. It was also improved in those treatments for finishing period and higher than control for total period. Feed conversion tended to be improved compared to that of control by the supplementation of probiotics for the first three weeks and seemed to show the similar tendency for the rest of two weeks. It was 1.611, 1.621 for the entire feeding period and improved compared with control. Total salmonella, was not decreased in ileal digesta of birds fed the probiotics compared with control, whereas the number of yeast increased in 0.1% treatment. However, the number of Lactobacillus and yeast in cecum was higher than control. Even though the blood cholesterol seem to high in 0.1% probiotics treatment, the ratio of HDL to total cholesterol showed higher than control. ND vaccine titer of birds fed probiotics were significantly higher than control (P<0.05). These results 0.1% multiple probiotics would be possible to improve the performance of broiler chicks and ND vaccine titer.

A Literature Review of Application of Sifeng Point (EX-UE 10) in Children (소아에서 사봉혈(四縫穴) 활용에 대한 문헌 조사)

  • Lee, Boram;Shin, Hye Jin;Lee, Jihong;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.32 no.3
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    • pp.72-89
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    • 2018
  • Objectives The objective of this study is to investigate the application of Sifeng point (EX-UE 10) in children and to make suggestions for domestic research and clinical application by reviewing relevant randomized controlled trials. Methods Eight electronic databases including English, Chinese, Korean databases were comprehensively searched for randomized controlled trials evaluating the effects of Sifeng point in children up to May 2, 2018. We extracted the year of publication, country, target diseases or symptoms, location of Sifeng, acupuncture method; such as acupuncture tool and depth of insertion, and frequency, number, and duration of the treatment. Results Fifty studies were included for analysis. All the included studies were conducted in China, and studies were published from 1962 to 2017. The most frequent target symptom was anorexia (46%). In addition, Sifeng point was used for digestive diseases or symptoms such as diarrhea, constipation, and mesenteric lymphadenitis, as well as respiratory diseases or symptoms such as cough, cold, acute bronchiolitis, recurrent respiratory tract infections, bronchopneumonia, and asthmatic bronchitis. Also, allergic diseases such as chronic urticaria, and other variety of symptoms such as malnutrition, fever, and iron-deficiency anemia were treated with the Sifeng point. The location of Sifeng points was inconsistent, and the most common location of the Sifeng point was the midpoint of transverse creases of the proximal interphalangeal joints of the index, middle, ring and little fingers (84.2%). The most commonly used acupuncture tool was three-edged needle (40.9%). All included studies have the method of squeezing out blood or mucus from the Sifeng points. The treatment was mostly conducted once per week (35.4%), mostly repeated for 4 times (32.6%). The most common treatment duration was 4 weeks (18.6%). Conclusions We could identify acupuncture method and various indications for the Sifeng points treatment. Based on this study, there is a need for the clinical application and related researches on the Sifeng points in children in Korea. In addition, the treatment location of Sifeng point should be standardized.

A case of idiopathic pulmonary hemosiderosis with seasonal recurrence (계절성으로 재발한 특발성 폐 혈철 침착증 1예)

  • Kwak, Ga Young;Lee, Na Young;Lee, Moon Hee;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.256-260
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    • 2009
  • Idiopathic pulmonary hemosiderosis (IPH) is a rare disease affecting mostly children. This disorder is characterized by recurrent episodes of hemoptysis, bilateral diffuse pulmonary infiltrates, and iron-deficiency anemia. An acute fulminant alveolar hemorrhage can be fatal due to respiratory failure, while chronic hemorrhage leads to hemosiderin-laden macrophages and pulmonary fibrosis. Genetic, autoimmune, allergic, environmental, and metabolic mechanisms of pathogenesis have been suggested, but the etiology of IPH remains unknown. We report on a 9-year-old girl with idiopathic pulmonary hemosiderosis who showed seasonal recurrences without cause.

High Prevalence of Helicobacter pylori Resistance to Clarithromycin: a Hospital-Based Cross-Sectional Study in Nakhon Ratchasima Province, Northeast of Thailand

  • Tongtawee, Taweesak;Dechsukhum, Chavaboon;Matrakool, Likit;Panpimanmas, Sukij;Loyd, Ryan A;Kaewpitoon, Soraya J;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8281-8285
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    • 2016
  • Background: Helicobacter pylori is a cause of chronic gastritis, peptic ulcer disease, and gastric malignancy, infection being a serious health problem in Thailand. Recently, clarithromycin resistant H. pylori strains represent the main cause of treatment failure. Therefore this study aimed to determine the prevalence and pattern of H. pylori resistance to clarithromycin in Suranaree University of Technology Hospital, Suranree University of Technology, Nakhon Ratchasima, Northeastern Thailand, Nakhon Ratchasima province, northeast of Thailand. Materials and Methods: This hospital-based cross-sectional study was carried out between June 2014 and February 2015 with 300 infected patients interviewed and from whom gastric mucosa specimens were collected and proven positive by histology. The gastric mucosa specimens were tested for H. pylori and clarithromycin resistance by 23S ribosomal RNA point mutations analysis using real-time polymerase chain reactions. Correlation of eradication rates with patterns of mutation were analyzed by chi-square test. Results: Of 300 infected patients, the majority were aged between 47-61 years (31.6%), female (52.3%), with monthly income between 10,000-15,000 Baht (57%), and had a history of alcohol drinking (59.3%). Patient symptoms were abdominal pain (48.6%), followed by iron deficiency anemia (35.3%). Papaya salad consumption (40.3%) was a possible risk factor for H. pylori infection. The prevalence of H. pylori strains resistant to clarithromycin was 76.2%. Among clarithromycin-resistant strains tested, all were due to the A2144G point mutation in the 23S rRNA gene. Among mutations group, wild type genotype, mutant strain mixed wild type and mutant genotype were 23.8%, 35.7% and 40.5% respectively. With the clarithromycin-based triple therapy regimen, the efficacy decreased by 70% for H. pylori eradication (P<0.01). Conclusions: Recent results indicate a high rate of H. pylori resistance to clarithromycin. Mixed of wild type and mutant genotype is the most common mutant genotype in Nakhon Ratchasima province, therefore the use of clarithromycin-based triple therapy an not advisable as an empiric first-line regimen for H. pylori eradication in northeast region of Thailand.

Nutrition Survey of Children of a Day Care Center in the Low Income Area of Pusan I. A Study on Nutrient Intake and Nutritional Status (부산 시내 일부 저소득층 유아원 원아의 영양실태에 관한 연구 I. 영양섭취실태 및 건강실태 조사)

  • 이정숙
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.22 no.1
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    • pp.27-33
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    • 1993
  • A nutrition survey of 99 children, 3 to 6 years old, in the day care center, situated in Kamman-dong of Pusan, as the location of one of the socioeconomically vulnerable groups, was undertaken between July 1 and 14, 1992, to investigate dietary intake and nutritional status. The results are summarized as follows. Hematocrit value was 38.9%. Mean content of serum iron was 53.5$\mu\textrm{g}$/100$m\ell$ and 17.2% of the subjects were below the borderline of anemia. Mean contents of serum total protein, serum albumin and serum complement $C_3$were at an acceptable level, But, 27% of the subjects were below the borderline of protein deficiency, Energy intake of the children was 68.6~87.5% of the RDAs and mean protein intake was 94.1~114.1% of the recommendation. Low intake of Ca, Fe, vitamin A, B$_1$, B$_2$, C, niarin were also found. The survey found 10% of the subjects skipped a meal once a day, The children intake 3.3~5.5 kinds of the food every meal. The following percentages of the children intake below 75% of the RDAs ; 68% of the children for Fe, 60.2% for vitamin C, 58.3% for niacin, 58.2% for Ca, 46.6% for energy, 37.9% of vitamin B$_2$, 37.8% of vitamin B$_1$.

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Survey on Health-related Factors, Nutrition Knowledge and Food Habits of College Students in Wonju Area (원주지역 대학생의 건강관련요인, 영양지식 및 식습관 조사)

  • Lee, Seung Lim;Lee, Sun Hee
    • Korean Journal of Community Nutrition
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    • v.20 no.2
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    • pp.96-108
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    • 2015
  • Objectives: This study was performed to investigate health-related factors, nutrition knowledge and food habits of college students in Wonju. Methods: A total of 442 (male: 221, female: 221) college students were recruited and a questionnaire-based survey was conducted. The general characteristics, health-related factors, nutrition knowledge, and food habits were investigated and data were analyzed using SPSS WIN (ver 21.0). Results: The body mass index ($22.9kg/m^2$ vs $20.9kg/m^2$, p < 0.001) was significantly higher in the males. The ratio of weight (p < 0.001) was significantly different between males and females. Health-related factor scores 'Exercise (p < 0.001)', 'Number of exercise (p < 0.001)', 'Times of exercise (p < 0.01)', 'Concerns about health (p < 0.05)', 'Health condition (p < 0.001)' were significantly higher in the males. 'Type of exercise (p < 0.001)' was significantly different between males and females. Score on 'Watching TV & computer games (p < 0.01)' was significantly higher in the females. Smoking (p < 0.001) was significantly higher in the males. Type of beverages consumed (p < 0.001) was significantly different between males and females. Nutrition knowledge score (11.8 vs 12.9, p < 0.05) was significantly higher in the females. Scores on 'Iron deficiency is leading to anemia (p < 0.01)' and 'carbonated beverages, such as coke, have no calorie (p< 0.05)' were significantly higher in the females. Food habits score (56.4 vs 53.7, p < 0.01) was significantly higher in the males. Scores on 'I have three meals a day (p < 0.01)', 'I have breakfast regularly (p < 0.001)', 'I have meals on time (p < 0.001)', 'I do exercise every day (p < 0.001)', 'I don't eat junk food often (p < 0.05)', 'I don't eat sweet food often (p < 0.05)', and 'I don't eat out often (p < 0.05)' were significantly higher in the males. Conclusions: Nutritional education for college students is needed in order to improve their health and nutritional education program should be tailored to meet various needs of these students.

A Study on Nutrient Intake, Anthropometric Data and Serum Profiles among High School Students Residing in Seoul (서울 지역 고등학생의 영양소 섭취와 체위 및 혈액성상)

  • 이현숙;김보은;조미숙;김화영
    • Korean Journal of Community Nutrition
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    • v.9 no.5
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    • pp.589-596
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    • 2004
  • This study was performed to investigate the anthropometric data, serum profiles, and nutrient intakes of high school students who are living in Seoul. Anthropometric data showed that mean height and weight were 174.1 cm and 66.6 kg in 99 male and 161.4 cm and 54.0 kg in 116 female students. Mean BMl for male and female students were 21.9 and 22.3 kg/$m^2$, and subjects with BMI > 25 kg/$m^2$ were 14 and 7%, respectively. Total cholesterol, HDL- and LDL-cholesterol of subjects were 149.6$\pm 3.1,\; 46.4 \pm 1.3,\; 86.4 \pm 2.3$,/TEX> mg/dl for males and 169.2 $\pm 3.1,\;50.7 \pm 1.0,\; 100.9 \pm 2.7 mg/dl$ for females, respectively. Hemoglobin (Hb) and total iron binding capacity (TIBC) were 12.8 $\pm 0.1 g/dl, \;437.3 \pm 7.2\mug/dl\; in\; male\; and\; 11.9 \pm 0.1 g/dl,\; 439.4 \pm 5.7\mug/dl$ in female, respectively. Based on Hb classification, 45.6% of male and 45.0% of female students fell into anemic condition. Intakes of energy, Ca, Fe, Zn, riboflavin, and folate were below the Korean RDA. In particular Ca (male and female, respectively, 64.6 and 64.3% RDA) and Fe (male and female, respectively, 78.6 and 64.3% RDA) intakes were extremely low. Serum triglyceride was positively significantly correlated with weight (r =0.22), BMI (r =0.279), waist circumference (WC, r =0.235), triceps skin-fold thickness (TSF, r =0.197) and obesity index (OI, r =0.279). Hb concentration was positively correlated with height (r + 0.387), weight (r =0.349), BMI (r =0.191) and waistlhip ratio (WHR, r =0.380). As for the correlation between serum profiles and nutrient intakes, the Hb concentration was positively correlated with energy (r =0.163), protein (r =0.149), Na (r =0.153), vitamin A (r =0.165), thiamin (r =0.201) and niacin (r =0.192, p < 0.01). These result suggest that the prevalence of Ca and Fe deficiency of student is high and dietary guideline for prevent anemia in this age needs to contain the adequate intake of energy and its related vitamins.

THE TYPES AND CONTENTS OF SWEETENERS IN LIQUID ORAL MEDICINES (경구용 액체약에 함유된 감미제의 종류와 함량)

  • Hwang, Min-Sung;Kim, Jung-Wook;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.4
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    • pp.661-667
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    • 2001
  • Though a consensus seems to exist about the regulation of the use of sugar-containing food, however. an unrecognized and significant supply of cariogenic carbohydrate remains in the form of sugar-containing liquid oral medicine to prevent dental caries. children who are taking long-term sugar-containing liquid medicine have an increased risk of developing dental caries. The aim of this study is to get the information about the sugars in liquid medicines prescribed for the children. To get the information, the number and date of all prescriptions of liquid medicines for one month at pediatric hospital of Seoul National University Hospital were investigated. From that data, the most frequently used pediatric oral liquid medicine is presented. Then, for the information of the type and contents of sweeteners in that preferred medicines, the manufacturers of each medicines were asked for the data of sugar types and contents, and the informations about the medicine contents were collected via facsimile. The most frequently used pediatric oral liquid medicine were followed as expectorant, purge, antibiotic, drug for iron deficiency anemia, sedative, antihistamine, anticonvulsant, NSAIDs in order. The mean value of sweetener content in liquid medicines was $52.3{\pm}22.4g/100ml$ and most frequently used sweetener is sucrose.

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Association of Airflow Limitation and COPD Composite Index with Peripheral Oxygen Saturation in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환자에서 기류제한 및 COPD 복합지수와 말초산소포화도의 연관성)

  • Jong Seong Lee;Jae Hoon Shin;Jin Ee Baek;Hyerim Son;Byung-soon Choi
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.34 no.1
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    • pp.57-66
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    • 2024
  • Objective: Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction that is only partly reversible, inflammation in the airways, and systemic effects. This study aimed to investigate the association between low peripheral oxygen saturation levels (SpO2), and composite indices predicting death in male patients with (COPD). Method: A total of 140 participants with post-bronchodilator FEV1/FVC ratio less than 0.7 were included. Three composite indices (ADO, DOSE, BODEx) were calculated using six variables such as age (A), airflow obstruction (O), body mass index (B), dyspnea (D), exacerbation history (E or Ex), and smoking status (S). Severity of airflow limitation was classified according to Global Initiative for Obstructive Lung Disease (GOLD) guidelines. SpO2 was measured by pulse oximetry, and anemia and iron deficiency were assessed based on blood hemoglobin levels and serum markers such as ferritin, transferrin saturation, or soluble transferrin receptor. Results: Participants with low SpO2 (<95%) showed significantly lower levels of %FEV1 predicted (p=0.020) and %FEV1/FVC ratio (p=0.002) compared to those with normal SpO2 levels. The mMRC dyspnea scale (p<0.001) and GOLD grade (p=0.002) showed a significant increase in the low SpO2 group. Receiver Operating Characteristic analysis revealed higher area under the curve for %FEV1 (p=0.020), %FEV1/FVC(p=0.002), mMRC dyspnea scale (p=0.001), GOLD grade (p=0.010), ADO (p=0.004), DOSE (p=0.002), and BODEx (p=0.011) in the low SpO2 group. Conclusion: These results suggest that low SpO2 levels are related to increased airflow limitation and the composite indices of COPD.