• 제목, 요약, 키워드: hematologic parameters

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위암에서 수술 전 혈액학적 검사의 예후인자로서의 가치 (Prognostic Values of Preoperative Hematologic Parameters in Gastric Cancer)

  • 김형주;권성준
    • 대한위암학회지
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    • v.5 no.1
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    • pp.29-33
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    • 2005
  • 목적: 위암 환자에 있어 치료시작 전 환자의 전반적 상태를 평가하기 위해 시행하는 혈액학적 검사 소견이 예후를 예측하는데 유용한가를 알아보고자 한다. 대상 및 방법: 2000년 12월부터 2003년 12월까지의 기간 동안 위암으로 한양대학교병원 외과에서 위절제술을 받은 환자 중 수술 전 혈액학적 검사결과 및 생존여부를 확인할 수 있었던 357명의 환자를 대상으로 하였다. 침윤성 처치가 혈액학적 검사 결과에 미칠 수 있는 영향을 배제하기 위해 외래 및 입원직후 어떤 처치도 시행하기 전에 채취한 혈액만을 이용하였다. 대상환자들의 기록을 통해 혈청 알부민, 혈색소, 혈소판 수, 림프구 수, 병기, 술 후 생존여부 및 생존기간 등을 조사하였다. 혈청 알부민은 3.5 g/dl 이상, 혈색소는 12 g/dl 이상을 정상으로 정의하였고, 혈소판 증가증은 $400\times10^{3}{\mu}l$ 이상이라 정의하였다. 비정상적인 검사 결과가 한 가지라도 있는 경우(제1군), 세 검사 결과 모두 정상인 경우(제2군)등의 두 군으로 나누어 나이, 성별, 종양의 크기, 위치, 병기분포의 차이 및 생존율 차이의 통계적 유의성을 비교, 검토하였다. 결과: 각 군 간에 연령, 종양의 크기 등에서는 통계적으로 유의한 차이가 없었다. TNM 병기가 진행할수록 혈청 알부민과 혈색소가 감소하고 혈소판 수가 증가하였으며 이는 모두 통계적 유의성을 보였다(P=0.000). 병기 분포에 있어서 제 1군에서 제 3군에 비해 진행된 경우가 유의하게 많았다. 종양의 위벽 침윤도 및 림프절 전이에 있어서 제 1군과 제 2군 사이에 유의한 차이가 있었으나(P=0.001, P=0.000) 원격전이의 경우 각 군 사이에 통계적인 차이는 없었다(P=0.125). 3년 생존률에 있어서 제 1군과 제 2군 사이에는 통계적으로 유의한 차이를 보였다(P=0.0375). 다변량 생존분석결과, 혈액학적 검사는 독립적인 예후 관련인자는 아니었다. 결론: 위암 환자에 있어서 술 전 시행한 혈액학적 검사는 비교적 저렴하고 간편한 검사로 환자의 일반적인 상태를 반영하며, 특히 혈소판 증가증, 혈청 알부민 감소, 빈혈 등이 나타난 경우 병의 예후가 나쁠 것임을 예측하는데 유용한 것으로 판단된다.

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Hospitalization Risk According to Geriatric Assessment and Laboratory Parameters in Elderly Hematologic Cancer Patients

  • Silay, Kamile;Akinci, Sema;Silay, Yavuz Selim;Guney, Tekin;Ulas, Arife;Akinci, Muhammed Bulent;Ozturk, Esin;Canbaz, Merve;Yalcin, Bulent;Dilek, Imdat
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.783-786
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    • 2015
  • Background: Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. Materials and Methods: In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. Results: The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). Conclusions: In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.

Benefits of Thromboelastography and Thrombin Generation Assay for Bleeding Prediction in Patients With Thrombocytopenia or Hematologic Malignancies

  • Kim, Seon Young;Gu, Ja Yoon;Yoo, Hyun Ju;Kim, Ji-Eun;Jang, Seonpyo;Choe, Sooyeon;Koh, Youngil;Kim, Inho;Kim, Hyun Kyung
    • Annals of Laboratory Medicine
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    • v.37 no.6
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    • pp.484-493
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    • 2017
  • Background: Thromboelastography (TEG) provides comprehensive information on the whole blood clot formation phases, whereas thrombin generation assay (TGA) reveals the endogenous thrombin levels in plasma. We investigated the potential significance of TEG and TGA parameters for prediction of clinical bleeding in hematologic patients on the basis of the patient's platelet levels. Methods: TEG and TGA were performed in 126 patients with thrombocytopenia or hematologic malignancies. The bleeding tendencies were stratified on the basis of the World Health Organization bleeding grade. Results: Maximum amplitude (MA) and clot formation in TEG and endogenous thrombin potential (ETP) in TGA showed significant associations with high bleeding grades (P =0.001 and P =0.011, respectively). In patients with platelet counts ${\leq}10{\times}10^9/L$, low MA values were strongly associated with a high bleeding risk. For bleeding prediction, the area under the curve (AUC) of MA (0.857) and ETP (0.809) in patients with severe thrombocytopenia tended to be higher than that of platelets (0.740) in all patients. Patients with platelet counts ${\leq}10{\times}10^9/L$ displayed the highest AUC of the combined MA and ETP (0.929). Conclusions: Both TEG and TGA were considered to be good predictors of clinical bleeding in patients with severe thrombocytopenia. Combination of the ETP and MA values resulted in a more sensitive bleeding risk prediction in those with severe thrombocytopenia.

May the Platelet to Lymphocyte Ratio be a Prognostic Factor for Epithelial Ovarian Cancer?

  • Kokcu, Arif;Kurtoglu, Emel;Celik, Handan;Tosun, Migraci;Malatyalıoglu, Erdal;Ozdemir, Ayse Zehra
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9781-9784
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    • 2014
  • Background: The study aimed to evaluate changes in hematologic parameters, including white blood cell, platelet count, platelet indices, the platelet to lymphocyte and neutrophil to lymphocyte ratios in patients with early and advanced stages of epithelial ovarian cancers. Materials and Methods: The study included 100 patients with epithelial ovarian cancer who underwent primary staging exploratory laparotomy. Preoperative hematologic parameters, tumor histopathologic type, grade, stage and serum CA-125 levels were retrospectively analyzed. These parameters were compared between the patients with early (stage I-II) and advanced (stage III-IV) ovarian cancer. Results: White blood cell count and platelet indices, including mean platelet volume, platelet distribution width and platelet crit did not show a statistically significant difference between groups with early and advanced ovarian cancer. However, the neutrophil to lymphocyte ratio, platelet count, the platelet to lymphocyte ratio and CA-125 level showed a statistically significant difference between the two groups (p<0.05, p<0.01, p<0.001, p<0.01 respectively). Conclusions: It was found that the neutrophil to lymphocyte ratio, platelet count and the platelet to lymphocyte ratio increased with the increasing stage of ovarian cancer. Furthermore, it was seen that the platelet to lymphocyte ratio is an independent prognostic factor related to the stage of epithelial ovarian cancer.

체외순환시 산화기 충전액에 첨가된 알부민의 임상적 효과 (Clinical Effect of Albumin Addition to the Prime solution in Cardiopulmonary Bypass)

  • 이형교;유세영
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.23 no.6
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    • pp.1152-1157
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    • 1990
  • Colloid solution is commonly used to increase the oncotic pressures of priming solutions used in the cardiopulmonary bypass circuit. To study the effectiveness of this practice, we retrospectively evaluated 24 patients undergoing cardiac operations to receive isoelectric solution plus 50 gm of albumin[group A], isoelectric solution plus 25 gm of albumin[group B] and isoelectric solution without albumin[group C] as the prime solution for the bypass circuit. Various clinical parameters related to the perioperative fluid balance, cardiopulmonary function, and renal function were studied. There were no differences between the three groups with regard to postoperative clinical parameter of cardiopulmonary, liver function and renal function. But at the previous report by Cho et al. [38], there was a significant difference between groups with regard to hematologic property, especially in crenated red blood cells. These hematologic events did not affect the clinical outcome but thorough evaluations are needed in order to prove the clinical effect of crenated red blood cell. We conclude that there is no clinically detectable advantage for the routinely supplementing of albumin to the priming solution of bypass circuit in cardiac operations. Whether this practice can be of value in selected cases needs to be further studied.

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Comparison of Two Apheresis Systems of COBE and Optia for Autologous Peripheral Blood Stem Cell Collection

  • Lee, Se-Na;Sohn, Ji Yeon;Kong, Jung Hee;Eom, Hyeon Seok;Lee, Hyewon;Kong, Sun-Young
    • Annals of Laboratory Medicine
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    • v.37 no.4
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    • pp.327-330
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    • 2017
  • Peripheral blood stem cell (PBSC) transplantation following myeloablative therapy is a mainstay of treatment for various types of malignancies. This study aimed to evaluate the differences between the Optia MNC and COBE Spectra MNC systems (Terumo BCT, Japan) according to apheresis procedures and the parameters of apheresis, products, and collection. The clinical data of 74 patients who underwent autologous PBSC collection from July 2012 to July 2015 were reviewed retrospectively. The patients comprised 48 (65%) men and 26 (35%) women with a median age of 56 yr (range, 23-66 yr). Of 216 procedures, 111 (51%) and 105 (49%) were processed by using COBE and Optia MNC, respectively. PBSC collection rates, throughput, numbers of stem cells retrieved, collection efficacy, and platelet loss were compared. There were no significant differences in the median CD34+ cell counts of collected products ($0.61{\times}10^8$ vs $0.94{\times}10^8$), CD34 collection efficiency (43.5% vs 42.1%), and loss of platelets (40.1% vs 44.7%). The Spectra Optia MNC apheresis system was comparable to the COBE Spectra system in collecting autologous CD34+ hematopoietic stem cells and retention of platelets.

병원자료에 근거한 혈액 및 혈액화학 검사항목의 참고구간 설정 (Reference Intervals from Hospital-Based Data for Hematologic and Serum Chemistry Values in Dogs)

  • 권영욱;박선일
    • 한국임상수의학회지
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    • v.27 no.1
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    • pp.66-70
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    • 2010
  • Reference interval is critical for interpreting laboratory results, monitoring response to therapy and predicting the prognosis of the patients in clinical settings. The aim of the present study was to update established reference intervals for routine hematologic and serum chemistry values for a population of clinically healthy dogs (range, 1-8 years) seen in an animal hospital. Blood was obtained by venipuncture while animals were physically restrained, and samples were analyzed for 9 chemistries on MS9-5H (Melot Schloesing Lab, France) and 6 hematology on Vet Test 8008 (IDEXX, USA). Data from 105 dogs (52 males and 53 females) for hematology and 113 dogs (37 males and 76 females) for chemistry were used to determine reference intervals using the parametric, nonparametric and bootstrap methods. Prior to analysis, all parameters were tested for normal distribution using Anderson-Darling criterion. Of the 9 biochemical analytes, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, creatinine, total protein, and glucose concentrations did not fit normal distribution for both original and transformed data. All but eosinophil count satisfied normal distribution for either original or transformed data. Parametric method can be used for original cholesterol concentrations, RBC, WBC, and neutrophil counts. This technique can also be used for power-transformed values of blood urea nitrogen concentrations and for logarithm of lymphocyte and monocyte counts. Non-parametric or bootstrap method was the preferred choice for the remaining 7 biochemical parameters and eosinophil count as they did not follow normal distributions. All three statistical techniques performed in similar reference intervals. When establishing reference intervals for clinical laboratory data, it is essential to assess the distribution of the original data to increase the accuracy of the interval, and non-parametric or bootstrap methods are of alternative for the data that do not fit normal distribution.

한국인의 고지혈증에 관한 연구 -고콜레스테롤혈증 소견자의 혈액학적 특성과 위험인자를 중심으로- (A Study on Hyperlipidemia in Koran -Specially Related to Hematological Characteristics and Risk Factors of Hypercholesterolemia-)

  • 황금희;노영희;허영란
    • 한국식품영양과학회지
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    • v.28 no.3
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    • pp.710-721
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    • 1999
  • This study was conducted to investigate the hematological characteristics and risk factors of hypercholesterolemia(HC) in Korean. 344 adult men who took the annual health check ups at D or J hospitals were participated in this cross sectional study. The subjects were grouped by plasma total cholesterol level into three groups: normal cholesterolemic(n=139), borderline hypercholesterolemic (n=93) and hypercholesterolemic(n=112) groups. The data of systolic and diastolic blood pressure (SBP/DBP), hemoglobin, plasma glucose, albumin and cholesterol levels were collected from medical records. The levels of plasma triglyceride(TG), HDL C, phospholipid, insulin, apo A and apo B were measured. The levels of plasma LDL C, VLDL C and atherogenic index(AI) were calculated. The subjects with HC had significantly higher SBP and DBP, albumin, TG, phospholipid, HDL C, LDL C, VLDL C and apo B level than those of the normal subjects. The relative and attributable risks on HC were 1.59 and 0.18 for hypertension(SBP/DBP$\geq$160/95), 2.08 and 0.35 for hypertriglyceridemia (TG $\geq$400mg/dl). Plasma total cholesterol level was positively correlated with several hematologic parameters: age(r=0.1242, p<0.05), DBP(r=0.1194, p<0.05), albumin(r=0.2029, p<0.001), plasma TG(r= 0.3829, p<0.001), phospholipid(r=0.6036, p<0.001), LDL C(r=0.8572, p<0.001), HDL C(r=0.2399, p< 0.001), AI(r=0.3116, p<0.001), apo B(r=0.2602, p<0.05) and Lp(a)(r=0.1372, p<0.05). However, plasma total cholesterol level was negatively correlated with the levels of Apo A1(r= 0.2922, p<0.001), and ABR(r= 0.3598, p<0.001).

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