• Title/Summary/Keyword: 만성질환 빈혈

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Second allogeneic hematopoietic stem cell transplantation in children to overcome graft failure or relapse after initial transplant (조혈모세포이식 후 생착 실패나 재발한 소아환자에서 2차 이식의 의의)

  • Kim, Dong-Yeon;Kim, Do Kyun;Kim, Soo Young;Kim, Seok Joo;Han, Dong Gyun;Baek, Hee Jo;Kook, Hoon;Hwang, Tai-Ju
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1329-1339
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    • 2006
  • Purpose : Failure of hematopoietic stem cell transplantation(HSCT) may be encountered in practice because of either relapse of the malignancy or dysfunction of the graft. Second HSCT may be the only option for some patients whose initial HSCT failed. Methods : From May, 1991 to December, 2004, 115 HSCTs were performed at the Pediatric Blood & Marrow Transplantation Center, Chonnam National University. This study was a retrospective analysis of the medical records of 15 patients who received the second HSCT after initial graft. Results : Among eight patients with nonmalignant diseases, two patients underwent the second HSCT because of primary graft failure and five because of late graft rejection. The remaining Fanconi anemia patient was re-transplanted due to development of AML. Two patients died and one experienced primary graft failure, but is still alive. The Kaplan-Meier 5-year overall survival rate was 75 percent and the disease free survival rate was 62.5 percent in nonmalignant diseases. All malignant patients underwent second transplants because of relapses. Four died of relapse and one of treatment-related complications. The Kaplan-Meier 2-year overall and event free survival rate was 28.6 percent each in malignant diseases. Conclusion : Second HSCT for graft dysfunction of nonmalignant disease seems to be feasible and should be considered as a standard practice. The relapse of malignant diseases remains a big obstacle even after the second HSCT, although a small portion of patients might be salvaged. Further investigation of novel therapeutic strategies, as well an the understanding of the biology should be explored.

Factors associated with the bone mineral density in Korean adults: Data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES) V (우리나라 성인남녀의 골밀도 관련요인: 국민건강영양조사 제 5기 1, 2차 년도(2010년, 2011년))

  • Kim, Kyung Sook
    • Journal of agricultural medicine and community health
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    • v.39 no.4
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    • pp.240-255
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    • 2014
  • Objective: The purpose of this study was to identify the correlates of bone mineral density of Korean adults. Methods: This study was based on the data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES, 2010~2011) V. Among 8,473 subjects of the survey, who were adults 19 years old or over with bone mineral density data, the current study excluded those whose data include a missing study variable or the response of 'I don't know', and finally analyzed the data of 5,986 subjects (2,692 males and 3,294 females). This study employed the following statistical methods of analysis: t-test, analysis of variance (ANOVA), and hierarchical multivariate linear regression analysis. Results: In multivariate analysis, in the case of men, the significant associated factors in bone mineral density were age, education level, body mass index (BMI), waist circumference, total muscle mass, exercise, and weight control; in the case of women, the significant associated factors in bone mineral density were age, education level, economic activity, BMI, total muscle mass, exercise, weight control. fat intake, uptake female hormone, menopause, and age of menarche. Conclusion: For both sexes, the strongest modifiable factor in influencing bone mineral density was total muscle mass. Therefore, to prevent osteoporosis and promote health, active health education and interventions such as regular exercise for total muscle mass increase should be implemented from an early growth period.

Anthropometric Measurements and Biochemical Nutritional Status of the Older Residents (50 years and over) in Andong Area (2) (안동주변 농촌지역 50세 이상 주민의 신체계측치 및 생화학적 영양상태에 관한 연구 (2))

  • Lee, Hye-Sang;Kwun, In-Sook;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.12
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    • pp.1599-1608
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    • 2008
  • This study aimed to assess the health status based on the anthropometric and biochemical measurements of middle-aged and elderly people living in Andong area. The subjects were 1,384 people (532 males, 852 females) aged 50 years and over (average 62.7 years). The mean anthropometric values for males and females were heights of 163.7 and 151.5 cm; weights 63.6 and 57.3 kg; body mass index (BMI) 23.6 and $24.9kg/m^2$; body fat 21.8 and 31.8%, respectively. Height and weight were lower, however, waist circumference (in female) and BMI were higher than those of the 2001 National Health and Nutrition Survey (NHNS). Obesity incidences of male and female subjects were 28.7% and 47.3% by BMI; 25.8% and 50.8% by % body fat; and 15.6% and 80.9% by waist circumference, respectively. Also, abdominal adiposity was very severe in female subjects of 50s. The mean biochemical measurements of male and female were as follows: systolic and diastolic blood pressure 136.9, 83.8 mmHg and 133.6, 82.5 mmHg; hemoglobin (Hb) 14.3 and 13.0 g/dL; hematocrit (Ht) 44.7 and 39.8%; blood albumin 4.15 and 4.04 g/dL; total-cholesterol 170.0 and 183.1 mg/dL; HDL-cholesterol 43.6 and 42.7 mg/dL; fasting blood glucose 96.7 and 93.0 mg/dL, respectively. Also, the prevalence of biochemically abnormal subjects according to each cut-off point of biochemical measurements were analyzed. The results for male and female were; hypertension 58.0% and 47.2%; iron deficient anemia 19.3% and 20.6% by Hb, 7.2% and 11.9% by Ht; hypoalbuminemia 9.8% and 11.7%; diabetes 12.0% and 10.2%; hypercholesterolemia 19.5% and 30.5%, respectively. From those results we found that hypoalbuminemia, hypertension and hypercholesterolemia were prevalent, and obesity in females of 50s, iron-deficient anemia and diabetes in males of 70 years and over were significant health problems in this area. Therefore, it seems to be necessary to examine their health status periodically and provide the appropriate health and nutrition education program, which includes low sodium intake, balanced diet, exercise and weight control, to prevent the occurrence of chronic diseases.

The Purpose and background of this study (노인질환에 대한 한양방동시종합검진 결과에 대한 보고)

  • Gwon, Gyeong-Suk;Lee, Tae-Hwan;Song, Jeong-Mo;Kim, In-Seop;Yun, Ho-Yeong;Im, Jun-Gyu
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.9-27
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    • 1994
  • This study is to analyze of senile disease status and the social problem according to increased old ages, and then to find distributions of old man's diseases and health status efficiency of oriental-occidental contemporary health examination. And it is the first oriental-occidental contemporary health examination of old man performed by JeonJu Woosuk University Oriental Medicine Hospital and Woosuk-Clinic in nation. Methods The objects in this research are 641's old man of KimJe Gun's over 60's years performed medical examination at JeonJu Woosuk University Oriental- Mmedicine-Hospital and Woosuk-Clinic by oriental-occidental medical contemporary exam., from 1994, 24th June till 1994. 13th July. The 1st occident medical examination methods were consisted of chest x-ray check. blood and urine exam., measurement of blood pressure, visual power and audiometry. The Oriental medical examination methods were consisted of four diagnostics (望,聞,問,切), present illness. chief complaint, past history, families history, social history by question and SA Sang constitution test index. The results and conclusions The results and conclusions are the next: 1. In order of distribution. the athletic disease (75.8%),the digestive disease(43.4%), the circulatory disease(41.5%), the respiratory disease(22.3%), EENT disease(8.1%), the endocrinopathy(5.6%), and the genito-urinary disease(5.3%) are the results of the object about 641's old man, by the oriental-occidental medicine's contemporay exam. 2. Distribution of disease distiction are lumbago. gastritis and peptic ulcer. knee joint pain. heart disease. hypertension. chronic bronchitis. asthma. anemia. DM. Tbc. visual disturbance. CVA. etc in order. 3. Disease distribution according to age is almost high incident in 60-75years. Disease incidence is decreased except E.E.N.T disease in over 76years. 4. The relationships of disease and family history are: the 25.0% of CVA pts. has family history and the 11.6% of hypertension pts has family history. so they showed high relative family history. In addition the 5.6% of TBC pts. and the 2.6% of DM pts. have family history. 5. The relationships of disease and drinking are: Drinking proportion is the 36.4% in respiratory disease pts. the 34.7% in hypertension pts. the 33.3% in heart disease pts.. the 28.4% in digestive disease pts.. but because of no surveying drinking amount we can't know the absolut relationships of disease and drinking. 6. The relationships of Disease and smoking are: Smoking proportion is the 44.1% in respiratory disease pts.. the 38.0% in Heart disease pts.. the 29.8% in Hypertension pts.. but because of no surveying of smoking amount. we can't know the absolut relationships of disease and smoking. 7. Distribution of Sasang constitution is : Tae-eum-in 44.8%. So-yang-in 30.7%. So-eum-in 24.6%. Tae-yang-in 0.0%. And disease distribution of Sasang constitution distinction is ; Tae-eum-in has high incidence of circulation disease(50.0%) and respiratory disease(23.1%).So-yang-in has high incidence of athletics disease(77.7%) and EENT disease(12.2%), So-eum-in has high incidence of digestive disease(65.8%). 8. Distribution of abnormal result in occidental medical examination and oriental-occidental contemporal exam result is considerably different. This is the reason of needing oriental medicine exam, for characteristics of Senile. I think that the oriental-occidental contemporary examination in old man is much more effecient than only occident medical examination. This oriental-occidental contemporary examination has many defects because it is the first practice. To participate in the public health program efficiently. I think that we must improve lots of problems and present the model of the oriental-occidental contemporary examination and the project of oriental medicine's for public health.

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Clinical findings of Glycogen Disease Type Ia Patients in Korea (당원병 제 Ia형 환아들의 임상적 고찰)

  • Park, Minju;Ahn, Hee Jae;Le, Jeongho;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.2
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    • pp.142-149
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    • 2014
  • Purpose: There are 15 types of Glycogen storage disease (GSD) that have been identified, and GSD type Ia is the most common type. There are several studies of Korean GSD type Ia patients' long-term complications. The aim of this study to find out clinical symptoms and prognosis of GSD type Ia patients. Methods: We performed clinical, biochemical and genetic analysis retrospectively on five patients diagnosed with GSD type Ia in a Soonchunhyang University Hospital from July 2002 to July 2014. Results: All patients had hepatomegaly at diagnosis, and they were all confirmed to have fatty liver at abdomen USG. They had no developmental delay, but two of them had growth retardation. Elevated blood lactate, triglyceride, and uric acid levels can find out all patients, but only one patient had hypoglycemia. They are diagnosed with GSD through gene analysis, and by gene analysis, they have c.648G>T (homozygote, splicing mutation), c.122G>A/c.648G>T, c.248G>A/c.648G>T mutations. Treatment with three times meals, three times snacks and four to six times use of uncooked constarch for all patients. Following the progress, one of them resulted in hypothyroidism, other one had renal stones. A patient diagnosed at 16 years old had liver cirrhosis and started having hemodialysis for ESRD. Conclusion: GSD type Ia patients had hepatomegaly, hyperlipidemia, hyperuricemia, and lactacidemia. Therefore patients who have such these symptoms are recommended gene analysis. A patient diagnosed at 16-years-old had liver cirrhosis and ESRD in progress, early diagnosis and treatment are important for GSD type Ia patients.

Study on Renal Anemia - A Double Tracer Study on Iron Metabolism and Red Cell Life Span in Chronic Renal Diseases using Radioactive Iron ($^{59}Fe$) and Chromium($^{51}Cr$) - (신성빈혈(腎性貧血)에 관(關)한 연구(硏究) - 만성신질환(慢性腎疾患)의 철대사(鐵代謝) 및 적혈구수명(赤血球壽命)에 관(關)하여 -)

  • Jung, Kyung-Tae;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.2 no.1
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    • pp.27-41
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    • 1968
  • The ferrokinetics and red cell life spans of the patients with chronic glomerulonephritis were investigated by the double tracing method using radioactive iron ($^{59}Fe$) and chromium ($^{51}Cr$). According to the serum NPN levels, the patients were subdivided into 3 groups: Group 1. 6 patients, had the levels below 40 mg/dl Group 2. 6 patients, had the levels between 41 mg/dl to 80 mg/dl Group 3. 10 patients, had the levels above 80 mg/dl The results were as follows: 1) Red blood cell-, hematocrit- and hemoglobin values were moderately reduced in patients with normal serum NPN levels, while markedly reduced in patients with elevated serum NPN levels. 2) The plasma volume was increased, while the red cell volume was decreased in patients with elevated serum NPN levels, hence, total blood volume was unchanged. 3) The serum iron level was slightly reduced h patients of groups 1 and 2, while was within the normal ranges in patients of group 3. 4) i) In patients with normal serum NPN levels, the plasma iron disappearance rate, red cell iron utilization rate, red cell iron turnover rate, daily red cell iron renewal rate, circulating red cell iron and red cell iron concentration were within the normal ranges, while the plasma iron turnover rate was slightly reduced. ii) In patients with elevated serum NPN levels, the plasma iron disappearance rate was delayed, while the plasma iron turnover rate was within the normal ranges. The red cell iron utilization rate, red cell iron turnover rate and circulating red cell iron were decreased and the period in which the red cell iron utilization rate reachd its peak was delayed in Group 3 patients. The daily red cell iron renewal rate and the red cell iron concentration were unchanged. iii) The mean red cell life span was within the normal ranges in patients with normal serum NPN levels, while was shortened in patients with elevated serum NPN levels.

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Two Cases of Transfusion Related Acute Lung Injury (수혈로 유발된 급성 폐 손상 2예)

  • Lee, Kyoung Ju;Kim, Hye Ok;Kim, Jung Ha;Ha, Eun Sil;Jung, Jin Yong;Lee, Seung Hyeun;Kim, Se Joong;Ju, Moon Kyung;Lee, Eun Joo;Kang, Eun Hae;Jung, Ki Hwan;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.473-478
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    • 2006
  • Transfusion related acute lung injury (TRALI) is a serious, potentially life-threatening complication of transfusion therapy that is sometimes under diagnosed and under reported. Patients with TRALI present with dyspnea/respiratory distress and fever. The symptoms, signs and chest radiological findings in TRALI are similar to transfusion associated circulatory overload, which makes it is difficult to distinguish it from circulatory overload. Although the mortality rate in cases of TRALI is relatively low, TRALI is the third most common cause of fatal transfusion reactions next to ABO blood type incompatibility and hepatitis. Mild-to-moderate cases of TRALI may be misdiagnosed as volume overload. Recently, we encountered two cases where the patients suffered from dyspnea and fever after a transfusion. and review of the relevant literature.

The current child and adolescent health screening system: an assessment and proposal for an early and periodic check-up program (현행 영유아 및 소아청소년 건강검진제도의 평가 및 대안)

  • Eun, Baik-Lin;Moon, Jin Soo;Eun, So-Hee;Lee, Hea Kyoung;Shin, Son Moon;Seong, In Kyung;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.300-306
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    • 2010
  • Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors—or example, good mental health, balanced nutrition, and more exercise.

Dietary behaviors of female marriage immigrants residing in Gwangju, Korea (광주지역에 거주하는 결혼이주 여성의 식생활 조사)

  • Yang, Eun Ju
    • Journal of Nutrition and Health
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    • v.49 no.3
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    • pp.179-188
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    • 2016
  • Purpose: This cross-sectional study aimed to document the dietary behaviors, dietary changes, and health status of female marriage immigrants residing in Gwangju, Korea. Methods: The survey included 92 female immigrants attending Korean language class at a multi-cultural family support center. General characteristics, health status, anthropometric data, dietary behaviors, and dietary changes were collected. Results: Mean age of subjects was 31.3 years, and home countries of subjects were Vietnam (50.0%), China (26.0%), Philippines (12.0%), and others (12.0%). Frequently reported chronic diseases were digestive diseases (13.2%), anemia (12.1%), and neuropsychiatry disorder (8.9%). Seventeen percent of the subjects was obese ($BMI{\geq}25kg/m^2$). Dietary score by Mini Dietary Assessment was 3.45 out of 5 points. Dietary scores for dairy foods, meat/fish/egg/bean intake, meal regularity, and food variety were low, and those for fried foods and high fat meat intake were also low. Thirty-three percent of subjects answered that they have changed their diet and increased their consumption of fruits and vegetables after immigration. Length of residence in Korea was positively associated with BMI and waist circumference. Length of residence tends to be positively associated with dietary changes and obesity as well as inversely associated with disease prevalence. Conclusion: The study shows that length of residence is inversely related to disease prevalence. However, this association is thought to be due to the relatively short period of residence in Korea and thus the transitional phase to adapting to dietary practices. As the length of residence increases, disease patterns related to obesity are subject to change. Healthy dietary behaviors and adaptation to dietary practices in Korea in female marriage immigrants will not only benefit individuals but also their families and social structure. Therefore, varied, long-term, and target-specific studies on female marriage immigrants are highly needed.