• Title, Summary, Keyword: 호중구감소증

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Neutropenia & Nutritional status during Chemotherapeutic cycle in Acute Myeloid Leukemia (급성골수성백혈병환자의 항암화학요법 주기내의 호중구감소증과 영양상태)

  • Kim, Myung-Hee;Kang, In-Soon;Jo, Ho-Yoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.2
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    • pp.438-446
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    • 2009
  • This study aims to investigate chemotherapy-induced neutropenia, nutritional status and both relation of patients with acute myeloid leukemia during 1st consolidation chemotherapy and the therapy-related cytopenic phase in order to determine more effective nutritional support. We review medical records of total 54 cases received first consolidation chemotherapy on P hospital in Busan. The duration of neutropenia(Absolute Neutrophil Count<$1000/{\mu}{\ell}$) is mean 14.78 days, neutropenia occur on mean 10th(9.54) day of chemotherapy(D10). The nutritional parameters of total protein, body weight, BMI showed no significant interval change during chemotherapeutic cycle except albumin, cholesterol. The neutropenia wasn't dependent on general factor of gender, age, comorbidities, Body Surface Area(BSA). The correlation wasn't revealed between neutropenia and nutritional status. In conclusion, although nutritional status didn't affect neutropenia, this study provides detailed information on the neutropenic response of acute myeloid leukemia patients during induction chemotherapy.

A Case of Neutropenia Induced by Short-Term Treatment of Vancomycin (반코마이신 단기간 투여로 유발된 호중구감소증 증례보고)

  • Kim, Su Hyun;Bang, Joon Seok;Kim, Kwang Joon;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.1
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    • pp.77-80
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    • 2013
  • 메치실린 저항성 황색 포도상구균(MRSA)에 감염된 환자에게 단기간 연속적으로 반코마이신을 투여했을 때 비정상적으로 호중구의 수치가 감소한 약인성 부작용 사례를 보고하고자 한다. 해당 여성 환자는 61세로서 MRSA 감염증을 판정받고 반코마이신 투여와 더불어 점차 백혈구(WBC)와 절대호중구수치(ANC)가 감소하였고, 제10일째에 이르러 호중구 감소증이 발생하여 ANC가 최저 430 $cells/mm^3$까지 낮아졌으나, 반코마이신의 투여를 중단하자 곧 정상수준으로 회복되었다. 본 사례는 Naranjo Probability Scale과 Korean Algorithm Score(Ver. 2.0)로 각각 평가하였을 때 반코마이신의 투여와 호중구감소증의 발현 사이에 모두 '가능한(probable)' 정도의 인과관계를 가진 것으로 평가되었다. 이는 통상적으로 20일 이상 연속투여를 할 때 임상적으로 관측되던 반코마이신-유래 호중구감소증이 단지 10일 정도의 단기간 투여만으로도 발생할 수 있다는 임상적 약물부작용의 사례로서, 향후 MRSA환자에게 반코마이신을 선택할 때에는 이와 같은 부작용을 고려하여 환자의 WBC와 ANC를 면밀히 관찰하면서 투여할 필요성이 있음을 시사한다.

Incidence and Factors Influencing Neutropenia in Patients with Chemotherapy (항암화학요법을 받은 유방암환자의 호중구 감소증 발생실태와 영향요인)

  • Ju, Eunsil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.519-525
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    • 2018
  • The purpose of this study was to identify the incidence of neutropenia in patients with breast cancer who received chemotherapy and to identify the differences in incidence according to influential factors. We analyzed the medical records of 353 breast cancer patients who received chemotherapy at university hospital in Seoul, Korea from January 2010 to March 2016. The collected data were analyzed by descriptive statistics, $X^2-test$, and logistic regression analysis using SPSS 20.0. Among the 353 subjects, 33.1% had neutropenia, and the factors that showed significant difference according to neutropenia were exercise performance, RT status, and regimen. The results of this study suggest that it is important to predict the prevalence of neutropenia in breast cancer patients receiving chemotherapy and to provide appropriate education and nursing intervention.

Therapeutic Effect of Different Doses of Recombinant Human Granulocyte Colony-Stimulating Factor(rhG-CSF) on Neonatal Sepsis Complicated by Neutropenia (호중구 감소증이 합병된 신생아 패혈증에서 Recombinant Human Granulocyte Colony-Stimulating Factor(rhG-CSF)의 투여 용량에 따른 치료 효과)

  • Choi, Moon Young;Jung, Yeon Sook;Son, Dong Woo;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.439-448
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    • 2002
  • Purpose : The aim of this study is to determine and compare the effects of adjunctive therapy with different doses of recombinant human granulocyte-colony stimulating factor(rhG-CSF) on reversing sepsis-associated neonatal neutropenia, and their survival rate in a group I/II-type trial. Methods : RhG-CSF was injected subcutaneously to 10 septic-neutropenic neonates with doses of $10{\mu}g/kg$ from Oct. 1995 to Sep. 1996, and was administered to another 12 septic-neutropenic neonates with doses of $5{\mu}g/kg$ from Oct. 1996 to Sep. 1997. Neutrophilic responses and the outcomes of both groups were compared. Results : In the rhG-CSF $10{\mu}g/kg$ treated group and in the $5{\mu}g/kg$ treated group, the absolute neutrophil count(ANC) was $1,065{\pm}89$($mean{\pm}SEM$) and $1,053{\pm}131$, respectively. The only difference between the two groups was the peak ANC at 48 hours. Eight patients from the remaining nine of rhG-CSF $10{\mu}g/kg$ treated group(88.9%) and ten in $5{\mu}g/kg$ treated group(83.3%) survived the sepsis and were discharged without any problems. Conclusions : RhG-CSF can increase the neutrophil count in critically ill septic neutropenic neonats. The survival rate of both groups were up to 90%. This finding suggests that both doses of rhG-CSF may be effective in a therapeutically useful time frame to treat septic neonates with neonatal neutropenia attributable to bone marrow supression or neutrophil consumption.

ORAL FINDINGS AND TREATMENT OF A PATIENT WITH CYCLIC NEUTROPENIA (주기성 호중구 감소증 환자의 구강 내 소견과 치료에 대한 증례 보고)

  • Kang, Eun-Joo;Choi, Nam-Ki;Kim, Seon-Mi
    • JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.40 no.2
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    • pp.133-140
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    • 2013
  • Cyclic neutropenia is a hematologic disorder characterized by a marked decrease in the number of circulating neutrophils occurring at regular intervals and after this period, the level of neutrophils usually recovers to a normal range. The clinical symptoms of cyclic neutropenia include fever, malaise, headaches and oral findings associated with painful soft tissue ulceration where lips, tongue and gingiva are typically involved. A 4 year 1 month old boy was presented to the hospital. His chief complaint was mobility of his teeth and swollen gums. The patient had suffered from cyclic neutropenia. Clinical examination revealed evident decay on all primary teeth except for the mandibular anterior teeth and localized alveolar bone loss around mandibullar right and left first primary molars which have mobility was notable. The patient was diagnosed with multiple dental caries, gingivitis and localized periodontitis associated with cyclic neutropenia and treated based on it. The dental treatment, including regular tooth care and appropriate treatment of dental caries or gingivitis, is essential for patients suffering cyclic neutropenia. Especially, proper care at an early stage is needed for young patients to minimize the unwanted consequences for permanent teeth development.

Comparison of Perception of the Neutropenic Diet between Nurses and Patients (호중구감소증 환자의 식품별 섭취허용에 대한 간호사와 환자의 인식 비교)

  • Kim, Mi-Ae;Jeong, Ihn Sook
    • Asian Oncology Nursing
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    • v.12 no.4
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    • pp.331-338
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    • 2012
  • Purpose: This descriptive study aimed to compare the perception of the acceptable foods for the neutropenic diet between nurses and patients by food type. Methods: The participants were 225 nurses working at chemotherapy wards and 71 patients in chemotherapy treatment. Data were collected with a self-administered questionnaire from January 2 to February 24, 2012, and analyzed with SPSS 12.0 program using descriptive statistics and the ${\chi}^2$-test. Results: Eighty-eight point eight percent of nurses and 76.1% of cancer patients thought the patients needed the neutropenic diets. The most important decisional criteria to determine dietary restriction was neutrophil count for nurses and food type for patients. The two groups showed significantly different allowance to raw fruits and raw vegetables, sterilized canned juice, fried vegetables, yogurt, uncooked tofu, salted fish, cooked fish, cooked shellfish, uncooked grain powder, jellified food, home-made bread/cookies, nuts including peanuts, instant coffee or tea and tea brewed. In general, patients were more permissive about the neutropenic diet than nurses. Conclusion: It is recommended to consider patients' preference as well as nurses' professional knowledge and publish standardized clinical diet guidelines for neutropenic patients with collaboration between nurses and patient representatives.

Bloodstream Infections in Children with Cancer between 2005 and 2008 in a Single Center (2005-2008년 단일 기관의 소아 혈액 종양 환자에서의 균혈증 양상: 소아 혈액 종양 환자에서의 균혈증)

  • Kim, Ji Hye;Kim, Hyung Jin;Lim, Yeon Jung;Lee, Young Ho;Oh, Sung Hee
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.36-48
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    • 2010
  • Purpose : In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. Methods : All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. Results : Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P =0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P =0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P =0.001). Conclusion : The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.

Production of Soluble Recombinant Human Granulocyte Colony Stimulating Factor in E. coli by Control of Growth Rate. (대장균에서 증식속도 조절에 의한 수용성 재조합 인간 과립구 콜로니 촉진인자의 생산)

  • 박세철;고인영;강희일
    • Microbiology and Biotechnology Letters
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    • v.32 no.2
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    • pp.135-141
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    • 2004
  • Human granulocyte colony-stimulating factor (hG-CSF) is a hematopoiesis agent that principally affects the differentiation of neutrophils in the bone marrow. At present, recombinant hG-CSF is used successfully in the treatment of chemotheraphy-induced neutropenia and its indication has been expanded to bone marrow transplantation and aplastic anemia. In this study, we have constructed rhG-CSF secretion plasmid pYRC1 in which OmpA signal sequence/hG-CSF gene was expressed under the control of the T7 promoter. rhG-CSF produced in E. coli BL21 (pYRC1) grown at $37{\circ}C$ was found in aggregates. However, 15% of the periplasmic protein was soluble rhG-CSF when the E. coli BL21 (pYRC1) was cultured at $25^{\circ}C$ for 7 h in the modified MBL medium containing 10 g/$\ell$ glucose with 10 $\mu$M IPTG induction. The production of soluble rhG-CSF in E. coli BL21 (pYRC1) using fed batch culture was also studied. In the fed batch culture system, the final yield of rhG-CSF produced from E. coli BL21 (pYRC1) was increased from 4.4 mg/$\ell$to 24 mg/$\ell$by controlling the specific growth rate from $0.43 h^{-1}$ to $0.14 h^{-1}$, and optimizing the time of induction.

The Increase of Apoptotic Neutrophils and Phagocytic Macrophage by Germanium in Acute Lung Injury Induced by Lipopolysaccharide (LPS에 의한 급성 폐손상에서 게르마늄에 의한 호중구 세포사와 큰포식세포의 포식능 증가)

  • Lee, Yoon-Jeong;Cho, Hyun-Gug;Jeune, Kyung-Hee
    • Applied Microscopy
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    • v.38 no.4
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    • pp.293-306
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    • 2008
  • The essential factor of acute respiratory distress syndrome (ARDS), an acute lung injury accompanied commonly by sepsis syndrome is accumulation of neutrophils in lung tissue. The study attempted to confirm whether a lung injury would be decreased with the anti-inflammatory effect of germanium by the treated germanium prior to the development of ARDS and whether nitric oxide influence in suppressing a lung injury. Test groups were divided in the following structure for experiment; CON that has been administered with sodium chloride to airway, LPS administered with endotoxin for 5 hours in the same amount and 5 hours of endotoxin administered Ge+LPS following 1 hours of pre-treated germanium. The result of a test using experimental animals, infilteration of neutrophils (p<0.001) in bronchoalveolar lavage fluid (BALF) was significantly decreased, the structure of lung tissue was preserved relatively well, and much neutrophils with distinct positive were observed on tunel staining which showed increase of apoptotic neutrophils in the pre-treated germanium group compare to the endotoxin administrated group. In observation of ultrastructural changes of cell in BALF, phagocytic alveolar macrophage was increased in alveolar space, the nucleus of most engulfed neutrophils were condensed, and some apoptosis neutrophils appears to be DNA fragmentation and effacement of cellular organelles were found in intercellular matrix in the pre-treated germanium group. However, the nitric oxide showed increase in all the groups excluding CON, and the nitric oxide effect such as degranulation diminishing of mast cells and apoptosis increase of neutrophils in the pre-treated group only. The situation appears that there was change in internal environment of the experimental animal by the pre-treated germanium before the nitric oxide is produced and the anti-inflammatory effect activated the pre-processed germanium by nitric oxide which activated following the change. Therefore, the nitric oxide created from macrophage in accordance with the pre-treated germanium appears to influence in alleviating a lung injury. Accordingly, acute lung injury is alleviated by the anti-inflammatory effect of germanium such as inhibition of neutrophils migration, induction of neutrophil apoptosis and increase of phagocytic function of phagocyte, and the nitric oxide produced from activated macrophage by germanium would influence in suppressing a lung injury.

Germanium Increases Alveolar Macrophage Engulfment of Apoptotic Neutrophils in Acute Lung Injury Induced by Endotoxin (내독소로 유도된 급성 폐 손상에서 게르마늄의 투여로 인한 호중구 세포사의 증가)

  • Cho, Hyun-Gug
    • Applied Microscopy
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    • v.35 no.4
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    • pp.84-90
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    • 2005
  • Neutrophils that influx into the alveolar spaces from circulatory bloods play a important role in pathogenesis of acute lung injury. During the acute inflammatory phase, in order to investigate the acceleration of macrophage phagocytosis to the neutrophils is able to reduce the neutrophil-derived acute lung injury, endotoxemia was induced by insufflation of lipopolysaccharide intratracheally and organic germanium was injected intraperitoneally after endotoxin treatment. At 5 h after endotoxin treatment, lung weight and BAL protein concentration are significantly increased (p<0.001) compared to sham, and that was remarkedly decreased (p<0.001, p<0.01) by injection of germanium. In addition germanium treatment resulted to decreased the number of alveolar PMNs and to increase the percentage of engulfed neutrophils by alveolar macrophages. These observations indicate that organic germanium may have a role of reduction to neutrophil-derived acute lung injury in endotoxemia.