• Clinical and Experimental Pediatrics
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• v.59 no.7
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• pp.298-302
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• 2016

Purpose: Recent reports showed that plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) could be a useful biomarker of intravenous immunoglobulin (IVIG) unresponsiveness and coronary artery lesion (CAL) development in Kawasaki disease (KD). The levels of these peptides are critically influenced by age; hence, the normal range and upper limits for infants and children are different. We performed an age-adjusted analysis of plasma NT-proBNP level to validate its clinical use in the diagnosis of KD. Methods: The data of 131 patients with KD were retrospectively analyzed. The patients were divided into 2 groups-group I (high NT-proBNP group) and group II (normal NT-proBNP group)-comprising patients with NT-proBNP concentrations higher and lower than the 95th percentile of the reference value, respectively. We compared the laboratory data, responsiveness to IVIG, and the risk of CAL in both groups. Results: Group I showed significantly higher white blood cell count, absolute neutrophil count, C-reactive protein level, aspartate aminotransferase level, and troponin-I level than group II (P<0.05). The risk of CAL was also significantly higher in group I (odds ratio, 5.78; P=0.012). IVIG unresponsiveness in group I was three times that in group II (odds ratio, 3.35; P= 0.005). Conclusion: Age-adjusted analysis of plasma NT-proBNP level could be helpful in predicting IVIG unresponsiveness and risk of CAL development in patients with KD.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.2037-2041
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• 2015

Background: Relationships between poor prognosis of ovarian malignancies and changes in complete blood count parameters have been proposed previously. In this work, we aimed to evaluate clinicopathologic features in adolescents with adnexal masses and sought to establish any predictive value of the platelet to lymphocyte ratio (PLR) in diagnosis. Materials and Methods: This retrospective study was conducted on 196 adolescent females with adnexal masses. Three groups were constituted with respect to clinical or histopathology results: group 1, non-neoplastic patients (n:65); group 2, neoplastic patients (n:68); and group 3 expectantly managed patients (n:63). The main parameters recorded from the hospital database and patient files were age, body mass index (BMI), chief symptoms, diameter of the mass (DOM), tumor marker levels, complete blood count values including absolute neutrophil, lymphocyte, and platelet counts, mean platelet volume, platelet distribution width, and platecrit, surgical features, and postoperative histopathology results. Results: The expectantly managed patients were younger than the other groups (p=0.007). The mean body mass index (BMI) was higher in the neoplastic group (p=0.016). Preoperative DOM, CA125, mean platelet volume and PLR were statistically significantly different between the groups (p<0.05). ROC curve analysis demonstrated that increased PLR (AUC, 0.609; p=0.011) and BMI (AUC, 0.611; p=0.011) may be discriminative factors in predicting ovarian neoplasms in adolescents preoperatively. When the cut-off point for the PLR level was set to 140, the sensitivity and specificity levels were found to be 65.7% and 57.6%, respectively. Conclusions: We suggest that beside a careful preoperative evaluation including clinical characteristics, ultrasonographic features and tumor markers, PLR may predict ovarian neoplasms in adolescents.

• Tuberculosis and Respiratory Diseases
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• v.78 no.2
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• pp.125-127
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• 2015

We report a case of agranulocytosis caused by ethambutol in a 79-year-old man with pulmonary tuberculosis. He was referred for fever and skin rash developed on 21th day after antituberculosis drugs (isoniazid, rifampicin, ethambutol, and pyrazinamide) intake. Complete blood count at the time of diagnosis of pulmonary tuberculosis was normal. On the seventh admission day, agranulocytosis was developed with absolute neutrophil count of $70/{\mu}L$. We discontinued all antituberculosis drugs, and then treated with granulocyte colony-stimulating factor. Three days later, the number of white blood cell returned to normal. We administered isoniazid, pyrazinamide, and ethambutol in order with an interval. However, fever and skin rash developed again when adding ethambutol, so we discontinued ethambutol. After these symptoms disappeared, we added rifampicin and ethambutol in order with an interval. However after administering ethambutol, neutropenia developed, so we discontinued ethambutol again. He was cured with isoniazid, rifampicin, and pyrazinamide for 9 months.

• Korean Journal of Veterinary Research
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• v.50 no.3
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• pp.179-185
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• 2010

The present study was undertaken to establish reference values for the composition blood lymphocyte populations and compare forty three Hanwoo neonatal calves (KC) with twenty one Holstein calves (HC) by blood cell count and immunophynotying. The percentages of CD2+, CD4+, CD8+, CD26+, ACT2+, MHC class, MHC class II and WC1+ T cells, B cells were determined by flow cytometry. The number of lymphocyte and monocyte in HC were higher than those of KC. However, the number of neutrophils was higher in HC than KC. The proportions of CD2+, CD4+, CD8+, MHC class, and WC1+ lymphocytes remained relatively stable during the study period, while there was a moderate increase in the relative percentage of CD26+, ACT2+, MHC class II and B cell from birth to approximately 3 weeks of age. Marked differences in the relative proportions of the lymphocyte subpopulations were noted between the individual calves. The present study shows that the T-cell subpopulations are present in peripheral blood of KC at levels comparable with HC, while the MHC class II and B cell population of KC increases significantly with age. The absolute number of WBC in KC was due to the decrease of absolute number of neutrophil rather than the increase of lymphocyte. The results indicated that KC have significantly higher number of neutrophils, and proportion of MHC class II and B cell than HC.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4623-4626
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• 2012

Background: The risk of treatment-related death (TRD) and febrile neutropaenia (FN) with adjuvant taxane-based chemotherapy for early breast cancer is unknown in Malaysia despite its widespread usage in recent years. This study aims to determine these rates in patients treated in University Malaya Medical Centre (UMMC). Patients and Methods: Patients who were treated with adjuvant taxane-based chemotherapy for early breast cancer stages I, II or III from 2007-2011 in UMMC were identified from our UMMC Breast Cancer Registry. The TRD and FN rates were then determined retrospectively from medical records. TRD was defined as death occurring during or within 30 days of completing chemotherapy as a consequence of the chemotherapy treatment. FN was defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$. Results: A total of 622 patients received adjuvant chemotherapy during this period. Of these patients 209 (33.6%) received taxane-based chemotherapy. 4 taxane-based regimens were used namely the FEC-D, TC, TAC and AC-PCX regimens. The commonest regimen employed was the FEC-D regimen accounting for 79.9% of the patients. The FN rate was 10% and there was no TRD. Conclusion: Adjuvant taxane-based chemotherapy in UMMC for early breast cancer has a FN rate of 10%. Primary prophylactic G-CSF should be considered for patients with any additional risk factor for FN.

• The Journal of Korean Academic Society of Nursing Education
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• v.3 no.2
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• pp.193-206
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• 1997

Because the oral mucositis is often inevitable in acute leukemia patients during chemotherapy, the efforts must be made to keep these leukemia patients from oral mucositis. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. This quasi-experimental study was performed to compare the prohpylatic value of these oral care protocols. Thirty-nine subjects were assigned to one of three groups. The first group performed bivon-normal saline gargling protocol, the second group performed chlorhexidine gargling protocol, and the last contrast group kept traditonal gargling protocol. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count (ANC) reached $1,000/mm^3$. It continued about 2-4 weeks. The data was analyzed by ANCOVA and Kruskal-Wallis one way ANOVA, chi-sqare, survival analysis. The results were as follows : The contrast group showed significantly highest mean score of the OAG and Beck's perception of oral discomfort among three groups from second week to third week. However chie-test and survial analysis showed that the incidence of severe mucositis were not significantly different among three groups. Conclusively we recommend that nurses who care acute leukmia patients use bivon-normal saline gargling protocol be careful to occur severe mucositis during chemotherapy.

• 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.

• Clinical and Experimental Pediatrics
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• v.59 no.3
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• pp.126-131
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• 2016

Purpose: To evaluate the diagnostic value of the Vesikari Scoring System (VSS) as an early predictor of pathogens in children with acute gastroenteritis (AG). Methods: In this retrospective study, the VSS score, absolute neutrophil count (ANC), and C-reactive protein (CRP) levels were analyzed in 107 hospitalized children with AG, aged 6 months to 17 years. Patients were divided into nonspecific, viral, and bacterial groups according to the pathogens detected using a multiplex polymerase chain reaction (PCR) test. Results: Patients in the bacterial group had significantly higher CRP values and VSS scores compared to those in the viral group and significantly higher VSS scores compared to those in the nonspecific group (P<0.05). Patients in the viral group had significantly higher VSS scores than those in the nonspecific group (P<0.05). Logistic regression analysis revealed that VSS was the most effective diagnostic tool for predicting the type of pathogen (P<0.05). The area under the receiver operating characteristics curve of VSS was significantly greater than that for ANC and CRP (P<0.05). At a cutoff point of 10 in the VSS, an acceptable diagnostic accuracy could be achieved for distinguishing between bacterial and viral pathogens in AG. Conclusion: VSS can be considered a useful and reliable infectious marker for pediatric gastroenteritis. VSS may be a good early predictor of the type of pathogen, enabling development of a treatment plan before results from a stool culture or PCR test are available.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.195-198
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• 2016

We report a 72-year-old male with known myelodysplastic syndrome who presented to the emergency department with a 7-day history of fever and dyspnea. Echocardiography revealed a round echogenic mass $13{\times}16mm$ in size attached to the atrial side of the tricuspid valve. Considering the high risk of infective endocarditis in the patient with a low absolute neutrophil count ($130/mm^3$), emergency surgery was performed. Intraoperatively, a single gelatinous neoplasm was resected, and subsequent reconstruction of the involved leaflet was accomplished using autologous pericardium. The tumor was pathologically confirmed as papillary fibroelastoma with no evidence of infective endocarditis. Papillary fibroelastoma is a rare cardiac neoplasm that occurs in either the mitral or aortic valves. Interestingly, a few cases of tricuspid valve papillary fibroelastoma have been reported so far. Similar echocardiographic findings between vegetation and tricuspid valve neoplasm make it difficult to distinguish these two disease entities.

• Asian Oncology Nursing
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• v.10 no.2
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• pp.210-217
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• 2010

Purpose: This survey was aimed to examine the current dietary restrictions practices for neutropenic patients among hospitals with 500 and more beds. Methods: Self-administered questionnaires were sent to 100 head or charge nurses of oncology or hemato-oncology wards by mail during October 2009, and 51 questionnaires were returned. The data were analyzed with descriptive statistics using SPSS (WIN version 12.0). Results: Of the hospitals surveyed, 47.1% (n=24) had guidelines on the dietary restrictions, and 80.4% (n=41) placed patients with neutropenia on restricted diets. The major decisional criteria of the dietary restriction was absolute neutrophil count (30.5%) and cooking status (29.2%). The most commonly restricted foods were raw fish or fresh meat (98.0%), uncooked intestine (98.0%), raw eggs (98.0%), draught beer (96.1%), and fresh fruits or vegetables (86.3%). Conclusion: The results showed variation in pattern of dietary restrictions and lower rate of guideline among hospitals, so that the need for the standard dietary restriction guideline is high. However, the role of diet in the development of infection in neutropenic patients is still unclear, which makes it difficult to establish dietary restriction guideline. Therefore, additional research are required to identify the relationship between dietary factors and infections.