• Journal of Yeungnam Medical Science
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• v.39 no.3
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• pp.244-249
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• 2022

Background: Chronic infectious, inflammatory, or neoplastic disorders are associated with anemia of chronic disease. Chronic inflammatory diseases such as periodontitis may contribute to masked anemia, especially in smokers. This study was aimed at verifying and comparing the efficacy of nonsurgical periodontal therapy (NSPT) for improving anemia among chronic periodontitis patients with and without the habit of smoking. Methods: Thirty systemically healthy individuals with chronic periodontitis were divided into two groups of 15 each, smokers (group A) and nonsmokers (group B). The groups were compared based on hematological parameters such as serum erythropoietin (SE) and serum ferritin (SF) levels at baseline and 3 months after NSPT for anemia evaluation. Results: The baseline SE levels in groups A and B were 11.84 and 15.19 mIU/mL (p=0.031), respectively; the corresponding levels at 3 months after NSPT were 13.00 and 17.74 mIU/mL (p=0.022). The baseline SF levels in groups A and B were 95.49 and 44.86 ng/mL (p=0.018), respectively; the corresponding levels at 3 months after NSPT were 77.06 and 39.05 ng/mL (p=0.009). Group B showed a significant increase and decrease in the SE and SF levels, respectively, at 3 months after NSPT (p=0.035 and p=0.039, respectively), whereas group A showed insignificant changes (p=0.253 and p=0.618, respectively). Conclusion: NSPT led to an improvement in anemia among chronic periodontitis patients. However, the improvement is less in smokers compared to that in nonsmokers. Furthermore, SF and SE levels might serve as effective biomarkers for assessing anemia in smokers and nonsmokers with chronic periodontitis.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.197-206
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• 2009

Purpose : Limited information is available on experiences of intravenous iron treatment in children. In this study, iron sucrose was administered intravenously to determine its effect, the factors predicting outcome, and safety in children on chronic dialysis. Methods : Twenty-one children whose serum ferritin levels were less than 100 ng/mL or transferrin saturations (TSAT) were less than 20% were enrolled. In 12 children on peritoneal dialysis (PD), the drug was infused intravenously as 200 mg/$m^2$ ($\leq$200 mg) at week 0, 2, 4, and 6. In 9 children on hemodialysis (HD), it was given intravenously as 8 weekly doses of 3 mg/kg ($\leq$100 mg) through week 0-7. Results : After treatment, serum ferritin levels increased significantly in both groups, and TSAT rose significantly in PD group. However, hemoglobin level did not rise significantly in both groups. Children with baseline hemoglobin less than 10 g/dL or baseline TSAT less than 20% showed significantly higher rise of hemoglobin after intravenous iron treatment. To the contrary, those with higher baseline hemoglobin and TSAT levels displayed higher rise in serum ferritin after the treatment. Although no serious adverse event occurred, TSAT levels exceeding 50% were noted in 6 patients in PD group. Conclusion : This suggests that 3 mg/kg/week of intravenous iron sucrose can be used safely in children on chronic HD, but 200 mg/$m^2$ every other week may incur excessive TSAT level in some patients on chronic PD.

• Journal of Nutrition and Health
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• v.15 no.4
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• pp.249-257
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• 1982

The aim of this study was to observe the relationships between the amount of menstrual blood loss (MBL) and age, parity, number of pregnancy and induced abortion, and the iron nutriture in married Korean women. Fifty-one healthy women aged 26 to 48 years were tested for their MBL, hemoglobin(Hb) concentration, hematocrit (Hct) value, mean corpuscular hemoglobin concentration (MCHC), serum iron and ferritin concentrations. The results of this study are summarized as follows : 1) The mean value and standard error of mean of the MBL was $32.0{\pm}3.94ml$, and the range of MBL was 3.8-127.2 ml for total subjects. Maximum number (23.5%) of the subjects fell in the group with MBL of 10-l9ml, while 17.7% showed MBL above 50m1. 2) There were no statistically significant differences on the mean amount of MBL between the age groups 25-48 years. 3) The mean amount of MBL in 1-2 and 3-4 para groups were 28.5 and 36.1 ml, respectively, but the difference between two groups was not significant 4) It was observed that the mean amount of MBL was gradually decreased as the number of pregnancy and induced abortion were increased, but the significance was not observed. 5) The mean values of Hb concentration, MCHC and serum iron concentration were slightly decreased in subjects with MBL of more than 50ml but the statistical significance was not observed. The mean of Hct value was not influenced by the amount of MBL. While serum ferritin concentrations were markedly decreased and the prevalence rate of anemia was markedly increased as the amount of MBL was increased. There was significant difference (P<0.05) between the mean amount of MBL with respect to the serum ferritin concentration.

• Clinical and Experimental Pediatrics
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• v.59 no.7
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• pp.308-311
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• 2016

We report a human parechovirus-3 (HPeV-3) infection in 2 neonates who had prolonged fever (>5 days) with palmar-plantar erythema. This distinctive rash was observed 4-5 days after fever onset, just before defervescence. Elevated aspartate aminotransferase, lactate dehydrogenase, and ferritin levels were characteristic laboratory findings in the 2 cases, suggesting tissue damage caused by hypercytokinemia. Case 1 was treated with intravenous immunoglobulin, considering the possibility of severe systemic inflammatory responses. The initial ferritin level was 385 ng/mL (range, 0-400 ng/mL); however, the level increased to 2,581 ng/dL on day 5 after fever onset. Case 2 presented with milder clinical symptoms, and the patient recovered spontaneously. HPeV-3 was detected in cerebrospinal fluid and/or blood samples, but no other causative agents were detected. The findings from our cases, in accordance with recent studies, suggest that clinical features such as palmar-plantar erythema and/or hyperferritinemia might be indicators of HPeV-3 infection in neonates with sepsis-like illness. In clinical practice, where virology testing is not easily accessible, clinical features such as palmar-plantar erythema and/or hyperferritinemia might be helpful to diagnose HPeV-3 infection.

• The Korean journal of internal medicine
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• v.33 no.6
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• pp.1234-1240
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• 2018

Background/Aims: Red blood cell distribution width (RDW) is a value representing the heterogeneity in the size of red blood cell, and it is usually used in distinguishing types of anaemia. Recently, it was reported that it could reflect the burden of inflammation in diverse diseases and their prognosis. Hence, in this study, we investigated whether RDW may contribute to discriminating adult onset Still's disease (AOSD) from sepsis in serious febrile patients within 24 hours after hospitalization. Methods: We reviewed the medical records and enrolled 21 AOSD patients, 27 sepsis patients and 30 matched healthy controls. We collected at least two laboratory results of variables including RDW within 24 hours after hospitalization, and we calculated their mean values. Results: Sepsis patients showed the significantly increased median white blood cell count, compared to AOSD patients ($14,390.0/mm^3$ vs. $12,390.0/mm^3$, p = 0.010). The median RDW in sepsis patients was higher than that in AOSD patients (15.0% vs. 13.3%, p = 0.001), and furthermore, the median RDW in both patient-groups was significantly higher than that in healthy controls. In contrast, the median ferritin level in sepsis patients was lower than that in AOSD patients (544.0 mg/dL vs. 3,756.6 mg/dL, p = 0.001). In multivariate analysis, RDW ${\geq}14.8%$ (odds ratio, 17.549) and ferritin < 2,251.0 mg/dL (odds ratio, 32.414) independently suggested sepsis more than AOSD in patients initially presenting with fever requiring hospitalization. Conclusions: RDW might be a rapid and helpful marker for a differential diagnosis between AOSD from sepsis at an early phase.

• Journal of Nutrition and Health
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• v.38 no.7
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• pp.533-543
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• 2005

The purpose of this study was to determine the iron status of preschool children in Ulsan, Korea. The study was con-ducted using 95 children aged 3 to 6 years by investigating the anthropometric indices and assessing the dietary intakes and biochemical analysis. A questionnaire for dietary intakes using 24-hr recall method were carried out by the mothers of the 95 subjects. And also a study was conducted to assess hematological and biochemical status of iron and prevalence of iron deficiency. The average height and weight were 105.4 $\pm$ 7.0 cm, 18.7 $\pm$ 3.2 kg in boys, 103.8 $\pm$ 6.7 cm, 17.6 $\pm$ 2.7 kg in girls. These were lower than the body growth standard values of Korean pediatrics. There was not a significant difference in both between boys and girls. For the daily nutrient intake, energy was 1201.5 $\pm$ 280.9 kcal (79.3$\%$RDA), protein was 63.8 $\pm$ 28.2 g (219.4$\%$RDA), iron was 11.9 $\pm$ 4.5 mg (133.2$\%$RDA). The iron nutritional status by hematological assay found that Hct was 34.7 $\pm$ 2.0 ($\%$), Hb was 12.0 $\pm$ 0.8 g/dl, RBC was 4.3 $\pm$ 0.3 ($10^6/{\mu}l$), MCV was 80.5 $\pm$ 3.0 fL, MCH was 27.8 $\pm$ 1.1 pg and MCHC was 34.6 $\pm$ 0.6 g/dl. The biochemical measurement of serum iron was 75.6 $\pm$ 30.3 ${\mu}g$/dl, TIBC was 320.3 $\pm$ 34.1 ${\mu}g$/dl, serum ferritin was 30.0 $\pm$ 14.8 ${\mu}g$/dl, Zinc-Protophor-phyrin (ZPP) was 32.7 $\pm$ 8.0 ${\mu}g$/dl, and ZPP/Heme was 71.1 $\pm$ 19.5 ($\mu$mole/mol heme). The prevalence with Hct, Hb, TS and serum ferritin less than cut-off value was $8.4\%,\;9.5\%,\;12.6\%$ and $4.4\%$ respectively. But the prevalence of iron deficiency estimated with ZPP and ZPP/Heme criteria were $25.3\%$ and $27.4\%$, and were higher than in case of any other indices. The prevalence of iron deficiency anemia ((low Hb (< 11.0 g/dl) and low serum ferritin (< 10 ${\mu}g$/L) or low TS (3-4 yews: < $12\%$, 5-6 years: < $14\%$)) was found in only one 3 year old girl. The prevalence of iron deficiency except Hct and Hb was the highest in 3 year group, but the prevalence by Hct and Hb was the highest in 5 year group. Iron deficiency and iron deficiency anemia do not seem to be a major public health problem in preschool children in Ulsan.

• KSBB Journal
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• v.21 no.3
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• pp.204-211
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• 2006

For the production of the recombinant human interferon-gamma(rhIFN-${\gamma}$) in Escherichia coli, human glucagon and ferritin heavy chain were used as fusion partners. Even though rhIFN-${\gamma}$ is expressed as an inclusion body form in E. coli because of strong hydrophobicity of itself, over 50% of fused rhIFN-${\gamma}$ was expressed as soluble form in E. coli $Origami^{TM}$(DE3) harboring pT7FH(HE)-IFN-${\gamma}$ which encodes ferritin heavy chain-fused rhIFN-${\gamma}$. In the case of using glucagon-ferritin heavy chain hybrid mutant as a fusion partner, 6X His-tag was additionally introduced to N-terminus of GFHM(HE)-IFN-${\gamma}$ for enhancing purification yields of rhIFN-${\gamma}$. Fusion protein HGFHM(HE)-IFN-${\gamma}$ with two 6X His-tag was more effectively bound to Ni-NTA agarose bead than GFHM(HE)-IFN-${\gamma}$ with a 6X His-tag. rhIFN-${\gamma}$ was completely purified from enterokinase-treated HGFHM(HE)-IFN-${\gamma}$ by Ni-NTA affinity column. For high-level production of rhIFN-${\gamma}$, glucose was used as the sole carbon source with simple exponential feeding rate($2.4{\sim}7.2g/h$) in fed-batch process. The effective lactose concentration for the expression of the rhIFN-${\gamma}$ was $10{\sim}20mM$. Under the fed-batch culture conditions, rhIFN-${\gamma}$ production yield reached 11 g DCW/L for 6 hours after lactose induction.

• Journal of Nutrition and Health
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• v.32 no.8
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• pp.887-896
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• 1999

The purpose of this research is to assess hematological and biochemical status and the prevalence of iron deficiency of pregnant women by gestational age to provide the primary data about iron nutritional status of pregnant women. Pregnant women visiting public health centers in Ulsan participated in study and were divided into 3 trimester by last menstrual period(LMP). Hemoglobin (Hgb), hematocrit(Hct)and mean corpuscular volume(MCV) among iron status indices were not statistically different from normal distribution, however total iron binding capacity(TIBC) and serum ferritin were skewed to left and serum iron and transferrin saturation(TS) were skewed to right. Hgb was positively correlated with Hct(r=0.93, p<0.001) but TIBC was negatively correlated with all indices. Serum ferritin was also correlated with all indices, especially in 3rd trimester but not reached to 1st trimester level. Mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), Red cell distribution width(RDW), serum iron and TS were not significantly different by trimester, however when serum serum iron was adjusted with hematocrit to correct the hemodilution, it significantly decreased in 2nd trimester. MCV increased in 2nd trimester and was maintained until late pregnancy, TIBC continued to increase throughout the trimester. The prevalence of anemic by CDC(Centers for Disease Control) Hgb criteria(Hgb <11.0g/dl in 1st and 3nd trimester, Hgb<10.5g/dl in 2nd trimester) was 2.8% in 1st trimester, 22.5% in 2nd trimester, 27.1% in 3rd trimester and was similar with prevalence by CDC Hct criteria(Hct < 33% in 1st and 3rd, Hct < 32% in 2nd). The prevalence of anemic of total subjects was 32.7% by WHO criteria(Hgb < 11.0g/dl). Although almost iron status indices increased in 3rd trimester, the prevalence of anemia by different criteria of all indices increased throughout the trimester, so iron nutritional status was considered as serious during late pregnancy. However, since factors other than iron deficiency, such as infection, infection, inflammation, other nutrient deficiency may also play a significant role, to differentiate the anemia due to mainly iron deficiency from the anemia due to other factors, serum ferritin is among the more useful indices in distinguishing the two conditions because it is depressed only in iron deficiency. Hgb<11.0g/dl and serum ferritin<12.0ug/L as the criteria of iron deficiency was suggested by CDC. 17.8% of all subjects were classified as iron deficient anemia, 14.9% as anemic from other reasons, 21.2% as iron deficiency any only 46.2% were in normal iron status.

• Journal of Nutrition and Health
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• v.33 no.5
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• pp.532-539
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• 2000

The purpose of this research is to assess th iron nutritional status of pregnant women and to evaluate the appropriateness of the present cut off levels of hemoglobin(Hgb), hematocrit(Hct) and total iron binding capacity(TIBC) for assessing iron deficiency status. Pregnant women who were visiting public helath centers in Ulsan were interviewed and agreed to attend the study. Blood sample was taken and biochemical analysis of blood was performed. The collected data were classified into 3 trimesters by gestational age and then statistical analysis was performed. The prevalence of anemia in all subjects was 32.3% by WHO criteria(Hgb < 11.0g/dl) and 17.8% of all subjects was iron deficient anemia by CDC criteria(Hgb < 11.0/dl and serum ferritin < 12.0ug/l). Since the iron deficient anemia generally occures at the last stage of iron deficiency, it is not efficient to diagnose and prevent the iron deficient anemia in pregnant women by using the present cut off level of Hgb. Therefore, the new cut off level of iron status indices is necessary for assessing iron deficiency in early pregnancy before manifestation of anemia and for reducing the prevalence of anemia in later pregnancy. For this reason, the present cut off levels of iron status indices were estimated and compared by assessing the iron deficiency judged by serum ferritin level (<12.0ug/l)as true iron deficiency. It follows from the results of this research that present cut off levels of Hgb, Hct and TIBC were very insensitive in identifying the subjection with iron deficiency. The appropriate cut off levels of Hgb were 11.5g/dl for total period of pregnancy, 12.0g/dl for 1st and 3rd trimester, and 11.5g/dl for 2nd trimester. The cut off level of Hct was 34.0% for total period for pregnancy, 35.0% for 1st trimester, and 34.0% for 2nd and 3rd trimester. The cut off level of TIBC was 400ug/dl for total period, 360ug/dl for 1st 2nd trimester, and 450ug/dl for 3rd trimester.

• Journal of Yeungnam Medical Science
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• v.18 no.2
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• pp.226-238
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• 2001

Background: Anemia in chronic renal failure plays an important role in increasing morbidity of dialysis patients. The causes of the anemia are multifactorial. With using of erythropoietin(EPO) most of uremia-induced anemia can be overcome. However, about 10% of renal failure patients shows EPO-resistant anemia. Hyporesponsiveness to EPO has been related to many factors: iron deficiency, aluminum intoxication, inflammations, malignancies and secondary hyperparathyroidism. So I evaluated the improvement of EPO responsiveness after correction of above several factors. Materials and Methods: Seventy-two patients on hemodialysis over 6 months were treated with intravenous ascorbic acid(IVAA, 300 mg t.i.w. for 12 weeks), After administration of IVAA for 12 weeks, patients were classified into several groups according to iron status, serum aluminum levels and i-PTH levels. Indivisualized treatments were performed: increased iron supplement for absolute iron deficiency, active vitamin D3 for secondary hyperparathyroidism and desferrioxamine(DFO, 5 mg/kg t.i.w.) for aluminum intoxication or hyperferritinemia. Results: 1) Result of IVAA therapy for 12 weeks on all patients(n=72). Hemoglobin levels at 2, 4, 6 week were significantly elevated compared to baseline, but those of hemoglobin at 8, 10, 12 week were not significantly different. 2) Result of IVAA therapy for 20 weeks on patients with 100 ${\mu}g/l$ ${\leq}$ ferritin < 500 ${\mu}g/l$ and transferrin saturation(Tsat) below 30%(n=30). After treatment of IV AA for 12 weeks, patients were evaluated the response of therapy according to iron status. Patients with 100 ${\mu}g/l$ ${\leq}$ ferritin < 500 ${\mu}g/l$ and Tsat below 30% showed the most effective response. These patients were treated further for 8 weeks. Hemoglobin levels at 2, 4 week were significantly increased compared to baseline with significantly reduced doses of EPO at 2, 4, 6, 10, 12, 16, 20 week. Concomitantly significantly improvement of Tsat at 2, 6, 16, 20 week compared to baseline were identified. 3) Result of IVAA therapy for 12 weeks followed by DFO therapy for 8 weeks on patients with serum aluminum above 4 ${\mu}g/l$(n=12) Hemoglobin levels were not significantly increased during IVAA therapy for 12 weeks but dosages of EPO were significantly decreased at 2, 4, 6, 8 week during DFO therapy compared to pre-treatment status. Conclusion: IVAA can be helpful for the treatment of the anemia caused by functional iron deficiency and can reduce the dosage of EPO for anemia correction. And administration of low dose DFO, in cases of increased serum aluminum level, can reduce the requirement of EPO.