ABSTRACT
BACKGROUND: While primary prophylaxis is a well-established and recommended treatment for children with severe hemophilia, there has not been Korean own data. The aim of this study is to lay the foundation for the optimal and available management of hemophilia in Korea. METHODS: We reviewed the medical records of the patients treated with regular factor VIII concentrates infusion as long term continuous treatment at Seoul Clinic of Korea Hemophilia Foundation since August, 2004, retrospectively. We analyzed the efficacy of prophylaxis with the frequency of joint bleed and clinically meaningful bleeding episodes. We also assessed the cost of primary prophylaxis, secondary prophylaxis and on-demand therapy by the factor concentrates consumption. RESULTS: The data from 65 patients were available to evaluate. Of 65 patients, 22 were treated with primary prophylaxis, and 43 with secondary prophylaxis. In the primary and secondary prophylaxis groups, there were 1.9 joint bleeds and 3.3 other bleeding episodes, 7.2 and 9.0, respectively. The mean consumption of factor concentrates per person for primary prophylaxis, secondary prophylaxis and on-demand therapy groups were 2,658.8 IU/kg/year, 2,665.1 IU/kg/year, and 1,271.9 IU/kg/year respectively. CONCLUSION: Now prophylaxis is the recommended treatment for severe hemophilia patients, we should manage our hemophilia patients with standard treatment. And the optimizing treatment regimen for each individual will be needed to establish by studies of individual pharmacokinetics and bleeding tendency.
Subject(s)
Child , Humans , Factor VIII , Hemophilia A , Hemorrhage , Joints , Korea , Medical Records , Retrospective StudiesABSTRACT
BACKGROUND: While primary prophylaxis is a well-established and recommended treatment for children with severe hemophilia, there has not been Korean own data. The aim of this study is to lay the foundation for the optimal and available management of hemophilia in Korea.METHODS: We reviewed the medical records of the patients treated with regular factor VIII concentrates infusion as long term continuous treatment at Seoul Clinic of Korea Hemophilia Foundation since August, 2004, retrospectively. We analyzed the efficacy of prophylaxis with the frequency of joint bleed and clinically meaningful bleeding episodes. We also assessed the cost of primary prophylaxis, secondary prophylaxis and on-demand therapy by the factor concentrates consumption.RESULTS: The data from 65 patients were available to evaluate. Of 65 patients, 22 were treated with primary prophylaxis, and 43 with secondary prophylaxis. In the primary and secondary prophylaxis groups, there were 1.9 joint bleeds and 3.3 other bleeding episodes, 7.2 and 9.0, respectively. The mean consumption of factor concentrates per person for primary prophylaxis, secondary prophylaxis and on-demand therapy groups were 2,658.8 IU/kg/year, 2,665.1 IU/kg/year, and 1,271.9 IU/kg/year respectively.CONCLUSION: Now prophylaxis is the recommended treatment for severe hemophilia patients, we should manage our hemophilia patients with standard treatment. And the optimizing treatment regimen for each individual will be needed to establish by studies of individual pharmacokinetics and bleeding tendency.
Subject(s)
Child , Humans , Factor VIII , Hemophilia A , Hemorrhage , Joints , Korea , Medical Records , Retrospective StudiesABSTRACT
PURPOSE: The survival rate of very low birth weight infants(VLBWI) has improved by virtue of specialized neonatal care. This study was performed to analyze the changes in incidence, survival rate and morbidity of VLBWI who admitted to Chonnam National University Hospital from 1996 to 2001. METHODS: We enrolled 565 VLBWI, and compared the incidence and the survival rate according to the birth weight or gestational weeks between period I(1996 to 1998) and period II(1999 to 2001). The mortality rate according to the postnatal age, cause of death, morbidity and days of hospital stay were also compared. Morbidity is categorized into 'short term' which is curable until discharge, and 'long term' causing any types of sequelae after discharge. RESULTS: Incidence of VLBWI significantly increased in period II over period I(6.0% vs. 11.0%, P<0.001). The survival rate also increased in period II(71.8% vs. 80.1%, P<0.05), especially in 1,000 to 1,249 gm of birth weight(P<0.001) and in 28 to 30 weeks of gestation(P<0.001). The most common cause of death was respiratory distress syndrome in period I; however it was sepsis in period II. Although overall and short term morbidity rate increased, long term morbidity and days of hospital stay didn't increase in period II. CONCLUSION: Although the incidence of VLBWI significantly increased and the survival improved in period II compared to period I, especially in 1,000 to 1,249 gm of birth weight and 28 to 30 weeks of gestation, 'long term' morbidity rate and hospital days didn't increase.
Subject(s)
Humans , Infant , Pregnancy , Birth Weight , Cause of Death , Incidence , Infant, Very Low Birth Weight , Length of Stay , Mortality , Parturition , Sepsis , Survival Rate , VirtuesABSTRACT
BACKGROUND: Hemophiliacs are known to have higher risk of exposure of hepatitis virus and immunosuppression. The aim of this study is to investigate the positive rate of viral markers for hepatitis and anti-HIV and the changes of lymphocyte subpopulations in Hemophiliacs in Chonnam GwangJu area. METHODS: One hundred four patients who had visited to the Hemophilic Clinic, Chonnam University Hospital from 1999 to 2001 were enrolled. They were checked for type A, B, C hepatitis viral markers, anti-HIV and lymphocyte subpopulations. The prevalence of hepatitis and lymphocyte subpopulation were compared according to severity and age of hemophiliacs. RESULTS: Anti-HAV IgM, anti-HAV IgG, HBsAg, anti-HBs, anti-HCV were positive in 40%(22/55), 65.5%(66/101), 42.3%(42/97) of cases tested. Positivity of anti-HCV showed trends of increase according to the severity of hemophiliacs (P11 years old) (P=0.003, P<0.001, respectively). Although all enrolled patients were negative for anti-HIV, absolute T and B cells counts were decreased in 71.6% and 14.9% of patients, respectively and inversion of CD4/CD8 ratio were found in 65.7%. But there were no statistical difference in not only decrease of T and B cells but also inversions of CD4/CD8 ratio according to age and severity. CONCLUSION: The number of hemophiliacs with previous history of hepatitis B virus infection and seropositivity of anti-HCV were increased according to the age and severity of hemophilia. Active vaccinations of hepatitis B may be required in hemophiliacs. The greater part of hemophiliacs showed decrease in T cell count and inverted CD4/CD8 ratio. The hemophiliacs need a cautiion for infection and follow up tests for immunologic function.
Subject(s)
Humans , B-Lymphocytes , Biomarkers , Cell Count , Follow-Up Studies , Hemophilia A , Hepatitis A Antibodies , Hepatitis B , Hepatitis B Surface Antigens , Hepatitis B virus , Hepatitis Viruses , Hepatitis , Immunoglobulin G , Immunoglobulin M , Immunosuppression Therapy , Lymphocyte Subsets , Lymphocytes , Prevalence , VaccinationABSTRACT
PURPOSE: The changes in the levels of eicosanoids and isoprostane (8-iso-PGF2alpha) were investigated in brain tissue of 7 day-old rats after hypoxic-ischemic (HI) injury. METHODS: The 7 day-old newborn rats underwent right unilateral common carotid artery ligation followed by exposure to hypoxia with 8% oxygen for 150 minutes. There after, the pups were decapitated during reoxygenation 21% period of 0, 1, 6, 24, and 72 hours and their cerebral hemisheres were dissected through sagittal plane. Ipsilateral and contralateral cerebral hemesheres to common carotid artery ligation were used to determine the water content for estimation of severity of brain edema (n=5) and to measure the levels of eicosanoid and isoprostane (n=7). The levels of 6-keto-PGF1alpha, TXB2, and PGE2 were measured by RP-HPLC (reversed-phase high-performance liquid chromatography) and the levels of isoprostane (8-iso-PGF2alpha) were measured by enzyme immunoassay. The changes of eicosanoid and isoprostane levels during reoxygenation period were observed and comparisons between ipsilateral and contralateral hemispheres were done. RESULTS: The edema of ipsilateral cerebral hemesheres to common carotid artery ligation was more severe than that of contralateral cerebral hemisheres (P<0.05). The levels of 6-keto-PGF1alpha, TXB2, and PGE2 were found to increase during the early period of reoxygenation after HI insult, peak at 1 hour, and then decrease to the control levels at 72 hour (P<0.05). But, the levels of 8-iso-PGF2alpha did not significantly increase during the period of reoxygenation. The levels of 6-keto-PGF1alpha, TXB2, and PGE2 of ipsilateral hemispheres had a tendency to be higher than those of contralateral hemispheres during the initial 6 hour reoxygenation period, but the levels of 8-iso-PGF2alpha of ipsilateral hemispheres were significantly higher than those of contralateral hemispheres during the relatively later reoxygenation period (P<0.05). CONCLUSION: Reoxygenation after hypoxic-ischemic injury increased the levels of 6-keto-PGF1alpha, TXB2, and PGE2 in 7 day-old rat brain during the early period of reoxygenation, but the levels of isoprostane (8-iso-PGF2alpha) were not significantly increased during the reoxygenation period after HI injury.
Subject(s)
Animals , Humans , Infant, Newborn , Rats , Hypoxia , Brain Edema , Brain , Carotid Artery, Common , Dinoprostone , Edema , Eicosanoids , Immunoenzyme Techniques , Ischemia , Isoprostanes , Ligation , OxygenABSTRACT
No abstract available.
Subject(s)
Infant, Newborn , Meconium Aspiration Syndrome , Meconium , Mortality , SuctionABSTRACT
No abstract available.