A Study on Bleeding after Shortening the Bed Rest Time of Pediatric Hemato-oncologic Patients after Bone Marrow Examination / 임상간호연구

Purpose@#The purpose of our study was to identify the bleeding risk factors and to validate the safety of shortening the bed rest time after bone marrow examination in pediatric hemato-oncologic patients. @*Methods@#From July 2019 to September 2020, 145 patients were enrolled from a single center. Medical records were reviewed retrospectively. Descriptive statistics were presented, and the data were analyzed using x2 -test, Fisher’s exact test, and a logistic regression. @*Results@#After two hours of bed rest, most of the patients (91.7%) did not have bleeding complications, and only 8.3% of the patients had a minor bleeding. The rate of major bleeding complications, including hematoma, retroperitoneal hemorrhage rate was zero. The bleeding complications was frequently found on bilateral procedures than unilateral procedures and the difference were statistically significant (p<.05). @*Conclusion@#Two hours of bed rest time after bone marrow examination could be safe and adequate in pediatric hemato-oncologic patients.

A Study on Bleeding after Shortening the Bed Rest Time of Pediatric Hemato-oncologic Patients after Bone Marrow Examination / 임상간호연구

Purpose@#The purpose of our study was to identify the bleeding risk factors and to validate the safety of shortening the bed rest time after bone marrow examination in pediatric hemato-oncologic patients. @*Methods@#From July 2019 to September 2020, 145 patients were enrolled from a single center. Medical records were reviewed retrospectively. Descriptive statistics were presented, and the data were analyzed using x2 -test, Fisher’s exact test, and a logistic regression. @*Results@#After two hours of bed rest, most of the patients (91.7%) did not have bleeding complications, and only 8.3% of the patients had a minor bleeding. The rate of major bleeding complications, including hematoma, retroperitoneal hemorrhage rate was zero. The bleeding complications was frequently found on bilateral procedures than unilateral procedures and the difference were statistically significant (p<.05). @*Conclusion@#Two hours of bed rest time after bone marrow examination could be safe and adequate in pediatric hemato-oncologic patients.

Decrease of peripheral blood lymphocyte count predicts response to neoadjuvant chemotherapy in breast cancer patients

Purpose@#Pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) holds promise as a significant prognostic factor to predict NAC response in breast cancer patients. The absolute peripheral blood lymphocyte (PBL) count has been suggested as an independent predictor of response to NAC. The current study evaluated the relationship between pCR and the change of PBL count in patients treated with NAC. @*Methods@#A total of 61 patients with histologically confirmed breast cancer treated with NAC followed by mastectomy between January 2010 and December 2019 were analyzed retrospectively. Correlational analyses confirmed a statistically significant relationship between PBL count and pCR. Following conformational correlational analyses, patients were divided into two groups according to cutoff values using the receiver operating characteristics curve and a logistic regression was conducted to determine the optimal conditions for achieving pCR. @*Results@#A total of 14 patients (22.9%) achieved pCR. Most PBL counts decreased after NAC relevant to pCR. Logistic regression analysis revealed that a small decrease of PBL was associated with pCR (P=0.028). The cutoff value of PBL decrease was 755×106/L, which was used to divide patients into high and low reduction groups. The pCR rate was 11.43% and 38.46% for the high and low reduction group, respectively (area under the curve, 0.707; 95% confidence interval, 0.556–0.858; P=0.020). The high reduction group was found to have more difficulty achieving pCR. @*Conclusion@#The decrease of PBL is significantly associated with pCR. Our data support that the decrease of PBL after NAC may be useful factors in predicting the response to NAC in breast cancer patients.

Decrease of peripheral blood lymphocyte count predicts response to neoadjuvant chemotherapy in breast cancer patients

Purpose@#Pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) holds promise as a significant prognostic factor to predict NAC response in breast cancer patients. The absolute peripheral blood lymphocyte (PBL) count has been suggested as an independent predictor of response to NAC. The current study evaluated the relationship between pCR and the change of PBL count in patients treated with NAC. @*Methods@#A total of 61 patients with histologically confirmed breast cancer treated with NAC followed by mastectomy between January 2010 and December 2019 were analyzed retrospectively. Correlational analyses confirmed a statistically significant relationship between PBL count and pCR. Following conformational correlational analyses, patients were divided into two groups according to cutoff values using the receiver operating characteristics curve and a logistic regression was conducted to determine the optimal conditions for achieving pCR. @*Results@#A total of 14 patients (22.9%) achieved pCR. Most PBL counts decreased after NAC relevant to pCR. Logistic regression analysis revealed that a small decrease of PBL was associated with pCR (P=0.028). The cutoff value of PBL decrease was 755×106/L, which was used to divide patients into high and low reduction groups. The pCR rate was 11.43% and 38.46% for the high and low reduction group, respectively (area under the curve, 0.707; 95% confidence interval, 0.556–0.858; P=0.020). The high reduction group was found to have more difficulty achieving pCR. @*Conclusion@#The decrease of PBL is significantly associated with pCR. Our data support that the decrease of PBL after NAC may be useful factors in predicting the response to NAC in breast cancer patients.

Long-Term Experience of Sperm Cryopreservation in Cancer Patients in a Single Fertility Center

PURPOSE: Sperm cryopreservation before cancer treatment is the most effective method to preserve the fertility of male patients. We present our 21 years experience with sperm cryopreservation for cancer patients, including an examination of semen quality, the current status of cryopreserved sperm, and the rate of sperm use for assisted reproductive technology (ART). MATERIALS AND METHODS: A total of 721 cancer patients at Fertility Center of CHA Gangnam Medical Center successfully performed sperm cryopreservation for fertility preservation from January 1996 to December 2016. Medical chart review was used to analyze patient age, marital status, cancer type, semen volume, sperm counts and motility, length of storage, and current banking status. RESULTS: The major cancers of the 721 patients were leukemia (28.4%), lymphoma (18.3%), testis cancer (10.0%). The mean age at cryopreservation was 27.0 years, and 111 patients (15.4%) performed sperm cryopreservation during or after cancer treatment. The mean sperm concentration was 66.7±66.3 ×106/mL and the mean sperm motility was 33.8%±16.3%. During median follow-up duration of 75 months (range, 1–226 months), 44 patients (6.1%) used their banked sperm at our fertility center for ART and 9 patients (1.2%) transferred their banked sperm to another center. The median duration from cryopreservation to use was 51 months (range, 1–158 months). CONCLUSIONS: Sperm cryopreservation before gonadotoxic treatment is the most reliable method to preserve the fertility of male cancer patients. Sperm cryopreservation should be offered as a standard of care for all men planning cancer therapy.

Mutant p53-Notch1 Signaling Axis Is Involved in Curcumin-Induced Apoptosis of Breast Cancer Cells

Notch1 has been reported to be highly expressed in triple-negative and other subtypes of breast cancer. Mutant p53 (R280K) is overexpressed in MDA-MB-231 triple-negative human breast cancer cells. The present study aimed to determine whether the mutant p53 can be a potent transcriptional activator of the Notch1 in MDA-MB-231 cells, and explore the role of this mutant p53-Notch1 axis in curcumin-induced apoptosis. We found that curcumin treatment resulted in an induction of apoptosis in MDA-MB-231 cells, together with downregulation of Notch1 and its downstream target, Hes1. This reduction in Notch1 expression was determined to be due to the decreased activity of endogenous mutant p53. We confirmed the suppressive effect of curcumin on Notch1 transcription by performing a Notch1 promoter-driven reporter assay and identified a putative p53-binding site in the Notch1 promoter by EMSA and chromatin immunoprecipitation analysis. Overexpression of mutant p53 increased Notch1 promoter activity, whereas knockdown of mutant p53 by small interfering RNA suppressed Notch1 expression, leading to the induction of cellular apoptosis. Moreover, curcumin-induced apoptosis was further enhanced by the knockdown of Notch1 or mutant p53, but it was decreased by the overexpression of active Notch1. Taken together, our results demonstrate, for the first time, that Notch1 is a transcriptional target of mutant p53 in breast cancer cells and suggest that the targeting of mutant p53 and/or Notch1 may be combined with a chemotherapeutic strategy to improve the response of breast cancer cells to curcumin.

Practices of Nutritional Ergogenic Aids Usage by Elite Bodybuilders and Weight Lifters / 대한지역사회영양학회지

The objective of the present study was to determine the prevalence and type of nutritional ergogenic aids use, and to determine the frequency, reasons for use of nutritional ergogenic aids. Thirty-four male bodybuilders (mean age = 27.0 years), twenty-four male weight lifters (mean age = 20.9 years) participated in the study. Participants completed a comprehensive survey detailing their usage patterns. In this study, 78.1% of bodybuilders and 79.2% of weight lifters reported using nutritional ergogenic aids. The most frequently taken nutritional ergogenic aids, in ranking order, were protein/amino acid powders (79.4%), multivitamin/minerals (67.7%) and creatine (67.6%) for bodybuilders, in contrast to sports drinks (100.0%), protein/amino acid powders (50.5%) and creatine (50.5%) for weight lifters. Over the half of the respondents, 79.4% of bodybuilders and 50.6% of weight lifters, used protein/amino acid powders to gain muscle mass and to stay healthy. Bodybuilders, 67.6% and weight lifters, 41.7%, used multivitamin/minerals to stay healthy and for energy. The intakes of most vitamin and minerals through diet and nutritional ergogenic aids were much greater than RDA. Vitamin B1, vitamin B2, niacin, vitamin B6 and folate intakes were ranged at 400-900%. Vitamin C intake was 1285.4% (for bodybuilders) and 1322.6% (for weight lifters). The correct answer rate of nutritional ergogenic aids was 46.0% for bodybuilders and 52.0% for weight lifters. Both bodybuilders and weight lifters took highly nutritional ergogenic aids and it tended to be taken irrespective of scientific background. Specific sport nutrition education applicable to athletes, especially strength athletes, is recommended. The findings of this investigation could be used to enable the professionals (sports dietician and physician) to identify common misconceptions regarding nutritional ergogenic aids and to implement educational programs.

Clinical Value of GRACE Score in the Prediction of Mortality in Patients with Acute Coronary Syndrome / 대한구급학회지

BACKGROUND: This study was aimed to evaluate the validity of the Global Registry of Acute Coronary Event (GRACE) in patients with acute coronary syndrome (ACS). METHODS: One thousand thirty hundred seventy eight patients (63.6+/-12.0 years, 921 male), who were admitted at coronary care unit (CCU) of Chonnam National University Hospital between January 2004 and December 2005, were analyzed. The patients were divided into two groups: the survived group (n=1,298, 871 male, 63.1+/-9.7 years) and the moribund group (n=80, 50 male, 67.4+/-8.5 years). Clinical characteristics, risk factors for atherosclerosis, echocardiographic findings, GRACE score and NT-proBNP were compared between groups. RESULTS: The overall mortality was 5.8 %, 80 out of 1,378 patients. Mortality was higher in patients with Killip IV (46.7%, 50 out of 107 patients) than Killip II or III and elderly patients more than 80 years (42.7%, 38 out of 89 patients). High Killip class and old age were associated with high mortality (p<0.0001 respectively). Total score of GRACE was elevated in the moribund group (142+/-40.3 vs. 240+/-40.0) and high GRACE score was significant predictor of mortality (p<0.0001, r=0.827). Predictive factors for mortality by multiple logistic regression analysis were GRACE score (OR 1.15, 1.11~1.20 95%CI, p<0.0001) and old age (OR 0.88, 1.14~1.33 95%CI, p<0.001). CONCLUSIONS: GRACE score is useful predictor for the mortality of ACS at CCU.

A Comparison of Nutritional Status and Muscle Strength of Elderly Women in a Social Welfare Center and Those Residing at Home / 대한지역사회영양학회지

In this study, the nutrient intakes, dietary quality, and muscle strength of elderly women in a social-welfare center of a large city were compared with those of elderly women at home in a large city. Also, the relationships between muscle strength and nutrient intake status were investigated in both elderly group. The results of this study were as follows: The ages of elderly in the social welfare center and of elderly in general home residing elderly were 68.2 and 70.3 years, respectively. The average energy and nutrient intakes of both groups were lower than the Korean RDA. There were no differences between the groups in terms of macro-nutrient composition and quantity. The elderly in center showed significantly lower intakes of vitamin B2, niacin and calcium than the home-residing elderly. The hand grip strength and back muscle strength were lower in the elderly of social welfare center, but a significant difference was found only in the left hand grip strength. The muscle strength, especially the left hand grip strength of those in social welfare center, showed significant correlations with various nutrient intakes. In contrast, generally no relationship between muscle strength and nutrients intakes status could be found in the home residing elderly. The variances in the mean hand grip strength and the left hand grip strength 19.0% and 18.6% respectively, were explained by their ages. This is in contrast to 22.3% and 32.4% of calorie intake and vegetable protein intake in the elderly of the social welfare center. In conclusion, the status of nutrient intake in those in the social welfare center seems to be low, and it is assumed that the low calorie and vegetable protein intake may contribute to the muscle strength decline in the socioeconomically high risk elderly.

The association between indicators of central obesity and bone mineral density in women

BACKGROUND: Obesity is a protective factor of osteoporosis, which is one of the important health problems in the elderly. The purpose of this study was to determine the association between indicators of central obesity and bone mineral density (BMD) in women. METHODS: Among the healthy people who visited a tertiary hospital in Pusan for health exam from January to May 1999, we selected 303 women. We measured body mass index (BMI), waist, waist to hip ratio (WHR), menopausal period, and BMD. The SPSS statistical program was used for statistical analysis and the following test used: correlation and partial correlation adjusted for age and menopausal period. RESULTS: The total subjects consisted of 162 premenopausal and 141 postmenopausal women. In all subjects, BMI and WHR were positively correlated with spinal BMDs, but after controlling for age and menopausal period, BMI (r=0.322, p<0.01) and waist (r=0.220, p<0.01) were related to spinal BMDs. In the premenopausal group, spinal BMDs were correlated with BMI, waist, but after controlling for age, they were related to BMI (r=0.270, p<0.01) and waist (r=0.193, p<0.05). In the postmenopausal group, BMI, waist, and menopausal period wrer correlated with spinal BMDs, and after controlling for age and menopausal period, BMI (r=0.365, p<0.01) and waist (r=0.251, p<0.01) remained related to spinal BMDs. In women of BMI below 25 kg/m2, spinal BMDs were correlated with waist(r=0.163, P=0.02)and not WHR. CONCLUSION: These results suggest that waist, not WHR was associated with spinal BMDs in women.

Serum lipoprotein(a) and lipid concentrations in patients with subclinical hypothyroidism

BACKGROUND: There are no agreement for abnormalities in serum lipid concentrations and lipoprotein(a)(Lp(a)) in patients with subclinical hypothyroidism. But there are no reports for consideration of postmenopausal state and hormone replacement therapy(HRT). Therefore, we analized serum Lp(a) and lipid concentrations in patients with subclinical hypothyroidism considering menopause and HRT and the correlation between serum Lp(a) level and thyroid stimulating hormone(TSH) concentration. METHODS: We undertook this study in 99 patients with subclinical hypothyroidism(TSH>5uIU/mL) and 297 age and sex matched normal control subjects. They had no abnormalities in liver and renal function, fasting blood glucose and medical and drug histories. We excluded who were recieving HRT. Serum free thyroxine, triiodothyronine , TSH were measured by radioimmune assay using commercial kits, and Lp(a), total cholesterol, TG and HDL by Latex and enzyme method, respectively. RESULTS: There were no significant differences of serum Lp(a), total cholesterol, LDL, TG, HDL concentrations in patients with subclinical hypthyroidism and control subjects, analyzing after dividing into men, premenopausal and postmenopausal women. In patiens with subclinical hypothyroidism, there was no correlation between serum Lp(a) and TSH concentraions(r=0.06, P>0.05). CONCLUSION: Considering menopause and HRT, there were no increase in serum Lp(a) and lipid concentrations in subclinical hypothyroidism. There was no correlation between serum Lp(a) and TSH concentration in patients with subclinical hypothyroidism.

Clinical Survey of 110 Cases of Optic Atrophy

1. 110 cases of optic atrophy from 7 months to 67 years old, 82 bilateral with 28 unilateral involvement observed at the National Medical Center in Korea Between 1959 and 1961 were analyzed for etiologic factors which were which were also based on a a review of literature. 2. Of the 110 cases, the largest single cause of optic atrophy af all type was brain tumor(18 cases, 16.4%) with exogenous poisoning(11 cases, 10%) second in frequency. 3. Cases of atrophy due to tuberculous meningitis(10 cases, 9.1%) were found in the age group of one to 15 years as the most frequent cause in childhood. 4. The retrobulbar neuritis was one of the most frequent causes(9 cases, 8.2%) in the adult. Also the traumatism(8 cases, 7.3%) as to the prevalent acuses of post-war blindness. 5. A characteristically low incidence of syphilis (4 cases, 3.6% without congenital syphilis) as the cause of the optic atrophy is one of the subject to be evaluated in the future.