RESUMEN
Lifelong learning is a key element of the conceptual framework of active aging. To understand how older adults experience active aging through participation in lifelong learning, the authors conducted a qualitative case study. The research participants were older adult learners attending evening schools aiming to pass the equivalency examination. Data were collected primarily using semi-structured interviews with five older adult learners, and additional data were collected from relevant documents. Data analysis and thematic discussion provided insights into how older adults experience active aging by participating in lifelong learning. Data analysis identified themes of overcoming limited education, taking the equivalency examination, and evolving goals. Thematic discussion revealed that older adults began learning to meet deficiency needs; however, they developed their goals after attending evening schools and passing the equivalency examination. In addition, lifelong learning is an indispensable element of active aging not only because learning is good for older adults' wellbeing, as reported in the literature, but also because older adults become more active in the systemic change of their environment and in the setting goals for their lives.
Asunto(s)
Envejecimiento , Aprendizaje , Anciano , Humanos , Investigación Cualitativa , República de Corea , Instituciones AcadémicasAsunto(s)
Leucemia Mieloide Aguda/diagnóstico , Neoplasias Primarias Secundarias/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras B/diagnóstico , Neoplasias de la Mama , Linaje de la Célula , Evolución Clonal , Progresión de la Enfermedad , Humanos , Neoplasias Primarias Secundarias/etiología , Leucemia-Linfoma Linfoblástico de Células Precursoras B/etiologíaRESUMEN
Mercury (Hg) has obesogenic properties. However, the associated health outcomes of population-level mercury exposure were unclear. This study investigated the relationships between blood mercury levels and obesity-related outcomes such as hyperlipidemia and elevated liver enzymes. Using the second cycle of the Korean National Environmental Health Survey (n = 6454), we performed logistic regression to examine the effects of Hg on hyperlipidemia and elevated liver enzymes. The blood mercury levels were significantly higher in the hyperlipidemia group (n = 3699, male: 4.03 µg/L, female: 2.83 µg/L) compared to the non-hyperlipidemia group (n = 2755, male: 3.48 µg/L, female: 2.69 µg/L), and high blood mercury levels were associated with an 11% higher risk of hyperlipidemia. The elevated liver enzymes group had higher mean blood mercury levels (n = 1189, male: 4.38 µg/L, female: 3.25 µg/L) than the normal group (n = 5265, male: 3.64 µg/L, female: 2.70 µg/L), and elevated blood mercury was associated with a 35% higher risk of elevated liver enzymes. Moreover, the effect was constant after adjusting for personal medications. These results indicate that mercury exposure is significantly associated with hyperlipidemia and elevated liver enzymes.
Asunto(s)
Leucemia Mielógena Crónica BCR-ABL Positiva/diagnóstico , Leucemia-Linfoma Linfoblástico de Células T Precursoras/terapia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Proteínas de Fusión bcr-abl/genética , Humanos , Cariotipo , Leucemia Mielógena Crónica BCR-ABL Positiva/etiología , Masculino , Leucemia-Linfoma Linfoblástico de Células T Precursoras/tratamiento farmacológico , Recurrencia , Trasplante de Células Madre/efectos adversos , Trasplante AutólogoRESUMEN
[This corrects the article DOI: 10.1371/journal.pone.0179986.].
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Mieloma Múltiple/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Médula Ósea/metabolismo , Médula Ósea/patología , Diferenciación Celular , Quimiocina CCL3/metabolismo , Diagnóstico Diferencial , Femenino , Glicoproteínas/sangre , Glicoproteínas/orina , Humanos , Hiperparatiroidismo/diagnóstico , Persona de Mediana Edad , Mieloma Múltiple/tratamiento farmacológico , Osteoclastos/citología , Osteoclastos/metabolismo , Tomografía Computarizada por Rayos XRESUMEN
The 2016 WHO diagnostic criteria for chronic myelomonocytic leukemia (CMML) require both absolute and relative monocytosis (≥1×109/L and ≥10% of white blood cell counts) in peripheral blood. Moreover, myeloproliferative neoplasm (MPN) features in bone marrow and/or MPN-associated mutations tend to support MPN with monocytosis rather than CMML. We assessed the impact of the 2016 WHO criteria on CMML diagnosis, compared with the 2008 WHO criteria, through a retrospective review of the medical records of 38 CMML patients diagnosed according to the 2008 WHO classification. Application of the 2016 WHO criteria resulted in the exclusion of three (8%) patients who did not fulfill the relative monocytosis criterion and eight (21%) patients with an MPN-associated mutation. These 11 patients formed the 2016 WHO others group; the remaining 27 formed the 2016 WHO CMML group. The significant difference in the platelet count and monocyte percentage between the two groups indicated that the 2016 WHO criteria lead to a more homogenous and improved definition of CMML compared with the 2008 WHO criteria, which may have led to over-diagnosis of CMML. More widespread use of molecular tests and more sophisticated clinical and morphological evaluations are necessary to diagnose CMML accurately.
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Leucemia Mielomonocítica Crónica/diagnóstico , Anciano , Femenino , Humanos , Janus Quinasa 2/genética , Leucemia Mielomonocítica Crónica/clasificación , Masculino , Persona de Mediana Edad , Monocitos/citología , Mutación , Trastornos Mieloproliferativos/diagnóstico , Trastornos Mieloproliferativos/genética , Recuento de Plaquetas , Estudios Retrospectivos , Trisomía , Organización Mundial de la SaludRESUMEN
Mobilization of hematopoietic stem cells (HSCs) from the bone marrow to the peripheral blood is a complex mechanism that involves adhesive and chemotactic interactions of HSCs as well as their bone marrow microenvironment. In addition to a number of non-genetic factors, genetic susceptibilities also contribute to the mobilization outcome. Identification of genetic factors associated with HSC yield is important to better understand the mechanism behind HSC mobilization. In the present study, we enrolled 148 Korean participants (56 healthy donors and 92 patients) undergoing HSC mobilization for allogeneic or autologous HSC transplantation. Among a total of 53 polymorphisms in 33 candidate genes, one polymorphism (rs11264422) in relaxin/insulin-like family peptide receptor 4 (RXFP4) gene was significantly associated with a higher HSC yield after mobilization in Koreans. However, in a set of 101 Europeans, no association was found between circulating CD34+ cell counts and rs11264422 genotype. Therefore, we suggest that the ethnic differences in subjects' genetic background may be related to HSC mobilization. In conclusion, the relaxin-relaxin receptor axis may play an important role in HSC mobilization. We believe that the results of the current study could provide new insights for therapies that use relaxin and HSC populations, as well as a better understanding of HSC regulation and mobilization at the molecular level.
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Movilización de Célula Madre Hematopoyética , Trasplante de Células Madre Hematopoyéticas , Polimorfismo de Nucleótido Simple , Receptores Acoplados a Proteínas G/genética , Receptores de Péptidos/genética , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Optimal timing of apheresis initiation is important for maximizing the hematopoietic stem cell (HSC) yield. This study aimed to identify useful parameters from automatic hematology analyzers for predicting the peripheral blood CD34+ cell count after mobilization. We prospectively enrolled 53 healthy donors and 72 patients, and evaluated 43 cell morphology parameters from Unicel DxH800 (Beckman Coulter, USA) and Advia 2120i (Siemens Healthcare Diagnostics, USA). The correlation of each parameter with the CD34+ cell count in pre-apheresis blood samples was analyzed. The delta neutrophil index (DNI) from Advia 2120i, standard deviation of volume of neutrophils and monocytes (SD-V-NE and SD-V-MO), standard deviation of conductivity of neutrophils and monocytes (SD-C-NE and SD-C-MO), mean conductivity of neutrophils and monocytes (MN-C-NE and MN-C-MO), and standard deviation of axial light loss of neutrophils and monocytes (SD-AL2-NE and SD-AL2-MO) from DxH800 showed significant correlations with the CD34+ cell count. SD-V-NE, SD-C-NE, and SD-C-MO showed good or fair area under the curve values for the prediction of the CD34+ cell count. SD-V-NE, SD-C-NE, and SD-C-MO from DxH800 will provide rapid, useful information for the initiation of apheresis after mobilization.
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Antígenos CD34/sangre , Neoplasias Hematológicas/sangre , Neoplasias Hematológicas/terapia , Movilización de Célula Madre Hematopoyética , Células Madre Hematopoyéticas , Adulto , Área Bajo la Curva , Eliminación de Componentes Sanguíneos , Recuento de Células , Forma de la Célula , Femenino , Neoplasias Hematológicas/patología , Trasplante de Células Madre Hematopoyéticas , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Curva ROCAsunto(s)
Proteínas de Fusión bcr-abl/genética , Leucemia/diagnóstico , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Células de la Médula Ósea/citología , Células de la Médula Ósea/patología , Femenino , Citometría de Flujo , Factor Estimulante de Colonias de Granulocitos/uso terapéutico , Humanos , Inmunofenotipificación , Leucemia/etiología , Fenotipo , Rituximab/administración & dosificaciónRESUMEN
PURPOSE: The objective of this prospective study was to evaluate the relationship between the circulating lymphocyte subpopulation counts during preoperative chemoradiotherapy (CRT) and tumor response in locally advanced rectal cancer. MATERIALS AND METHODS: From August 2015 to June 2016, 10 patients treated with preoperative CRT followed by surgery were enrolled. Patients received conventional fractionated radiotherapy (50.4 Gy) with fluorouracil-based chemotherapy. Surgical resection was performed at 4 to 8 weeks after the completion of preoperative CRT. The absolute blood lymphocyte subpopulation was obtained prior to and after 4 weeks of CRT. We analyzed the association between a tumor response and change in the lymphocyte subpopulation during CRT. RESULTS: Among 10 patients, 2 (20%) had evidence of pathologic complete response. In 8 patients with clinically node positive, 4 (50%) had nodal tumor response. All lymphocyte subpopulation counts at 4 weeks after CRT were significantly lower than those observed during pretreatment (p < 0.01). A high decrease in natural killer (NK) cell, count during CRT (baseline cell count - cell count at 4 weeks) was associated with node down staging (p = 0.034). CONCLUSION: Our results suggest that the change of lymphocyte subset to preoperative CRT may be a predictive factor for tumor response in rectal cancer.
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Proteínas de Fusión bcr-abl/genética , Leucemia Mieloide Aguda/genética , Proteínas Nucleares/genética , Tirosina Quinasa 3 Similar a fms/genética , Anciano , Secuencia de Bases , Médula Ósea/metabolismo , Médula Ósea/patología , Análisis Mutacional de ADN , Femenino , Duplicación de Gen , Humanos , Hibridación Fluorescente in Situ , Leucemia Mieloide Aguda/diagnóstico , Reacción en Cadena de la Polimerasa Multiplex , Mutación , Nucleofosmina , Cromosoma FiladelfiaAsunto(s)
Leucemia Mielógena Crónica BCR-ABL Positiva/diagnóstico , Mieloma Múltiple/diagnóstico , Anciano , Antineoplásicos/uso terapéutico , Médula Ósea/patología , Proteínas de Fusión bcr-abl/genética , Proteínas de Fusión bcr-abl/metabolismo , Humanos , Mesilato de Imatinib/uso terapéutico , Leucemia Mielógena Crónica BCR-ABL Positiva/complicaciones , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Recuento de Leucocitos , Masculino , Mieloma Múltiple/complicaciones , Mieloma Múltiple/tratamiento farmacológico , Recuento de Plaquetas , Reacción en Cadena de la Polimerasa , Trombocitosis/etiologíaAsunto(s)
Células de la Médula Ósea/patología , Leucemia Mieloide/patología , Leucemia Promielocítica Aguda/patología , Síndromes Mielodisplásicos/patología , Enfermedad Aguda , Adulto , Células de la Médula Ósea/metabolismo , Aberraciones Cromosómicas , Diagnóstico Diferencial , Femenino , Humanos , Hibridación Fluorescente in Situ , Cuerpos de Inclusión/metabolismo , Leucemia Mieloide/genética , Leucemia Mieloide/metabolismo , Leucemia Promielocítica Aguda/genética , Leucemia Promielocítica Aguda/metabolismo , Síndromes Mielodisplásicos/genética , Síndromes Mielodisplásicos/metabolismo , Proteínas de Fusión Oncogénica/genética , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
CONTEXT: The Samsung LABGEO(HC10) Hematology Analyzer (LABGEO(HC10)) is a recently developed automated hematology analyzer that uses impedance technologies. The analyzer provides 18 parameters including 3-part differential at a maximum rate of 80 samples per hour. OBJECTIVE: To evaluate the performance of the LABGEO(HC10). DESIGN: We evaluated precision, linearity, carryover, and relationship for complete blood cell count parameters between the LABGEO(HC10) and the LH780 (Beckman Coulter Inc) in a university hospital in Korea according to the Clinical and Laboratory Standards Institute guidelines. Sample stability and differences due to the anticoagulant used (K2EDTA versus K3EDTA) were also evaluated. RESULTS: The LABGEO(HC10) showed linearity over a wide range and minimal carryover (<1%) for white blood cell, hemoglobin, red blood cell, and platelet parameters. Correlation between the LABGEO(HC10) and the LH780 was good for all complete blood cell count parameters (R > 0.92) except for mean corpuscular hemoglobin concentration. The bias estimated was acceptable for all parameters investigated except for monocyte count. Most parameters were stable until 24 hours both at room temperature and at 4°C. The difference by anticoagulant type was statistically insignificant for all parameters except for a few red cell parameters. CONCLUSIONS: The accurate results achievable and simplicity of operation make the unit recommendable for small to medium-sized laboratories.
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Pruebas Hematológicas/instrumentación , Anticoagulantes/farmacología , Automatización de Laboratorios , Recuento de Células Sanguíneas/instrumentación , Plaquetas/citología , Plaquetas/efectos de los fármacos , Plaquetas/metabolismo , Plaquetas/patología , Ácido Edético/farmacología , Impedancia Eléctrica , Eritrocitos/citología , Eritrocitos/efectos de los fármacos , Eritrocitos/metabolismo , Eritrocitos/patología , Pruebas Hematológicas/normas , Hemoglobinas/análisis , Hospitales Universitarios , Humanos , Ensayo de Materiales , Guías de Práctica Clínica como Asunto , Reproducibilidad de los Resultados , República de Corea , Factores de TiempoRESUMEN
Blasts showing hemophagocytosis have been very rarely reported in acute lymphoblastic leukemia. We report a pediatric case of B lymphoblastic leukemia (BLL) with t(12;21)(p13;q22); TEL-AML1 (ETV6-RUNX1) showing erythrophagocytosis and thrombophagocytosis by leukemic blasts. About 4% of the leukemic blasts in marrow aspirate smears showed phagocytosis of erythrocytes, platelets, or nuclear remnants in a 3-year-old Korean boy with a diagnosis of BLL. Conventional cytogenetics and molecular analysis revealed the presence of t(12;21)(p13;q22); TEL-AML1 (ETV6-RUNX1). The patient responded well to chemotherapy and is in a state of complete remission.
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Cromosomas Humanos Par 12/genética , Cromosomas Humanos Par 13/genética , Subunidad alfa 2 del Factor de Unión al Sitio Principal/genética , Células Progenitoras Mieloides/fisiología , Proteínas de Fusión Oncogénica/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/patología , Translocación Genética/genética , Preescolar , Análisis Citogenético , Eritrocitos/fisiología , Humanos , Inmunofenotipificación , Masculino , Fagocitosis/fisiología , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , República de CoreaRESUMEN
BACKGROUND: Acute promyelocytic leukemia (APL) can be life threatening, necessitating emergency therapy with prompt diagnosis by morphologic findings, immunophenotyping, cytogenetic analysis, or molecular studies. This study aimed to assess the current routine practices in APL and the clinico-pathologic features of APL. METHODS: We reviewed the medical records of 48 Korean patients (25 men, 23 women; median age, 51 (20-80) years) diagnosed with APL in 5 university hospitals between March 2007 and February 2012. RESULTS: The WBC count at diagnosis and platelet count varied from 0.4 to 81.0 (median 2.0)×10(9)/L and 2.7 to 124.0 (median 54.5)×10(9)/L, respectively. The median values for prothrombin time and activated partial thromboplastin time were 14.7 (11.3-44.1) s and 29 (24-62) s, respectively. All but 2 patients (96%) showed a fibrin/fibrinogen degradation product value of >20 µg/mL. The D-dimer median value was 5,000 (686-55,630) ng/mL. The t(15;17)(q22;q12 and PML-RARA fusion was found in all patients by chromosome analysis and/or multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), with turnaround times of 8 (2-19) d and 7 (2-13) d, respectively. All patients received induction chemotherapy: all-trans retinoic acid (ATRA) alone (N=11, 26%), ATRA+idarubicin (N=25, 58%), ATRA+cytarabine (N=3, 7%), ATRA+idarubicin+cytarabine (N=4, 9%). CONCLUSION: Since APL is a medical emergency and an accurate diagnosis is a prerequisite for prompt treatment, laboratory support to implement faster diagnostic tools to confirm the presence of PML-RARA is required.