• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.2
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• pp.50-54
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• 2018

Jehovah's Witnesses do not accept blood transfusions, because of their particular interpretation of the Old and New Testaments. When people with such religious convictions are in need of medical care, their faith and belief may become an obstacle for proper treatment, and pose legal, ethical, and medical challenges for the health care providers. We report two inherited metabolic disorder cases in South Korea where the infants died whilst under medical care because of parental refusal of blood transfusions for religious reasons. Case 1 had methylmalonic acidemia, Down syndrome and associated congenital cardiac anomalies requiring surgery. Case 2 had anemia and methylmalonic acidemia requiring dialysis to treat hyperammonemia and metabolic acidosis. For effective medical management, they needed life-saving blood transfusions. As a part of alternative treatment, Erythropoietin was administered in both cases. As a result, two babies died from their extremely low hemoglobin and hematocrit. The hemoglobin concentrations below 2.7 g/dL without cardiac problem and 5.4 g/dL with cardiac anomaly complicated by pulmonary hypertension are considered life-threatening hemoglobin threshold. The medical professional must respect and accommodate religious beliefs of the patients who can make informed decisions. However, when parents or legal guardians oppose medical treatment of their babies and incompetent care receivers on cultural and religious grounds, the duty to assist and save persons exposed to serious danger, particularly life-threatening events must come first.

• Journal of the korean veterinary medical association
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• v.15 no.1112
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• pp.559-562
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• 1979

산양에서 수혈후 적혈구과다증을 지속시킬 수 있는지 또 해당중간생산물들이 변하는 가에 관하여 연구한바 아래의 결론을 얻었다. 1. 산양의 상동적혈구는 순환혈액에서 곧 사라졌다. 이와 같은 현상은 수혈적혈구가 지속적으로 적혈구과다증을 일으킬 수 없다는 것을 시사한다. 2. 적혈구용적과 혈색소농도는 수혈후 유의성 있게 증가되었으나 해당중간생산물인 GSH 2,3-DPG 및 ATP는 유의성 있게 변하지 아니하였다.

• Journal of Veterinary Clinics
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• v.15 no.1
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• pp.193-195
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• 1998

A one-month old Holstein calf with clinical histories of diarrheal weekness and behavioural abnormality revealed clinical findings of anemia and dehydration. The red blood cells were $1.4{\times} 10^{6}/{\mu}l$ and packed red cell volume was 45%. A blood smear showed a large number of circulating Trypanosoma theileri. To treat Trypanosomiasisi the patient received once a daily oral dosage o$\ulcorner$ 10 mg/kg of the Quinidine sulfate including transfusion (200 ml) for 3 days. After 2 weeks, the calf recovered body condition. These results suggest that Administration of Quinidine sulfate in trypanosomiasis may be a useful treatment approach.

• Journal of Korea Entertainment Industry Association
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• v.13 no.8
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• pp.661-670
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• 2019

The purpose of this study was to analyze influential factors for blood transfusion for patients undergoing total knee arthroplasty and total hip arthroplasty, which are chronic degenerative arthritis, using the 2017 sample data of Health Insurance Review & Assessment Service, to research the impact of blood transfusion on the usage of medical services among arthroplasty patients, and ultimately to provide some information on how to offer quality medical services. The findings of the study were as follows: First, whether there were any significant differences in the use or nonuse of transfusion during total knee arthroplasty according to hospital characteristics and patient characteristics was compared. As for significant variables, the type of health care institution, the level of sickbed, gender and anemia were found to have been statistically significantly related. Second. whether there were any significant differences in the use or nonuse of transfusion during total hip arthroplasty according to hospital characteristics and patient characteristics was compared. As for significant variables, the type of health care institution and the level of sickbed were found to have been statistically significantly related. Third, whether there were any significant differences in the presence or absence of diabetes among the total knee arthroplasty patients according to hospital characteristics and patient characteristics was compared. As for significant variables, the type of health care institution, the number of sickbed and anemia were found to have been statistically significantly related. In the case of the total hip arthroplasty patients, there were no variables that were significantly related.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.260-267
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• 1990

During a eight month period[from December, 1988 to July, 1989], a series of 35 adults undergoing redo-valve replacement or coronary artery bypass grafting was selected to an autotransfusion group[n=10] or a control group[n=25]. The Cell Saver System[Haemonetics Corp., Graintree, Mass] was employed for autotransfusion. With this system, all blood shed in the operative field before and after cardiopulmonary bypass and remained in cardiotomy reservoir after cardiopulmonary bypass was aspirated by means of a locally heparinized collecting system. After the salvaged blood was centrifuged, the resulting red cell concentrate subsequently reinfused. The patients receiving autologous blood required significantly less banked homologous blood than their controls[3213k1020 ml and 506051931 ml, respectively: p=0.001] There were no clinical infections in the autotransfusion group, although 40% of the cultures of processed blood were positive. And there was no apparent intergroup difference of the clinical and the hematologic and hemostatic laboratory findings. We conclude that autotransfusion using cell saver is effective for saving the homologous blood transfusion in cardiac surgery.

• Journal of Trauma and Injury
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• v.26 no.4
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• pp.291-296
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• 2013

Purpose: Prolonged ventilation leads to a higher incidence of ventilator-associated pneumonia (VAP), resulting in weaning failure and increased medical costs. The aim of this study was to analyze clinical results and prognostic factors of VAP in patients with blunt chest trauma. Methods: From 2007 to 2011, one hundred patients undergoing mechanical ventilation for more than 48 hours were divided into two groups: a VAP-negative group, (32 patients, mean age; 53 years, M:F=25:7) and a VAP- positive group, (68 patients, mean age; 60 years, M:F=56:12). VAP was diagnosed using clinical symptoms, radiologic findings and microorganisms. The injury severity score (ISS), shock, combined injuries, computerized tomographic pulmonary findings, transfusion, chronic obstructive lung disease (COPD), ventilation time, stay in intensive care unit (ICU) and hospital stays, complications such as sepsis or disseminated intravascular coagulation (DIC) and microorganisms were analyzed. Chi square, t-test, Mann-Whitney U test and logistic regression analysies were used with SPSS 18 software. Results: Age, sex, ISS, shock and combined injuries showed no differences between the VAP - negative group and - positive group (p>0.05), but ventilation time, ICU and hospital stays, blood transfusion and complications such as sepsis or DIC showed significant differencies (p<0.05). Four patients(13%) showed no clinical symptoms eventhough blood cultures were positive. Regardless of VAP, mortality-related factors were shock (p=0.036), transfusion (p=0.042), COPD (p=0.029), mechanical ventilation time (p=0.011), ICU stay (p=0.032), and sepsis (p=0.000). Microorgnisms were MRSA(43%), pseudomonas(24%), acinetobacter(16%), streptococcus(9%), klebsiela(4%), staphillococus aureus(4%). However there was no difference in mortality between the two groups. Conclusion: VAP itself was not related with mortality. Consideration of mortality-related factors for VAP and its aggressive treatment play important roles in improving patient outcomes.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.240-245
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• 1988

This study was prospectively planned to realize the reduction of calcium ion in serum along with the cardiopulmonary bypass[CPB], to find out the cause of the reduction, and to verify the justification of the classical methods of calcium replacement. Nine patients with various open heart surgeries by CPB in 1987 wee selected at random. Calcium chloride was added as follows:: For each unit of ACD blood transfusion, 600mg of calcium chloride was added. In case of massive transfusion, 600 mg of calcium chloride was injected every 2 or 3 units of transfusion. On occasions such as weaning from CPB, or following defibrillation, or hypotension, weak myocardial contractility of the heart, calcium chloride was needed in an amount of 10 mg / kg. In ICU, calcium chloride was limited to use in low serum level or in emergency use. Total calcium decreased early bypass and progressively increased above the preoperative value during late bypass and three hours thereafter, Ionized calcium increased during late bypass and three hours following. Total and ionized calcium depicted similar patterns of change during open heart surgery. Decrease of the calcium at the early bypass was thought from reduction of total protein and alkalosis during bypass. Meanwhile, increase of both calciums during the end of surgery was presumably attributable to addition of calcium chloride in priming solution, injections of calcium chloride in the process of termination of bypass. We conclude that enough calcium was replaced by the classical methods of calcium supplement.

• The Korean Journal of Blood Transfusion
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• v.23 no.2
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• pp.162-168
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• 2012

Background: Potassium, the most common cation in the intracellular space, plays a critical role in our physiology. Potassium imbalance may cause life-threatening problems, ranging from general weakness to cardiac arrest due to ventricular fibrillation. For emergency physicians, detection of such derangement within a short period of time is of critical importance. In this study, we wanted to determine whether analysis of whole blood samples can be used as a screening tool for potassium imbalance by comparative analysis of whole blood and serum samples. Methods: Two samples were drawn from 227 patients. The whole blood sample was taken from the radial artery and contained in a commercially available arterial blood collection syringe with a lithium-heparin coating. The serum sample was contained in a commercially available vacuum bottle in a non-additive silicone coated tube and transported to the laboratory. The study population was divided into three groups, patients with normal whole blood potassium, patients with decreased whole blood potassium, and patients with elevated whole blood potassium. Potassium levels for each group were coupled with serum potassium levels and compared. Results: No significant difference in potassium values was observed between whole blood and serum samples (P<0.05). Strong associations were observed among the three groups (normal range, hypokalemia, and hyperkalemia group). Compared to the normal group (r=0.851), the hyperkalemia group showed a stronger association between variables (r=0.897), and the hypokalemia group showed a weaker association (r=0.760). Their correlation coefficients were highly significant (P<0.05). Conclusion: Our study illustrates that point-of-care testing using whole blood with whole blood can be a reliable screening tool when treating patients with suspicious potassium abnormality, especially in hyperkalemia patients.

• Clinical and Experimental Pediatrics
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• v.50 no.12
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• pp.1225-1230
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• 2007

Purpose : Multiple transfusions in patients with chronic anemia can result in excessive iron deposition in tissues and organs. Effective iron chelation therapy in chronically transfused patients can only be achieved when iron chelators remove sufficient amounts of iron equivalent to those accumulated in the body from transfusions, thus leading to maintain body iron load at a non-toxic level. This study was retrospectively carried out to investigate the effect of intravenous iron chelation therapy with deferoxamine in patients who have received multiple transfusions. Methods : From March 2005 to January 2007, 15 patients who have received multiple transfusions were included in this study. Transfusion dependent patients were defined as those receiving >1 packed red blood cell (RBC) units/month for at least 6 months. They received intravenous deferoxamine for 7 days (10-30 mg/kg/day, 24 hour continuous infusions). Before and after deferoxamine infusions and 3 months later, we compared serum iron, TIBC, and ferritin in transfusion dependent patients and transfusion independent patients. Results : There were 6 males and 9 females and their age range was 5.6-21.3 (median 8.3) years. Transfusion dependent patients were 7 and 8 were transfusion independent states after stem cell transplantation or chemotherapy. There was no significant change in ferritin level after deferoxamine treatment for the transfusion dependent patients but significant falling of ferritin level was observed for the transfusion independent patients 3 months later compared with baseline ferritin level (P=0.046). Some adverse events were observed but symptoms were mild and tolerable. Conclusion : Seven days of intravenous deferoxamine was safe and effective in transfusion independent patients. In transfusion dependent patients, chelation therapy should be maintained, in order to minimize or prevent iron accumulation and storage in the tissues.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.153-157
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• 2004

The aim of our study is to determine maximum surgical blood order schedule (MSBOS) in each surgical operation through analyzing usage of blood products at Bundang Jesaeng General Hospital. We investigated the amount of transfused red cells for each operation and calculated crossmatching-to-transfusion ratio (C/T ratio) and MSBOS. This was accomplished by referring to the Laboratory Information System program during 1 year from January through December 2003. Coronary artery bypass surgery and decompressive craniectomy showed the highest MSBOS in our hospital. The average C/T ratio was 3.2 and excessive reservations for blood products have been made for many operations. From this study, guidelines for the optimal blood ordering for each surgery were suggested.