• Journal of Microbiology and Biotechnology
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• 제26권6호
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• pp.1046-1056
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• 2016

RV-23 is a melittin-related antibacterial peptide (MRP) with lower cytotoxicity than either melittin or AR-23, another MRP. The aim of this study was to explore the mechanism of RV-23's antibacterial selectivity and its hemocompatibility. The results showed that all the peptides exhibited lytic activity against Staphylococcus aureus and Escherichia coli, with RV-23 showing the highest potency. Moreover, RV-23 had lower cytotoxicity than melittin or AR-23 at their minimal inhibitory concentration. In addition, CD experiments showed that melittin, RV-23, and AR-23 all had a typical α-helical structure, and RV-23 had the lowest α-helix content. The structural information showed that RV-23 has the lowest hydrophobicity and highest hydrophobic moment. Because hydrophobicity and α-helix content are believed to correlate with hemolysis, the results indicate that the selective lytic activity against bacteria of RV-23 may be due to its low hydrophobicity and α-helicity, which lead to low cytotoxicity without affecting antibacterial activity. Furthermore, RV-23 did not affect the structure and function of blood components such as red blood cells, platelets, albumin, and the blood coagulation system. In conclusion, RV-23 is a cell-selective antibacterial peptide with high hemocompatibility due to its unique structure.

• Journal of Korean Neurosurgical Society
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• 제60권1호
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• pp.75-81
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• 2017

Objective : Spinal deformity surgery has the potential risk of massive blood loss. To reduce surgical bleeding, the use of tranexamic acid (TXA) became popular in spinal surgery, recently. The purpose of this study was to determine the effectiveness of intra-operative TXA use to reduce surgical bleeding and transfusion requirements in spinal deformity surgery. Methods : A total of 132 consecutive patients undergoing multi-level posterior spinal segmental instrumented fusion (${\geq}5$ levels) were analyzed retrospectively. Primary outcome measures included intraoperative estimated blood loss (EBL), transfusion amount and rate of transfusion. Secondary outcome measures included postoperative transfusion amount, rate of transfusion, and complications associated with TXA or allogeneic blood transfusions. Results : The number of patients was 89 in TXA group and 43 in non-TXA group. There were no significant differences in demographic or surgical traits between the groups except hypertension. The EBL was significantly lower in TXA group than non-TXA group (841 vs. 1336 mL, p=0.002). TXA group also showed less intra-operative and postoperative transfusion requirements (544 vs. 812 mL, p=0.012; 193 vs. 359 mL, p=0.034). Based on multiple regression analysis, TXA use could reduce surgical bleeding by 371 mL (37 % of mean EBL). Complication rate was not different between the groups. Conclusion : TXA use can effectively reduce the amount of intra-operative bleeding and transfusion requirements in spinal deformity surgery. Future randomized controlled study could confirm the routine use of TXA in major spinal surgery.

• International journal of advanced smart convergence
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• 제9권4호
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• pp.8-15
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• 2020

This study was conducted in order to determine the effect of intraoperative hemoglobin changes on intraoperative neuromonitoring (IONM). This was a retrospective study that included 339 participants who underwent cerebrovascular surgery. We compared anesthetic agents, intraoperative hemoglobin, hematocrit, blood transfusion, and blood loss. We examined motor evoked potential and sensory evoked potential to patients. There were significant differences in hemoglobin changes, bleeding levels, transfusion, anesthesia time, and postoperative mobility disorders. Moreover, compared with patients who received transfusions, those who did not receive transfusion had a lower average hemoglobin level, as well as a higher bleeding amount, and a need of higher anesthesia time and anesthetic dose. Also, we found vasospasm occurred while surgery can bring adverse results after operation. This study showed that an intraoperative decrease in hemoglobin levels affects the function of cerebral perfusion, which could result in abnormal nerve monitoring results. However, as this study could not find a relation of anesthetics to IONM, there is a need for further research regarding the association between anesthetics and hemoglobin changes and IONM.

• 산업공학
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• 제10권1호
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• pp.119-134
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• 1997

The management of blood inventory is very important within the medical care system. The efficient management of blood supplies and demands for transfusions is of great economic and social importance to both hospitals and patients. For any blood type, there is a complex interaction among the optimal inventory level, daily demand level, daily supply level, transfusion to crossmatch ratio, crossmatch release period, issuing policy and the age of arriving units that determine the shortage and outdate rate. In this paper, we develop an efficient decision rule for blood inventory management in a hospital blood bank which can support efficient hospital blood inventory management using simulation. The primary use of the efficient decision rule will be to establish minimum cost function which consists of inventory levels, period in inventory, outdate and shortage rate for whole blood and various component inventories for a hospital blood bank or a transfusion service. If the administrator compute the mean daily demand for each blood type, the mean daily supply for each blood type, the length of the crossmatch release period and the average transfusion to crossmatch ratio, then it is possible to apply the efficient decision rule to compute the optimal inventory level, inventory period, outdate and shortage rate. This rule can also be used as a decision support system that allows the blood bank administrator to do sensitivity analysis related to controllable blood inventory parameters.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.8009-8013
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• 2015

Background: Orthotopic organ transplantation, a treatment option for irreversible organ dysfunction according to organ failure, severe damaged organ or malignancy in situ, was usually accompanied with massive blood loss thus transfusion was required. We aimed to evaluate the adverse impact of blood transfusion on solid organ transplantation. Materials and Methods: From January, 2009 to December, 2014, patients who received orthotopic organ transplantation at Far Eastern Memorial Hospital medical center were enrolled. Clinical data regarding anemia status and red blood cell (RBC) transfusion before, during and after operation, as well as patient outcomes were collected for further univariate analysis. Results: A total of 105 patients who underwent orthotopic transplantation, including liver, kidney and small intestine were registered. The mean hemoglobin (Hb) level upon admission and before operation were $11.6{\pm}1.8g/dL$ and $11.7{\pm}1.7g/dL$, respectively; and the nadir Hb level post operation and the final Hb level before discharge were $8.3{\pm}1.6g/dL$ and $10.2{\pm}1.6g/dL$, respectively. The median units (interquartile range) of RBC transfusion in pre-operative, peri-operative and post-operative periods were 0 (0-0), 2 (0-12), and 2 (0-6) units, respectively. Furthermore, the median (interquartile range) length of hospital stay (LHS) from admission to discharge and from operation to discharge were 28 (17-44) and 24 (16-37) days, respectively. Both peri-operative and post-operative RBC transfusion were associated with longer LHS from admission to discharge and from operation to discharge. Furthermore, it increased the risk of post-operative septicemia. While peri-operative RBC transfusion elevated the risk of acute graft rejection in patients who received orthotopic transplantation. Conclusions: Worse outcome could be anticipated in those who had received massive RBC transfusion in transplantation operation. Hence, peri-operative RBC transfusion should be avoided as much as possible.

• 한국산학기술학회논문지
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• 제16권6호
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• pp.4031-4039
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• 2015

저출산 고령화로 헌혈인구는 감소하고, 노년층의 혈액사용량은 증가할 것으로 예상되어 혈액부족과 수혈의 안정성 문제가 대두되고 있다. 이에 본 연구에서는 만성 퇴행성관절염인 슬관절과 고관절 전치환술 환자의 수혈에 영향을 주는 요인을 분석하고자 하였다. 이를 위해 건강보험심사평가원의 2011년 환자표본자료 중 입원환자 5,370명을 대상으로 하였으며, SPSS 20 프로그램을 이용하여 로지스틱 회귀분석을 실시하였다. 독립변수로 사용된 변수는 병원특성과 환자특성으로 병원특성은 의료기관 종류, 설립구분, 기관소재지와 가동병상수를, 환자특성으로는 성, 연령, 중증도, 전신마취유무, 주 진단, 빈혈유무와 의료보험종류로 구분하였다. 분석결과, 슬관절전치환술 환자의 수혈에 유의한 영향을 미치는 변수로는 의료기관 종류, 기관소재지, 성, 연령, 중증도, 주 진단, 빈혈유무였으며, 고관절전치환술 환자의 수혈에 유의한 영향을 주는 변수로는 의료기관 종류, 기관소재지, 성, 연령, 중증도, 전신마취유무, 빈혈유무였다. 수혈현황과 영향요인을 분석한 본 연구는 비용 효과적이며, 양질의 의료를 위한 기초자료로 활용될 수 있을 것으로 기대한다.

• 대한임상검사과학회지
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• 제49권4호
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• pp.495-497
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• 2017

Thalassemia major is a genetic disorder with a defective synthesis of either the alpha or the beta chain of hemoglobin A. Blood transfusion is crucial for the survival in these patients. Unfortunately, endocrine dysfunction is a very common complication in these patients and is principally due to excessive iron overload as a result of frequent blood transfusions. Although regular blood transfusion may increase life expectancy, disturbances in growth and pubertal development, abnormal gonadal functions, impaired thyroid, parathyroid and adrenal functions, diabetes, and disorderly bone growth are common side effects. We hereby present a case of a 23-year-old, unmarried woman with beta thalassemia major presenting with primary amenorrhea, poor development of secondary sexual character, and short stature. Thorough history, clinical examination, and laboratory investigation, including dynamic function test (insulin tolerance test) were conducted. These tests confirmed that she had multiple endocrinopathies, including hypogonadotropic hypogonadism, growth hormone deficiency, and subclinical adrenal insufficiency, which were caused by iron overload. She required hormone replacement therapy. Early recognition of possible deficiencies in hypothalamo-pituitary-end organ hormones caused by iron overload in thalassemia patients that undergo frequent blood transfusion procedures is essential. Appropriate treatments, including transfusion regimen and chelation therapy, as well as specific treatment of each complication are the crucial for the successful management and improvement of quality of life these patients.

• 한국동물위생학회지
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• 제41권4호
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• pp.271-276
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• 2018

This study was conducted to investigate the prevalence of dog erythrocyte antigen (DEA) 1 with DEA 1.1 and DEA 1.2 on 122 Jindo dogs (29 males, 93 females) from 2014 to 2015 using a monoclonal antibody card kit (blood typing card kit, Korea Animal Blood Bank Inc., South Korea). Among the tested dogs, 14.8% (18/122) were positive for the DEA 1.1 antigen and 85.2% (104/122) were positive for the DEA 1.2 antigen. The prevalence of positive types for the DEA 1.2 antigen was significantly higher than the DEA 1.1 antigen (P<0.01). The prevalence of positive types for the DEA 1.1 antigen was higher in white-haired Jindo dogs than yellow-haired dogs (P<0.05). However, there was no gender difference in the prevalence of the DEA 1.1 antigen (P=0.665). The incidence of sensitization after the first transfusion without blood group test was 12.6% and the incidence of acute hemolytic transfusion reaction after the second transfusion in the same immunized dogs was 1.6%. Therefore, the blood group test for the DEA 1 antigen should be performed for Jindo dogs to ensure safe and effective transfusion therapy and further studies remain to be conducted for other DEAs among Jindo dogs.

• 대한수혈학회지
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• 제29권3호
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• pp.291-300
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• 2018

배경: 적혈구를 폐쇄계에서 동결하고 세척하는 경우 동결해동적혈구의 보존기간을 24시간 이상으로 연장할 수 있다. 본 연구에서는 고농도글리세롤법과 자동화 장비인 Haemonetics ACP 215를 이용한 폐쇄계에서 적혈구의 동결과 세척과정을 평가하였다. 방법: ACP 215를 이용하여 35단위의 적혈구에 글리세롤을 최종농도가 40% (wt/vol)가 되도록 첨가하고 30단위는 즉시 동결하였으며, 나머지 5단위는 잔여 글리세롤을 제거한 다음 동결하였다. 동결한 적혈구는 $-80^{\circ}C$에 보관 후 해동 세척하여 SAG-M 보존액에 부유하고, $4^{\circ}C$에서 보존하면서 안정성 및 품질관리 지표를 분석하였다. 결과: 잔여 글리세롤을 제거하지 않은 동결적 혈구는 잔여 글리세롤을 제거한 동결해동적혈구에 비해 해동 후 보존기간 동안 칼륨 유출이 현저히 낮게 나타났다. 잔여 글리세롤을 제거하지 않은 동결해동적혈구를 해동 후 $4^{\circ}C$에서 7일간 보존하는 동안 측정한 모든 안정성 및 품질지표는 AABB와 유럽연합의 기준에 모두 적합하였다. 결론: ACP 215를 사용하여 동결 전 잔여 글리세롤을 제거하지 않고 바로 적혈구를 동결하는 방법은 동결보존과정이 단순하고 동결해동적혈구의 안정성이 향상되어 향후 수혈을 위한 동결적혈구에 현실적으로 적용가능성이 높은 것으로 생각된다.

• 대한임상독성학회지
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• 제6권1호
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• pp.37-41
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• 2008

Methemoglobinemia can be caused by dapsone toxicity. We report a case dapsone induced methemoglobinemia unresponsive to methylene blue successfully treated by exchange transfusion. A 52-year-old male ingested a handful of dapsone. He presented with severe peripheral cyanosis in lips and fingertips and his methemoglobin level was found to be 21.9%. After admission, methylene blue (1%) at 1 mg/kg was injected each time peripheral cyanosis and rising serum methemoglobin occurred. Despite methylene blue therapy, the patient‘s methemoglobin level continued to fluctuate. Five days after the injections of methylene blue, many Heinz bodies were visualized in the peripheral blood, suggestive of hemolytic anemia occurrence. By hospital day 6, serum methemoglobine levels were elevated and not measurable (> 50%) and the patient was constantly in a semi-comatose mental state. An exchange transfusion carried out by utilizing 6 units of packed red blood cells and 4 units of fresh frozen plasma was performed. The patient's methemoglobin levels were subsequently kept up below 20% and his peripheral cyanosis receded. Physicians should recognize the important role of exchange transfusion in refractory dapsoneinduced methemoglobinemia.