• Journal of Medicine and Life Science
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• 제20권4호
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• pp.172-177
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• 2023

This study assessed risk factors for blood transfusion after Cesarean section in patients with partial placenta previa. We retrospectively reviewed the medical records of 149 patients who underwent Cesarean sections for partial placenta previa between January 2010 and October 2021. Clinical characteristics were compared between the two groups: the blood transfusion group (n=22), defined as patients who received a blood transfusion during surgery or within 24 hours after surgery, and the non-blood transfusion group (n=127), which included other patients. Multivariable logistic regression analysis identified two risk factors independently associated with blood transfusion: antenatal hemorrhage (adjusted odds ratio [aOR], 16.283; 95% confidence interval [CI], 4.405-60.190; P<0.001) and preoperative hemoglobin (g/dL) (aOR, 0.427; 95% CI, 0.246-0.739; P=0.002). Thus, patients who are at risk for these two factors should be carefully managed with sufficient preparation for blood transfusion and anesthetic management.

• 대한임상검사과학회지
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• 제36권2호
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• pp.158-162
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• 2004

The over-preparation of blood for elective surgery causes some problems such as returning of blood, inefficient task and loss of reagents. In recent blood transfusion practice, there has been changing patterns of blood use in elective surgery as various side effects of transfusion have become known and operation techniques are developed. This study was performed to evaluate the optimal utilization of blood for various elective and/or emergency surgery. We surveyed the quantity of blood transmitted to wards, returned to blood bank, and the number of crossmatching test done for the elective surgery of the patients at the D. University Hospital, the tertiary teaching hospital from August 1, 2001 to October 31, 2001. Crossmatched to transfusion ratio (C/T ratio) was calculated, in which C means the unit of accomplished crossmatching test and T means the unit of transfused blood component. The unit of transfused blood was analysed in terms of issuing time, sex, age, clinical department, and blood component type. The usage of bloods for the emergency surgery was also analyzed. In our study, C/T ratio was highest on Monday (1.54) and Tuesday (1.53), and higher in female patients(1.54) than in male patients (1.32). No significant relationship was observed between age groups. Among clinical departments, thoracic and cardiovascular surgery showed the highest C/T ratio (1.54). From above results, we could be sure that the management of transfusion practice was relatively appropriate in recent years, although the entire introduction of type and screen (T&S) method was desirable. If the T&S method is performed, the C/T ratio would be almost 1.00 and it would also relieve the duty of blood bank.

• 대한임상검사과학회지
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• 제54권1호
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• pp.73-77
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• 2022

혈액제제(BPs)는 한정적인 자원이다. 혈액제제는 가장 적절하게 사용되어야 하지만 근거 기반 없이 무분별하게 사용되고 있는 것이 사실이다. 본 연구는 헤모글로빈 수치를 기준으로 혈액제제의 사용 적절성을 평가하는 것을 목적으로 하였다. 2020년 11월 1일부터 2021년 10월 31일까지 병원에서 수행된 혈액 공급 데이터는 병원의 디지털 종합의료정보시스템을 활용하였다. 총 제공 건수는 21,303건이었고, 진료과별로 사용하는 농축적혈구제제의 공급 중 헤모글로빈 수치(>7.0 g/dL)의 경우는 1,173건으로 나타났다. 수혈의 오남용은 사회적 비용을 증가시키고, 수혈의 적절성은 더욱 중요해지고 있어, 각 의료기관은 수혈지침 평가지표를 검토하고, 수혈지침의 혈액제제 방출 현황 및 수혈지침의 교육프로그램을 점검하여 적절성을 평가해야 할 것으로 사료된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권4호
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• pp.276-280
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• 2016

Dieulafoy lesions, vascular anomalies typically found along the gastrointestinal tract, have been viewed as rare and obscure causes of sudden intestinal bleeding, especially in pediatric patients. Since their discovery in the late 19th century, the reported incidence has increased. This is due to an increased awareness of, and knowledge about, their presentation and to advanced endoscopic diagnosis and therapy. Our patient was a three-year-old male, without a complex medical history. He presented to the emergency department with acute hematemesis with blood clots and acute anemia requiring blood transfusion. Endoscopy revealed four isolated Dieulafoy lesions along the lesser curvature of the stomach, which were treated with an epinephrine injection. The Dieulafoy lesion, although thought to be rare, should be considered when investigating an acute gastrointestinal bleed. These lesions have been successfully treated endoscopically. Appropriate anticipation and preparation for diagnosis and therapy can lead to optimal outcomes for the pediatric patient.

• Journal of Yeungnam Medical Science
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• 제6권1호
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• pp.185-195
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• 1989

Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon hematologic disease characterized by an abnormal sensitivity of blood cells to the lytic action of serum complement. We experienced one case of PNH in Yeungnam University Hospital from May 1983 to May 1989. The patients was followed up without severe complications for 4 years since diagnosis with the only consevating treatments such as washed blood transfusion, adrenal corticosteroids, androgens, folate and iron preparation, intermittently.

• 한국간호교육학회지
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• 제13권1호
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• pp.82-89
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• 2007

Purpose: The purpose of this study was to develop and evaluate an e-Learning Program designed to enhance novice nurses's performance ability Method: The e-Learning program was designed for novice nurses before beginning to work in a hospital using a KMS(Knowledge Management System). This study was carried out from February 2006 to April 2007. The program had progressive steps including design, pilot test & modification, contents development, program application and evaluation. After the program design and pilot testing, the learner's satisfaction was analyzed. Result: The program site is http://kms.emc.ac.kr titled, 'Cyber Education Center'. The sixteen part course has been developed as follows: blood sugar test, skin test, insulin test 1, insulin test 2, blood culture, blood sampling, heat therapy, cold therapy, glycerin enema, preparation of operation, oxygen therapy, suction technique, transfusion, foley catheterization and aseptic technique. The overall learner's satisfaction score was 4.08 out of 5 points. Conclusion: E-Learning could be useful for education and nursing work. This method may be effective for clinical nurses.

• 대한임상검사과학회지
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• 제50권3호
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• pp.354-358
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• 2018

수혈 준비 시 비예기 항체 선별검사를 통한 항체의 유무와 그 종류를 아는 것은 매우 중요하다. DiaMed-ID시스템을 이용하여 대전지역 일개 대학병원에 2016년 1월부터 2017년 12월까지 2년 동안 의뢰된 비예기 항체 선별검사 양성자 중에서 항체동정은 55명에서만 되었고 주로 여성에서 자주 동정되었다. Rh 36예(65.5%), Lewis 7예(12.7%), Kidd 4예(7.3%), Duffy 4예(7.3%), MNSs 3예(5.5%), Rh+Kidd 복합 1예(1.8%)가 동정되었는데, Rh 계열은 Anti-E 19예(34.5%), Anti-E/-c 4예(7.3%), Anti-C/-e 4예(7.3%), $Anti-E/-c/-Jk^b$ 1예(1.8%)가, Lewis 계열은 $Anti-Le^a$ 3예(5.5%), $Anti-Le^b$ 3예(5.5%), Kidd 계열은 $Anti-Jk^a$ 1예(1.8%), $Anti-Jk^b$ 3예(5.5%)가 동정되었다. Duffy와 MNSs 계열은 각각 $Anti-Fy^a$ 1예(1.8%), $Anti-Fy^b$ 3예(5.5%), Anti-M 2예(3.6%), Anti-S 1예(1.8%)가 동정되었다. 최근 대전의 비예기 항체 빈도와 분포가 반영된 이 연구는 효율적인 수혈준비에 도움이 될 것이다.

• Journal of Preventive Medicine and Public Health
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• 제21권1호
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• pp.195-206
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• 1988

Two major issues of the blood bank management are quality assurance and inventory control. Recently, in Korea blood donation has gained popularity increasingly to allow considerable improvement of the quality assurance with respect to blood collection, transportation, storage, component preparation skills and hematological tests. Nevertheless the inventory control, the other issue of blood bank management, has been neglected so far. For the supply of blood by donation barely meets the demand, the blood bank policy on the inventory control has been 'the more the better.' The shortage itself by no means unnecessitate inventory control. In fact, in spite of shortage, no small amount of blood is outdated. The efficient blood inventory control makes it possible to economize the blood usage in the practice of state-of-the-art medical care. For the efficient blood inventory control in Korean hospitals, this tudy is to develop formulae forecasting the standard blood inventory level and suggest a set of policies improving the blood inventory control. For this study informations of $A^+$ whole bloods and packed cells inventory control were collected from a University Hospital and the Central Blood Bank of the Korean Red Cross. Using this informations, 1,461 daily blood inventory records were formulated.48 varieties of blood inventory control environment were identified on the basis of selected combinations of 4 inventory control variables-crossmatch, transfusion, inhospital donation and age of bloods from external supply. In order to decide the optimal blood inventory level for each environment, simulation models were designed to calculate the measures of performance of each environment. After the decision of 48 optimal blood inventory levels, stepwise multiple regression analysis was started where the independent variables were 4 inventory control variables and the dependent variable was optimal inventory level of each environment. Finally the standard blood inventory level decision rule was developed using the backward elimination procedure to select the best regression equation. And the effective alternatives of the issuing policy and crossmatch release period were suggested according to the measures of performance under the condition of the standard blood inventory level. The results of this study' were as follows ; 1. The formulae to calculate the standard blood inventory level($S^*$)was $S^*=2.8617X(d)^{0.9342}$ where d is the mean daily crossmatch(demand) for a blood type. 2. The measures of performace - outdate rate, average period of storage, mean age of transfused bloods, and mean daily available inventory level - were improved after maintenance of the standard inventory level in comparison with the present system. 3. Issuing policy of First In-First Out(FIFO) decreased the outdate rate, while Last In-First Out(LIFO) decreased the mean age of transfused bloods. The decrease of the crossmatch release period reduced the outdate rate and the mean age of transfused bloods.

• Journal of Trauma and Injury
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• 제34권3호
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• pp.212-217
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• 2021

Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient's consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient's transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.

• Parasites, Hosts and Diseases
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• 제30권3호
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• pp.201-208
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• 1992

Theileria sergenti merozoite의 면역원성 polypeptide중 29, 34, 35 그리고 105KD를 함유한, 수용성 항원을 흘스타인 송아지 (1개월령)에게 접종한 후, 제주도의 야외 목장에 방목시킴으로써 진드기로부터 병원성 충주의 도전에 따른 항원의 효력, 안전성 그리고 방어력을 관찰하였다. 즉 송아지 20두에 수용성 항원(100 mg/dose)을 Freund's adjuvant와 함께 1차 접종, 4주 후에 추가접종하였으며, 다른 20두의 송아지를 대조군으로 사용하였다. 추가접종 5주 후에 이들 송아지를 야외 목장에 방목, 매월 혈액학적 그리고 생화학적 변화를 관찰하였다 예방접종군에 있어서 hematocrit와 총적혈구수는 진드기 도전 전과 비교하여 약간의 변화를 인정할 수 있었다. 일반적인 혈액학적 소견은 예방접종군과 비교하여 유의한 차이를 인정할 수 있었다(p<0.05). 7월에 있어서 적혈구내 기생률은 예방접종군에 있어서는 0.4%이었으나, 대조군에 있어서는 약 3.6%이었다. 체중 증가율, albumin, aspartate alninotransferase, total protein, 그리고 bilirubin에 있어서도 유의한 차이 (p<0.05)를 인정할 수 있었다. 예방접종군의 혈액학적 그리고 생화학적 측정치는 대조군 보다는 정상치에 접근하였다. 실험종료 직후에 있어서 예방접종군의 30% 송아지와 대조군의 모든 송아지의 치료와 대조군 중 25%는 수혈이 요구되었다. T. sergenti merozoite의 수용성 항원에 대한 이 같은 연구 결과는 앞으로 유전공학적 백신제조를 위한 연구자료로 활용될 수 있을 것이다.