• Neonatal Medicine
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• 제25권4호
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• pp.170-177
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• 2018

Purpose: Preterm infants frequently require red blood cell (RBC) transfusions in neonatal intensive care units (NICU). Storage RBCs undergo many changes during storage periods. We aimed to compare the hemoglobin (Hb) correction effect according to the period of RBC storage and investigate the factors influencing Hb correction. Methods: This retrospective study reviewed the medical records of 289 patients who received RBC transfusion more than once in the NICU of Kosin University Gospel Hospital between February 2006 and March 2016. The subjects were classified into two storage groups: short-term (${\leq}7days$, n=88) and long-term (>7 days, n=201), according to the period of RBC storage. We checked Hb levels by complete blood cell count tests conducted within 2 days before and 5 to 9 days after the first transfusion. We compared the Hb difference between the two groups and analyzed the factors influencing Hb correction. Results: Excluding the use of an invasive ventilator, there was no significant difference between the two groups in terms of clinical characteristics. There was no significant difference in the Hb correction effect between the two groups (P=0.537). Birth weight greater than 1,500 g, higher weight at transfusion, and larger volume of transfusion were significant prognostic factors affecting greater changes in Hb. In addition, surgery experience, higher Hb level at transfusion, and additional blood tests were found to be significantly associated with less changes in Hb. Conclusion: The RBC storage period did not affect the Hb correction effect. The Hb correction effect may be diminished in infants with lower birth weight and lower weight at transfusion under unstable clinical conditions.

• 대한수혈학회지
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• 제29권3호
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• pp.273-281
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• 2018

배경: 만성 적혈구 수혈 환자에서 철과잉 여부를 알아보기 위해 페리틴 검사를 시행하는데, 페리틴은 체내 저장철의 양을 반영하지만, 염증, 감염 등에서도 비특이적으로 증가할 수 있다. 본 연구에서는 고페리틴혈증을 보이는 환자에서 페리틴이 증가한 원인을 분석하고 적혈구제제 수혈과의 연관성을 알아보고자 하였다. 방법: 2017년 1월부터 12월까지 본 의료기관에 내원하여 페리틴 검사를 시행한 환자들의 의무기록을 후향적으로 검토하였다. 시행한 페리틴 검사에서 1,000 ng/mL이상의 결과를 보인 경우를 고페리틴혈증으로 정의하고 연구대상으로 정하였다. 페리틴 검사와 함께 시행된 혈청 철, TIBC (Total iron bind capacity), CRP (C-reactive protein) 검사결과와 진단명 등 의무기록을 조사하여 고페리틴혈증의 원인을 분석하였다. 결과: 해당 기간 동안 고페리틴혈증 결과를 보인 건은 238명 환자에서 417건이었다. 질환별로는 혈액종양질환이 31명에서 125건(30.0%)으로 가장 많았으며, 감염질환이 두번째로 많았다. 철과잉이 의심되는 경우는 33명 환자에서 119건이었으며, 이 중 검사 시행 전 1년 동안 적혈구제제수혈이 8단위를 초과한 경우는 12명(76건)이었다. 결론: 고페리틴혈증을 보이는 환자에서 실제 철과잉으로 판단되는 경우, 기저질환의 영향이 있었고 만성 적혈구제제 수혈과도 연관이 있었다. 체내 철 저장 상태를 정확히 파악하기 위해서 페리틴 외에 CRP, 철 포화도를 함께 측정하는 것이 도움이 된다. 습관적인 철분제제 처방, 잦은 수혈 처방시에 철과잉 발생 여부에 주의를 기울여야 한다.

• 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.

• Clinical and Experimental Pediatrics
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• 제63권2호
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• pp.56-62
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• 2020

Background: Red blood cell (RBC) transfusion improves cardiorespiratory status of preterm infants by increasing circulating hemoglobin, improving tissue oxygenation, and reducing cardiac output. However, RBC transfusion itself has also been suggested to negatively affect short-term outcomes such as intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) in premature infants. Purpose: This study aimed to analyze the relationship between RBC transfusion and short-term outcomes in very low birth weight (VLBW) infants (birth weight, <1,500 g). Methods: We retrospectively reviewed the medical records of VLBW infants admitted to the Soonchunhyang University Bucheon Hospital between October 2010 and December 2017. Infants who died during hospitalization were excluded. The infants were divided into 2 groups according to RBC transfusion status. We investigated the relationship between RBC transfusion and short-term outcomes including BPD, ROP, NEC, and IVH. Results: Of the 250 enrolled VLBW infants, 109 (43.6%) underwent transfusion. Univariate analysis revealed that all short-term outcomes except early-onset sepsis and patent ductus arteriosus were associated with RBC transfusion. In multivariate analysis adjusted for gestational age, birth weight and Apgar score at 1 minute, RBC transfusion was significantly correlated with BPD (odds ratio [OR], 5.42; P<0.001) and NEC (OR, 3.40; P= 0.009). Conclusion: RBC transfusion is significantly associated with adverse clinical outcomes such as NEC and BPD in VLBW infants. Careful consideration of the patient's clinical condition and appropriate guidelines is required before administration of RBC transfusions.

• The Korean Journal of Physiology
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• 제24권1호
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• pp.15-26
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• 1990

Hemoglobin was purified from the outdated human red blood cells. Phospholipids were purified from egg yolk and stored in chloroform. The artificial red blood cells (hemosome) were prepared by encapsulation of hemoglobin with phospholipid mutilayer using rotary vacuum evaporator. The shape and size of hemosomes were measured by phase contrast microscope and image analyzer. The function of hemosomes was tested by measuring oxygen dissociation curve using blood gas analyzer. In order to test whether hemosomes are useful as blood substitute they were infused into rats of which one third of total blood were drawn. The results obtained are summarized at followings. 1) Hemosomes were spherical shape and their mean diameter was 0.7 um. 2) Oxygen dissociation curve of hemosomes showed the same figure as that of normal red blood cells. 3) All rats given 1/3 transfusion with hemosomes survived until sacrificed whereas three of four rats given 1/3 transfusion with saline died within 1 hour and the rest of them died within 24 hours.

• 대한수혈학회지
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• 제23권2호
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• pp.107-114
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• 2012

배경: 혈액제제 내에 혼입된 백혈구로 발생하는 부작용을 예방하기 위해서 백혈구필터를 이용한 백혈구의 제거가 널리 이용되고 있다. 그러나 상용 백혈구 필터로는 이식편대숙주병을 예방하기에는 충분한 백혈구제거가 되지 않아 고가의 기기를 이용한 방사선 조사를 시행하고 있는 실정이다. 한편 항체를 대체하는 압타머를 이용한 기술들이 활발히 개발되어 임상에 사용되기 시작하고 있다. 이에 백혈구에 결합하는 압타머를 이용한 압타머필터를 개발 하여 그 효율과 임상적용 가능성을 평가하고자 하였다. 방법: 포항공대 압타머사업단에 CD45항원에 결합하는 압타머 선별을 의뢰하여 제공받았으며 이를 비드에 부착시켜 백혈구와 결합하도록 한 후 자석을 이용해 제거하는 형식의 압타머필터를 개발하였다. 대한적십자사 혈액원에서 제공받은 백혈구제거적혈구 14단위에 압타머필터를 사용하여 잔여 백혈구를 제거한 후 백혈구 제거율과 적혈구 회수율, 세균배양을 시행하였다. 결과: 압타머필터 후 백혈구는 45.6%가 제거되었으며 92.8%의 적혈구회수율을 보였다. 세균배양에서는 아무것도 자라지 않았다. 결론: 압타머를 이용한 세포제거 기술을 혈액 필터에 적용하고자 CD45항원에 결합하는 압타머를 발굴하여 비드에 부착한 후 수혈 혈액을 필터링함으로써 해당 항원을 가진 세포 즉 백혈구를 제거하도록 하는 압타머필터를 개발하여 이를 평가하였다. 향후 압타머 부착 효율 및 필터과정 개선, 다른 항원에 대한 압타머 적용 등을 통해 혈액제제에서 백혈구 제거율을 높여 이식편대숙주병 예방을 위한 방사선조사를 대체하는 등 임상에 적용할 수 있을 것으로 생각된다.

• 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.

• 한국의료질향상학회지
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• 제28권2호
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• pp.30-38
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• 2022

Purpose: The Health Insurance Review and Assessment Service (HIRA) in South Korea initiated a quality assessment (QA) program for blood transfusion healthcare services in 2020 to ensure patient safety and appropriate blood use. This study examines the quality of blood transfusion services since the first national QA program for blood transfusion services in Korea. Methods: We analyzed HIRA claims and QA investigation data based on inpatient medical records from all tertiary, general, and primary hospitals between October 2020 and March 2021. The target population was patients aged 18 years and older who received either total knee arthroplasty or red blood cell transfusion. The QA indicators for transfusion healthcare service consisted of four quality indicators and four monitoring indicators. Results: We analyzed the results of QA indicators for transfusion service from the medical records of 189,668 patients from 1,171hospitals and expressed indicators as proportions. The average results for evaluation indicators were as follows: transfusion checklist presence, 64.8%; irregular antibody tests, 61.8%; transfusions in which the hemoglobin levels before transfusion met the transfusion guidelines for patients undergoing total knee arthroplasty, 20.6%, and transfusions in patients undergoing total knee arthroplasty, 59.3%. The average results for monitoring indicators were as follows: transfusion management implementation in medical institutions, 56.9%; preoperative anemia management in anemia patients undergoing total knee arthroplasty, 43.9%; one-unit transfusions, 82.5%; and the transfusion index. Conclusion: The quality of blood transfusion healthcare varied and the assessment revealed that there is scope for improvement. Hospitals require more effective blood transfusion management and this can be facilitated by providing feedback on the QA results about blood transfusion healthcare services to medical institutions, and by disclosing the results to the public.

• The Korean Journal of Physiology
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• 제26권1호
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• pp.37-44
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• 1992

The encapsulation of the Purified bovine hemoglobin with Phospholipids obtained from egg folk was performed using a rotary vacuum evaporator. The prepared Hb-containing liposome (hemosome) had good properties as artificial red blood cell. The shape and size of the hemosomes were measured by a phase contrast microscope and image analyzer. The function of the hemosome as oxygen carrier was tested by measuring oxygen saturation curve with blood gas analyzer and infusing it into rats. The prepared hemosome was 1.184 + 0.423 ${\mu}m$ in diameter and round in shape. $P_{50}$ value of the hemosome solution was 28 mmHg. The synthesized red cells seem to function as oxygen carrier, because the severely bled rats were prolonged in their life by transfusion of the hemosome solution containing bovine hemoglobin.

• 한국임상수의학회지
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• 제15권1호
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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.