• Title/Summary/Keyword: count of WBC

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A Clinical Review of Acute Respiratory Distress Syndrome (ARDS) Due to Miliary Tuberculosis (급성호흡곤란증후군으로 발현된 속립성 결핵의 임상적 고찰)

  • Ahn, Young-Soo;Lee, Sang-Moo
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.1
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    • pp.17-26
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    • 2002
  • Background : The detection and early elimination of the causes for acute respiratory distress syndrome(ARDS) at the initial stage can result in a more favorable prognosis. Miliary tuberculosis as a cause of the ARDS is quite rare. A diagnosis of miliary tuberculosis is difficult due to the diversity of radiological patterns and non-specific clinical finfings, and low sensitivity of sputum examinations for acid-fast bacilli(AFBs). An analysis of the clinical data is the first step in diagnosing these unusual, rare cases. Materials and Methods : In this study the clinical features, laboratory data, radiological findings and diagnostic methods were analyzed in 9 cases with an initial presentation of ARDS due to miliary tuberculosis. The ARDS was defined by the definition of the American-Europian consensus conference 1992. Results : The mean age of the patients was $67{\pm}18$ years (F:M=7:2). The chief complaints were dyspnea(5/9), coughing (3/9) and fever(5/9). On a physical examination, fine or coarse crackles were noted(6/9). The ARDS developed on average 6.7 days after the initial respiratory symptoms. The mean $PaO_2/FiO_2$ of the patients was $133.5{\pm}53.4$, the number of cases with a WBC<5000/$mm^3$ was 4 out of 9 cases. A platelet count<70,000/$mm^3$ was observed in 2 out of 9 cases, and the serum albumin level was $2.6{\pm}0.6$ g/dL. The initial simple chest PA showed ground glass appearances and consolidation in all cases, However, the miliary nodular densities were observed in only 4 out of the 9 cases. HRCT revealed alveolar densities and a consolidation in 5 out of 6 cases, and miliary nodules in 5 out of 6 cases, The diagnosis of tuberculosis was made by a liver biopsy (4/4, 100% sensitivity), a bone marrow biopsy (1/2, 50% sensitivity), and an open lung biopsy (1/1), the sputum AFB was positive in only 2 out of 9 cases. The patient was treated with INH, RFP, EMB, PZA, and steroids. The survival rate was 55.5%. Conclusion : Miliary tuberculosis should be considered as one of the causes for ARDS in areas where there is a high prevalence of tuberculosis. The chief complaints of the patients on admission are dyspnea, fever and coughing without any specific riskfactors. A liver biopsy is particularly useful in ARDS patients with mechanical ventilation to determine the causes of the ARDS if miliary tuberculosis is suspected as being the underlying disease.

Factors Associated with Residual Pleural Thickening After Chemotherapy in Tuberculous Pleurisy (결핵성 흉막염에서 항결핵제 치료 후의 잔여 흉막비후와 관련된 인자)

  • Lee, Ki-Man;Ahn, Jong-Joon;Seo, Kwang-Won;Park, Jee-Hyun;Lee, Mi-Suk;Hwang, Jae-Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.607-614
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    • 2001
  • Background : Residual pleural thickening is frequently seen following treatment for tuberculous pleurisy, and pleural decortication is performed occasionally in patients with severe residual pleural thickening. However, predictive factors for the development of residual pleural thickening are uncertain at the initial diagnosis of the tuberculous pleurisy. Therefore, the purpose of this study was to identify the associated factors for residual pleural thickening at initial diagnosis. Methods : We separated 63 patients diagnosed as tuberculous pleurisy into two groups; group 1 consisted of patients without residual pleural thickening and group 2 comprised patients with residual pleural thickening at the end of tuberculous pleurisy treatment. We analyzed the clinical characteristics, radiological findings, pleural biopsy and characteristics of pleural fluid between group 1 and group 2. Results : The study population and clinical symptoms of the two groups were not significantly different and the duration of symptoms before treatment and the peripheral WBC were similar between the two groups. The presence of pulmonary tuberculosis, pleural fluid loculation or the amount of pleural effusion sid not differ significantly between the two groups. The incidence of positive AFB staining(group 1 : 8%, group 2 : 38%) and granuloma(group 1 : 30%, group 2: 62%)on pleural biopsy specimens was significantly higher in group 2 than in group 1. Pleural fluid WBC and differential count, adenosine deaminase level, pH, protein level or glucose level did not differ between the two groups. However, group 2 had higher LDH levels ($1370{\pm}208mg/dL$) than group 1 ($860{\pm}71mg/dL$, p<0.05). Conclusion : In tuberculous pleurisy, patients with residual pleural thickening following treatment demonstrated a higher incidence of positive AFB staining and granuloma on the pleural biopsy specimens or higher LDH level in the pleural fluid than patients without residual pleural thickening From these results, we speculate that the amount of tuberculous bacilli and granuloma are probably correlated with residual pleural thickening in the tuberculous pleurisy.

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Clinical characteristics and progress of Kawasaki disease patients who had early treatment with intravenous immune globulin (가와사끼병에서 면역글로불린 조기 투여군의 임상적 특성 및 치료 경과)

  • Park, So-Yoon;Lee, Young Hwan
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.1005-1010
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    • 2007
  • Purpose : To determine the optimal time of high dose intravenous immune globulin (IVIG) treatment, we analysed the clinical characteristics and progress of a group of Kawasaki disease patients who had early treatment with IVIG. Method : A retrospective study was conducted of 188 patients with Kawasaki disease who were admitted to Yeungnam University Medical Center from January 2000 to December 2005. All patients were treated with a high dose IVIG and high dose aspirin for the initial acute phase treatment. The early treatment group consisted of 94 patients who received treatment before 5 days of fever, and the conventional group consisted of 94 patients who were treated on or after day 5. The patients' sex, age, laboratory findings, total duration of fever, duration of fever after initial IVIG, need for additional IVIG and coronary artery status were noted. Result : There were no significant differences between the two groups in sex ratio and age. No significant differences were noted in the level of WBC count, ESR, CRP, serum albumin, LDH, total duration of fever and coronary abnormality. But the value of ALT($151.8{\pm}17.3$ vs. $81.9{\pm}13.4$, P=0.002), duration of fever after initial IVIG ($3.8{\pm}0.5days$ vs. $2.1{\pm}0.2days$, P=0.003), and rate of additional IVIG (15.9% vs. 6.3%, P=0.037) were significantly higher in the early treatment group. There was no significant difference in initial dose of IVIG, but dosage of aspirin was lower in early treatment group (P=0.037). Conclusion : There is no evidence that early treatment of IVIG has greater efficacy in preventing cardiac sequelae than conventional treatment. In addition, early treatment is likely to result in a greater requirement for additional IVIG treatment.

Effects of Supplementary Copper Sources (Cu Sulfate, Cu-Methionine, Cu-Soy Proteinate) on the Performance Broiler Chickens (구리 공급원들(Cu Sulfate, Cu-Methionine, Cu-Soy Proteinate)의 첨가가 육계의 생산성에 미치는 영향)

  • Lee, Mun-Ku;Kim, Chan-Ho;Shin, Dong-Hun;Jung, Byoung-Yun;Paik, In-Kee
    • Korean Journal of Poultry Science
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    • v.38 no.2
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    • pp.121-128
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    • 2011
  • This study was conducted to investigate the effects of dietary supplementation of Cu-sulfate, Cu-methionine chelate (Cu-Met) and Cu-soy proteinate (Cu-SP) on the performance, blood parameters and mineral contents of muscle. It was conducted with a total of 1,000 one d old broilers chickens (Ross$^{(R)}$) which were assigned to four dietary treatments; Control, Cu sulfate (200 ppm Cu as $CuSO_4{\cdot}5H_2O$), Cu-Met (200 ppm Cu as Cu-methionine chelate), Cu-SP (200 ppm Cu as Cu-soy proteinate). There were significant differences (p<0.05) among treatments in weight gain. Weight gain of Cu treated groups were higher than the control during 3~5 wk. There were significant differences (p<0.05) among treatments in feed intake during 0~3 wk. Cu-Met was significantly (p<0.05) lower than the control but the differences among Cu treatments were not significant. There were significant differences (p<0.05) among treatments in feed conversion rate (FCR). Cu treated groups were lower than the control during the whole period. Production efficiency factor (PEF) was significantly higher (p<0.01) in Cu treated groups than the control. Nutrient availabilities of diets were not significantly different among the treatments. The count of white blood cell (WBC) and eosinophil (EO) were lower in Cu-SP treatment than in the control. Copper concentration in the liver was significantly (p<0.01) higher in Cu treated groups than the control. Zinc concentration in the breast and wing muscle was lower in Cu treated and that of leg muscle was higher in Cu-Met than the control. The result of this experiment showed that Cu supplementation at the level of 200 ppm as Cu sulfate, Cu-Met and Cu-SP improves weight gain (4~5 wk), FCR and PEF. Differences among Cu sources were not significant.

Effect of Fermented Brown Seaweed Waste (FBSW) on Milk Production, Composition and Physiological Responses in Holstein Dairy Cows (발효미역부산물의 첨가가 Holstein 비유우의 비유성적 및 생리반응에 미치는 영향)

  • Hong, Zhong-Shan;Lee, Zhe-Hu;Xu, Cheng-Xiong;Yin, Jin-Long;Jin, Young-Cheng;Lee, Hyun-Jun;Lee, Sang-Bum;Choi, Yun-Jaie;Lee, Hong-Gu
    • Journal of Animal Science and Technology
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    • v.52 no.4
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    • pp.287-296
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    • 2010
  • This study was conducted to determine effects of fermented brown seaweed waste (FBSW) on milk production, composition and physiological responses as functional feed for 60 days in Holstein dairy cows. A total of 24 Holstein dairy cows (average age 49.33 months, average lactation days 175, Reproduction 2.0) were randomly allocated into control(basal diet), 1% FBSW (180g in basal diet) and 2% FBSW (360g in basal diet) groups with 8 replications for 60 days. Daily milk yield and composition (fat, protein, SNF, MUN) were not affected by FBSW supplementation, but Ca level in milk was significantly increased 4.29 mg/dl and 2.91 mg/dl in 1% and 2% groups compared to control group (p<0.05) at the end of the experiment, respectively. The somatic cell count (SCC) in milk was not significant. The plasma $T_4$ level (concentration) were increased in 1% and 2% FBSW compared to control group at the end of the experiment (p<0.05), but between triiodothyronine ($T_3$) and thyroxin ($T_4$) levels were not significant. Concentrations of plasma glucose in control, 1% FBSW and 2% FBSW groups were 64. 37mg/dl, 66.15mg/dl and 73.02 mg/dl and plasma NEFA level was 0.30~0.32 mEq/dl. Concentrations of BUN tended to be higher for FBSW group than control group. Although WBC, RBC, Hb, Hct, T-B, ALP, and GPT levels were not affected by FBSW supplementation, GOT level was significantly decreased in cows fed 1% FBSE diet compared to control group (P<0.05). Therefore we strongly suggest that the 1% FBSW supplementation in basal diet increases the milk yield and Ca level in Holstein dairy cows.

Nonoperative Management of Blunt Liver Trauma (둔상성 간 손상환자의 비수술적 치료)

  • Baik, Jung Ju;Kim, Jung Il;Choi, Seung Ho;Choi, Young Cheol;Jun, Si Youl;Lee, Jun Ho;Hwang, Seong Youn
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.161-171
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    • 2005
  • Background: The management of hepatic injuries has changed dramatically during the past two decade after the technologic breakthroughs in radiologic imaging techniques. Recently, the non-operative management of blunt hepatic trauma has become the standard of care in hemodynamically stable patients. We reviewed our experience of the non-operative management of blunt hepatic trauma. And the purpose of this study was to examine the prognostic factors and indicators affecting the decision for treatment modality of emergent hepatic trauma. Methods: The medical records of 84 patients who were treated for blunt hepatic injury at Masan Samsung Hospital from January 2002 to December 2003. The patients were divided two groups, non-operative(Non-OP) and operative(OP), according to the treatment modality. The two groups were compares for age, sex, mechanism of injury, grade of liver injury scale, combined injury, systolic blood pressure, pulse rate, hemoglobin, hematocrit, WBC count, S-GOT, S-GPT, ALP, transfusion amount during initial 24 hours, amount of infused crystalloid fluid, length of ICU stay, length of ward care, morbidity and mortality. The grade of the liver injury were determined by using the organ injury scale(OSI). Results: Among the 84 patients, 46 cases(54.8%) were managed non-surgically, and 3 cases of Non-OP group were treated by transarterial embolization. Between the two groups, there were significant difference in age, injury grade, combined injury, hemoglobin, hematocrit, initial systolic blood pressure, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, and length of ICU care, morbidity and mortality.(p<0.05) The overall mortality rate was 8.3%, but 2.2% mortality in the non-operative group. Conclusion: Non-operative management may be considered as a first choice in hemodynamic stable patients with blunt liver trauma. The reliable indicators affecting the treatment modality of blunt hepatic trauma were systolic BP, Hb, Hct, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, liver injury grade and combined injury. Strict selection of treatment madality and aggresive monitoring with intensive care unit were more important.

Study on Correlation with DSOM Fluents and CBC, Biochemical Examination (DSOM 변수와 일반혈액검사 및 일반화학검사와의 상관 관계)

  • Chi, Gyoo-Yong;Kim, Jong-Won;Lee, Yong-Tae;Kim, Kyu-Kon;Lee, In-Sun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.1
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    • pp.308-317
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    • 2007
  • This study was investigated to know the correlation of complete blood count(CBC), biochemical examination and DSOM fluents(Diagnosis System of Oriental Medicine, (C)2005-01-122-004154). There are 5 fluents in DSOM such as DSOM score(病機點數), mean of the index for pathogenic factor(病機指標 平均), 5-division of DSOM score(病機點數 五點尺度), 5-division of the index for pathogenic factor(病機點數 五點尺度), weighted pathogenic factor(病機加重値).We have carried out clinical trials who volunteered for Sasang constitutional medicine and Oriental OB & GY, Oriental Medical hospital of Dong-Eui University, from May 2005 to June 2006. Volunteers were 245 persons. Because 7 persons didn't checkup DSOM, so we analyzed the results statistically for 238 persons. In the relation of CBC and DSOM, the scores(病機點數, zp) and mean of the index for Pathogenic factor(病機指標 平均, zps) showed correlation more frequently, and correlation with results of RBC, hemoglobin, hematocrit was more significant. Correlation with fluents of pathogenic factor(病機) were more significant and high in deficiency of blood(血虛), insufficiency of Yang(陽虛), coldness(寒), damp(濕), dryness(燥), kidney(腎), phlegm(痰), heat syndrom(熱), lung(肺), and was very low in spleen(脾). There was no correlation with deficiency of Yin(陰虛). If volunteers have DSOM fluents, results of RBC and RBC index was decreased(- derection), and results of RDW, ESR was increased(+ direction). But increase and decrease direction in heat syndrom(熱), lung(肺) was contrary to the others. Correlation with fluents of Pathogenic factor(病機) of WBC, platlet, PDW, MPV was not many. In the relation of biochemical examination and DSOM fluents, correlation with results of albumin, uric acid, triglyceride was more significant. If volunteers have fluents of pathogenic factor(病機), result of examination was usually decreased. Especially result of examination was decreased(- derection) highly in deficiency of blood(血虛), stagnation of (氣滯) coldness(寒), dryness(燥), and was increased(+ direction) highly in heat syndrom(熱), lung(肺). But there was a tendency to show high correlation with specific pathogenic factor (病機) and specific examination in biochemical examination.

Characterization and Prognosis Significance of JAK2 (V617F), MPL, and CALR Mutations in Philadelphia-Negative Myeloproliferative Neoplasms

  • Singdong, Roongrudee;Siriboonpiputtana, Teerapong;Chareonsirisuthigul, Takol;Kongruang, Adcharee;Limsuwanachot, Nittaya;Sirirat, Tanasan;Chuncharunee, Suporn;Rerkamnuaychoke, Budsaba
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4647-4653
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    • 2016
  • Background: The discovery of somatic acquired mutations of JAK2 (V617F) in Philadelphia-negative myeloproliferative neoplasms (Ph-negative MPNs) including polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) has not only improved rational disease classification and prognostication but also brings new understanding insight into the pathogenesis of diseases. Dosage effects of the JAK2 (V617F) allelic burden in Ph-negative MPNs may partially influence clinical presentation, disease progression, and treatment outcome. Material and Methods: Pyrosequencing was performed to detect JAK2 (V617F) and MPL (W515K/L) and capillary electrophoresis to identify CALR exon 9 mutations in 100 samples of Ph-negative MPNs (38.0 PV, 55 ET, 4 PMF, and 3 MPN-U). Results: The results showed somatic mutations of JAK2 (V617F) in 94.7% of PV, 74.5% of ET, 25.0% of PMF, and all MPN-U. A high proportion of JAK2 (V617F) mutant allele burden (mutational load > 50.0%) was predominantly observed in PV when compared with ET. Although a high level of JAK2 (V617F) allele burden was strongly associated with high WBC counts in both PV and ET, several hematological parameters (hemoglobin, hematocrit, and platelet count) were independent of JAK2 (V617F) mutational load. MPL (W515K/L) mutations could not be detected whereas CALR exon 9 mutations were identified in 35.7% of patients with JAK2 negative ET and 33.3% with JAK2 negative PMF. Conclusions: The JAK2 (V617F) allele burden may be involved in progression of MPNs. Furthermore, a high level of JAK2 (V617F) mutant allele appears strongly associated with leukocytosis in both PV and ET.

The Clinical Study on 40 Cases of Patient with Chronic Prostatitis (만성전립선염환자(慢性前立腺炎患者) 40예(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Cho, Chung Sik;Kim, Chul Jung
    • Journal of Haehwa Medicine
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    • v.8 no.2
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    • pp.245-257
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    • 2000
  • A clinical study was done 40 patients of chronic prostatitis who was treated in Dept. of Internal Medicine, Oriental Medicine Hospital, Taejon University, from 1 Mar. 1999 to 31 Oct. 1999. The results were as follows. 1. In distribution of age, 30's and 40's were 57.5% the most, 20's and 60's were 35.0%, 50's was 7.5%. 2. In distribution of past history, the urethritis(45.0%) was the most. 3. In distribution of ocupation, a white-collar worker was 35.0%, a business man was 22.5%, a public servant was 12.5%, etc. 4. Sitting the mean time of day were distributed 5~7 hours, above 7 hours, 3~5 hours, under 3 hours, etc. 5. The resting interval of a long distance drive were distributed 2 hours(35.0%), 3 hours(32.5%), etc. 6. The habit of enduring ejaculation during sexual intercourse was showed 45.0%. 7. The habit of enduring urination was showed 20.0%. 8. Influency of mental stress was showed 90.0%. 9. Ten cases(25.0%) were showed riding horse or riding bicycle. 10. Four cases(10.0%) were showed wearing tight trousers. 11. The habit of put a wallet his hip pocket was showed 57.5%. 12. The most common symptom was distributed the others symp-tom(66.8%) and the voiding symptom(63.3%) more than pain-neuro-logical symptom(37.5%) and symptom related with sexual function (26.6%). 13. In distribution of palpation, lower abdominal pain, lumbar pain, perineal or parascrotal pain were mostly showed right side. Moreover diagnosis of pulsation was weakly showed chi pulse of right. 14. Duration of disease were distributed above 1 year(82.5%), under 1 year(17.5%). Degree of prostatitis was severe showed adove 1 year. 15. The distribution of WBC count of the prostatic secretion, com-paring with before therapy and after therapy, were showed from 5 cases to 0 case in very many/HPF, from 23 cases to 13 cases in many/HPF, from 12 cases to 13 cases in 10~30/HPF, from 0 case to 13 cases in under 10/HPF. 16. Therapeutic improvement of symptom were distributed pain-neurological symptom(94.8%), the others symptom(90.8%), the void-ing symptom(89.6%) and symptom related with sexual function(67.5%). 17. Differentiation of symptoms and signs were distributed dificiency of spleen-lung vital energy, wetness-heat of lower warmer, dificiency of spleen-kidney yang, dificiency of kidney yin, wetness-phlegm, dificiency of vital energy and blood. The prescriptions were Bojungikgitang(44.6%), Yukmijihwangtang(20.7%), Palmijihwangtang(12.0%), etc.

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Predictive Factors of Blood Transfusion Requirement in Blunt Trauma Patients Admitted to the Emergency Room (응급실에 내원한 둔상환자의 수혈 필요성 예측인자)

  • Oh, Ji Sun;Kim, Hyung Min;Choi, Se Min;Choi, Kyoung Ho;Hong, Tae Yong;Park, Kyu Nam;So, Byung Hak
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.218-226
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    • 2009
  • Purpose: In multiple blunt trauma patients, transfusion may be a significant therapeutic adjunct to non-operative management. The blood products must be expedited and efficiently to patients in impending shock caused by hemorrhage or traumatic coagulopathy, but the decision to perform blood transfusion has been made empirically, based on the clinician' and has not been guided by objective parameters, but own opinion, that may result in an underestimate of or a failure to detect bleeding, in delayed transfusion, and in a reduced outcome. This article presents quickly assessable predictive factors for determining if a blood transfusion is required to improve outcomes in multiple blunt trauma patients admitted to the emergency room. Methods: In a retrospective review of 282 multiple blunt trauma patients who visited our emergency center by emergency rescuer during a 1-year period, possible factors predictive of the need for a blood transfusion were subjected to univariate and multivariate logistic regression analysis. Results: Of blunt trauma patients, 9.2% (26/282), received red blood cells in the first 24 hours of care. Univariate analysis revealed significant associations between blood transfused and heart rate (HR) > 100 beats/min, respiratory rate (RR) > 20 breaths/min, Glasgow Coma Scale (GCS) < 14, Revised Trauma Score (RTS) < 11, white blood cell count (WBC) < 4000 or > 10000, and initial abnormal portable trauma series (Cspine lateral, chest AP, pelvis AP). A multiple regression analysis, with a correction for diagnosis, identified HR > 100 beats/min (EXP 3.2), GCS < 14 (EXP 4.1), and abnormal trauma series (EXP 2.9), as independent predictors. Conclusion: In our study, systolic blood pressure (SBP) < 90 mmHg, old age > 65 years, hemoglobin < 13g/dL, mechanism of injury were poor predictors of early blood transfusion. Initial abnormal portable trauma series, HR > 100 beats/min, and GCS < 14 were quickly assessable useful factors for predicting a need for early blood transfusion in blunt trauma patients visiting the emergency room.