• Journal of Korean Society of Industrial and Systems Engineering
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• v.13 no.21
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• pp.133-141
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• 1990

Human blood is a perishable product : it has a legal lifetime of 21 days from collection, during which it can be used for transfusion to a Patient of the same type, and after which it has to be discarded. Therefore, blood must be supplied safely and effectively because it is one of the medical resources which keep humanlife. In this study, the effects of blood issuing policies on average inventory levels and average age of blood at transfusion are determined by simulation applied the theory of absorbing Markov chains. And as a practical study, the daily demand distribution of blood is estimated by using the data of B General Hospital. The distribution estimated follows poisson distribution and the estimator of parameter estimated from the poisson distribution is 0.762. Simulation is done by using the parameter. The most important problem when control blood is the amount of outdata. So we compared random policy with Modified LIFO and Modified FIFO by using outdata. As a results it is shown that Modified LIFO and Modified FIFO by using outdata. As a results it Is shown that Modified LIFO and Modified FIFO present better issuing policy than Random Policy.

• Journal of Korean Neurosurgical Society
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• v.44 no.5
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• pp.341-344
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• 2008

The authors present a case of 68-year-old woman who underwent resection of a metastatic adenocarcinoma in the left parietooccipital area. The intraoperative course was uneventful; however, after closure of the scalp incision, increased bleeding from the suture line was noted. A computerized tomography scan that was performed immediately after operation revealed acute epidural hemorrhage with mass effect under the bone flap. The patient developed disseminated intravascular coagulation and immediate re-exploration was performed. This patient was successfully treated owing to early recognition of the condition and immediate treatment with transfusion. Neurosurgeons should be alert that hypercoagulabe state is common in cancer patients and consumptive coagulopathy can occur after resection of metastatic brain tumor.

• Journal of Yeungnam Medical Science
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• v.39 no.4
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• pp.336-340
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• 2022

Although posterior reversible encephalopathy syndrome (PRES) is induced by various causes, a few cases have occurred after severe anemia correction. In this case report, a 45-year-old female patient visited emergency department with a chief complaint of dizziness due to severe anemia related to hypermenorrhea caused by uterine myoma. Before her operation, she had an abrupt headache and seizure during anemia correction with transfusion and injection of gonadotropin-releasing hormone agonist. Immediately after the operation, she experienced visual disturbances, followed by limb weakness and tonic-clonic movements. Magnetic resonance imaging showed alterations in parietal and occipital lobes suggesting cerebrovascular edema with hypoperfusion. Here, we presented and discussed the clinical and radiologic features of PRES related to anemia correction.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.2
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• pp.100-107
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• 2015

Purpose: We investigated the iron status of very low birth weight infants receiving multiple erythrocyte transfusions during hospitalization in the neonatal intensive care unit (NICU). Methods: We enrolled 46 very low birth weight infants who were admitted to the Kyungpook National University Hospital between January 2012 and December 2013. Serum ferritin was measured on their first day of life and weekly thereafter. We collected individual data of the frequency and volume of erythrocyte transfusion and the amount of iron intake. Results: A total of 38 (82.6%) of very low birth weight infants received a mean volume of $99.3{\pm}93.5mL$ of erythrocyte transfusions in NICU. The minimum and maximum serum ferritin levels during hospitalization were $146.2{\pm}114.9ng/mL$ and $456.7{\pm}361.9ng/mL$, respectively. The total volume of erythrocyte transfusion was not correlated to maximum serum ferritin concentrations after controlling for the amount of iron intake (r=0.012, p=0.945). Non-transfused infants took significantly higher iron intake compared to infants receiving ${\geq}100mL/kg$ erythrocyte transfusion (p<0.001). Minimum and maximum serum ferritin levels of non-transfused infants were higher than those of infants receiving <100 mL/kg erythrocyte transfusions (p=0.026 and p=0.022, respectively). Infants with morbidity including bronchopulmonary dysplasia or retinopathy of prematurity received a significantly higher volume of erythrocyte transfusions compared to infants without morbidity (p<0.001). Conclusion: Very low birth weight infants undergoing multiply erythrocyte transfusions had excessive iron stores and non-transfused infants also might had a risk of iron overload during hospitalization in the NICU.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.984-988
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• 1999

Background: Donor-specific blood transfusion(DSBT) before organ transplantation has been demonstrated to prolong allograft survival; the mechanism of this effect has remained unclear. Only a few researches have been performed on this subject in our country. Material and Method: To investigate the effect of DSBT, we selected 5 donor recipient combinations using rats of pure strain such as PVG, ACI, and LEW. One ml of donor whole blood was transfused to each recipient through the femoral vein 7 days prior to transplantation. The donor heart was transplanted to the recipient's abdominal vessels heterotopically using modified Ono and Lindsey's microsurgical technique. Five transplantations were done for each combination. Postoperatively, donor heart beat was palpated everyday through the recipent's abdominal wall. Rejection was defined as complete cessation of donor heart beat. Result: The allogeneic heart grafts transplanted from PVG strain to ACI strain(PVG ACI) without DSBT were acutely rejected(mean survival 10.2 days). With pretransplant DSBT, the cardiac allografts in PVG ACI and LEW PVG combinations survived indefinitely(more than 100 days), those in ACI PVG combination survived 12 to 66 days(mean 31.8 days), those in PVG LEW survived 8 to 11 days(mean 10.0 days), and those in ACI LEW survived 7 to 9 days(mean 8.0 days). In brief, DSBT prior to heart transplantation was definitely effective in PVG ACI and LEW PVG combinations and moderately effective in ACI PVG combination, but not effective in PVG LEW and ACI LEW combinations. Conclusion: DSBT prior to heart transplantation showed variable effects, but might prolong cardiac allograft survival indefinitely in some donor recipient strain combinations. The mechanism of this effect should be further investigated.

• Journal of Yeungnam Medical Science
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• v.28 no.2
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• pp.124-132
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• 2011

Background: Antiplatelet agent administration is critical in managing coronary-artery disease, but there is a concern regarding operation-related bleeding and an increase in blood transfusion in such, especially when delivering combined antiplatelet agents. This study was conducted to evaluate the effect of the administration of antiplatelet agents on off-pump coronary-artery bypass surgery (OPCAB). Methods: From March 2003 to December 2009, 49 patients who had undergone OPCAB were collected retrospectively. The patients were divided into three groups according to the administration of antiplatelet agents before the OPCAB operation: 21 patients were given an aspirin agent (group 1), 19 patients were given combined agents (aspirin+clopidogrel) (group 2), and nine patients were not given any antiplatelet agent (group 3). The three groups' perioperative hematologic and coagulation profiles, including their platelet counts, hemoglobin levels, hematocrit, prothrombin times, and aPTTs (activated partial thromboplastin times), and their postoperative bleeding, related complications, transfusion requirements, and operation times, were compared. Results: The operation time in group 2 was 4.3 hours, longer than those in the two other groups, and urgent operation was significantly most frequent in group 2 (63%). The amount of blood loss and the number of patients who received blood transfusion were not different in the three groups. The perioperative hemoglobin level, hematocrit, platelet count, prothrombin time, and aPTT were also not significantly different among the three groups. Conclusion: The continuous administration of antiplatelet agents to the patients in this study did not increase their postoperative bleeding or operation-related complications. Therefore, OPCAB may well be considered even if combined antiplatelet agents are being administered.

• Journal of Gastric Cancer
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• v.14 no.3
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• pp.173-179
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• 2014

Purpose: The prevalence of gastric cancer in the elderly is increasing. The purpose of this study was to clarify factors related to morbidity following gastric cancer surgery in elderly patients. Materials and Methods: For this study, data from 411 patients who underwent curative gastrectomies with lymph node dissections between March 2010 and January 2013 were retrospectively studied using a prospectively designed database. Patients were divided into 2 groups (<70 years vs. ${\geq}70$ years). For each group, perioperative factors were analyzed to determine if they were associated with postoperative morbidity and mortality. Results: Comorbidities were more prevalent in the elderly group (${\geq}70$ years). Intraoperative and postoperative transfusions were also more frequently required in the elderly group. There was no significant difference in the number of retrieved lymph nodes between the 2 groups (44.3 vs. 46.6 nodes). In a comparison of the elderly versus non-elderly groups, the postoperative morbidity rates were 22.7% versus 8.9% (P<0.001) and the postoperative mortality rates were 4.2% versus 0% (P=0.002), respectively. Of the possible non-surgical complications, pulmonary problems were predominately found in the elderly group (P<0.001). Surgical complications were evenly distributed between the 2 groups (P=0.463). Postoperative morbidity was significantly associated with older age and postoperative transfusion. Multivariate analysis showed that higher body mass index (BMI) and postoperative transfusion were important factors associated with postoperative complications in the elderly group. Conclusions: Pulmonary complications were frequently problematic in elderly patients. Higher BMI and postoperative transfusion were significant risk factors for postoperative complications in elderly patients with gastric cancer.

• Journal of Chest Surgery
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• v.46 no.3
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• pp.185-191
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• 2013

Background: Cardiopulmonary bypass (CPB) induces variable systemic inflammatory reactions associated with major organ dysfunction via polymorphonuclear neutrophils (PMNs). Ulinastatin, a urinary trypsin inhibitor, inhibits PMN activity and reduces systemic inflammatory responses. The aim of this study is to evaluate the effect of ulinastatin on postoperative blood loss and laboratory changes in patients undergoing open heart surgery. Materials and Methods: Between January 2008 and February 2009, 110 patients who underwent atrioventricular valve surgery through right thoracotomy were divided into two groups. Patients received either 5,000 U/kg ulinastatin (ulinastatin group, n=41) or the equivalent volume of normal saline (control group, n=69) before aortic cross clamping. The primary end points were early coagulation profile changes, postoperative blood loss, transfusion requirements, and duration of intubation and intensive care unit stay. Results: There were no statistically significant differences between the two groups in early coagulation profile, other perioperative laboratory data, and postoperative blood loss with transfusion requirements. Conclusion: Administration of ulinastatin during operation did not improve the early coagulation profile, postoperative blood loss, or transfusion requirements of patients undergoing open heart surgery. In addition, no significant effect of ulinastatin was observed in major organs dysfunction, systemic inflammatory reactions, or other postoperative profiles.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.254-259
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• 2009

Purpose: Pelvic trauma is a serious skeletal injury with high mortality. Especially in cases of severe injury trauma, treatment outcomes depend on early diagnosis and intervention. We expect trauma surgeon to play an important role in the management of severe multiple trauma patients. Methods: A retrospective study was performed on pelvic trauma patients with hemodynamic instability between March 2005 and September 2009. We divided the time period into period I (March 2005~Feburary 2009) and period II (March 2009~September 2009). The trauma surgeon and team started to work from period II. Data were collected regarding demographic characteristics, mechanism of injury, type of pelvic fracture, ISS(injury severity score), treatment modality, transfusion requirement, time to definitive treatment, and mortality. Results: During period I, among 7 hemodynamically unstable patients, 4(57.1%) patients died. However during Period II, only one of 6(16.6%) patients died. The demographic data and injury scores showed no differences between the two time periods, but the time to definitive treatment was very short with trauma team intervention(14.4 hrs vs. 3.9 hrs). Also, the amount of transfusion was less(41.1 U vs. 13.9 U). With arterial embolization, early pelvic external fixation led to less transfusion and made patients more stable. Conclusion: This study demonstrated the importance of the trauma surgeon and the trauma team in cases of hemodynamically unstable pelvic trauma. Even with the same facility and resources, an active trauma team approach can increase the survival of severely injured multiple trauma patients.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.223-229
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• 1984

An attempt to confirm the associations of some selected risk factors of HBV infection and measure their risks, a cross-sectional study with 1,209 urban office workers was carried out. For the study, a simple questionnaire which contained several questions on personal experience and behaviors on several known selected risk factors of HBV infection was applied to each subject, and the Hepatitis B virus surface antigen and its antibody were checked by RPHA and PHA method, respectively. Risk factors chosen for this study were experience of blood transfusion and personal contact variables, such as frequencies of eating-out, drinking after office hours, going to tea room, sharing cigarettes, etc. The results obtained were as follows: 1. The proportion of HBsAg positive was 10.6%, and total HVB infected including the Anti-HBs positive cases without vaccination was 44.2%. Both were higher in male than in female. 2. Frequent personal contact through glasses and dishes in eating-outs and drinkings turned out not to be a significant risk factor of Hepatitis B surface antigenecity. 3. Frequent visits to tea room was a significant risk factor of HBV infection which combined HBsAg positive cases and Anti-HBs cases who had not received HBV vaccination. The odds ratio was 1.56 4. Blood transfusion was not a significant risk factor of both HBsAg positive and total HBV infection. In summary, indirect oral contacts through eating-outs and drinkings was not significant risk factor in Korea at least between adults. Blood transfusion is no more major source of HBV infection in Korea probably because the adquate screening test of HBsAg for the blood donors is being made.