BACKGROUND: Transfusion is a choice of treatment and should be used in order to maintain patients' lives and health. In order to supply safe blood, the quality improvements of hospital blood collection centers should be periodically monitored. To establish systematic surveillance of blood management system, we would like to suggest proper program. METHODS: Twenty-nine hospital small scale blood centers, collects less than 100 units of blood collection per year, were evaluated. Qualified were selected among blood bank specialists who were eligible to simultaneously perform inspections and consultations, and who had attended inspectors' workshop. RESULTS: Among twenty-five blood collection centers, four blood collection centers were closed prior to inspections. Among them, two blood collection centers were evaluated as inadequate. Among adequate centers, some questionnaires were evaluated as "not applicable" mainly for reasons pertaining to personnel and facilities, such as blood component preparation rooms and/or center administrators. CONCLUSION: A checklist for an inspection program should be reviewed continuously. Additionally, detailed guidelines for inspection should be standardized prior to commencing of subsequent year's inspection program. Finally, guidelines for inspection should be established for every questionnaire.
Blood Banks ; Checklist ; Quality Improvement ; Referral and Consultation ; Specialization ; Surveys and Questionnaires

No abstract available.
Cryptococcosis* ; Humans

We experienced a case of Plasmodium falciparum gametocytemia successfully treated with primaquine in a twenty seven-years old woman. The patient had been admitted due to general malaise after diagosis and treatment of P. falciparum at Tanzania one month ago. On microscopic examination, P. falciparum gametocytemia was seen and treated with mefloquine for one week but gametocytemia was not disappeared. After primaquine treatment for two weeks, she was successfully treated.
Female ; Humans ; Mefloquine ; Plasmodium falciparum* ; Plasmodium* ; Primaquine* ; Tanzania

No abstract available.
Humans ; Quality of Life* ; Renal Dialysis* ; Renal Insufficiency*

Tracheobronchial rupture following tracheal intubation with double-lumen endobronchial tube (DLT) is a rare complication, but may result in a massive air leakage with resultant pneumothorax, mediastinal emphysema and extensive subcutaneous emphysema in the postoperative period. We report a case of sustained laceration of the posterior membranous part of the trachea possibly due to overinflation of the double-lumen endobronchial tube. A 76-year-old, 45 kg, female was scheduled for a repair of her bronchopleural fistula. Following induction of anesthesia, intubation was performed with Robertshaw's DLT, and a tracheal cuff was inflated with 6 ml of air, but the sound of an air leak was heard coming from the patient's mouth during controlled ventilation. A further 5 ml of air was added 1 ml at a time into the tracheal cuff but the air leak sound continued. At that point, the sound was considered to originate from the bronchopleural fistula rather than from lack of sufficient air. After a thorough deflation of the tracheal cuff, 6 ml of air was reinjected and the operation was resumed. A 4 cm split was unexpectedly noticed in the posterior wall of the trachea during the operation and was repaired without complication.
Aged ; Anesthesia ; Female ; Fistula ; Humans ; Intubation ; Lacerations ; Mediastinal Emphysema ; Mouth ; Pneumothorax ; Postoperative Period ; Rupture* ; Subcutaneous Emphysema ; Trachea ; Ventilation

Pulmonary alveolar proteinosis is characterized by the remittent or progressive accumulation of lipid-rich proteinaceous material within the alveolar sacs in the absence of inflammatory response. Whole-lung lavage is the only consistent treatment for pulmonary alveolar proteinosis. We have utilized whole-lung lavage for the successful treatment of a 62 year-old female patient with pulmonary alveolar proteinosis. There was no persistent complication during the procedure and the postanesthetic recovery except temporary fever and hypoxic event. The patient was symptomatically, physiologically, and radiologically improved within days after the procedures.
Female ; Fever ; Humans ; Middle Aged ; Pulmonary Alveolar Proteinosis* ; Therapeutic Irrigation*

No abstract available.
Aged ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use ; Blood Cells/pathology ; Bone Marrow Cells/pathology ; Carcinoma, Non-Small-Cell Lung/*drug therapy/radiotherapy ; Humans ; Karyotyping ; Leukemia, Megakaryoblastic, Acute/*diagnosis/etiology ; Lung Neoplasms/*drug therapy/radiotherapy ; Male

PURPOSE: Myasthenia gravis(MG) is relatively rare in childhood and shows some distinct epidemiologic and clinical features according to ages and races. The role of immunosuppressive therapy such as steroid treatment is not well established. The objective of this study is to characterize clinical features of childhood MG and to evaluate the outcomes of steroid treatment. METHODS: We studied 23 MG patients(7 male and 16 females) with symptom onsets from 1 to 14 years of age(mean 4.1 years). RESULTS: Fifteen patients were ocular type and 6 patients were generalized type. Sero-positivity to acetylcholine receptor antibodies was found in 85% of the patients. Two patients who showed initial ocular manifestations experienced secondary generalization without steroid treatment. Alopecia totalis and moyamoya disease were associated with systemic MG in two cases. Eighteen patients were treated with both anticholine esterase and steroid while 2 patients were treated with steroid only. Complete remission was observed in 6 patients(30%) while 11 patients(55%) had one or more recurrences and only partial responses were acquired in 4 patients(20%). CONCLUSION: We found some different epidemiologic features from western countries including a relatively high proportion of ocular MG and earlier onset age especially in ocular MG. Further long-term follow up study on responses to steroid treatment will be necessary to evaluate clinical benefits in the disease progression.
Acetylcholine ; Age of Onset ; Alopecia ; Antibodies ; Continental Population Groups ; Disease Progression ; Follow-Up Studies ; Generalization (Psychology) ; Humans ; Male ; Moyamoya Disease ; Myasthenia Gravis* ; Recurrence

BACKGROUND: Propofol and ketamine are believed to reduce airway resistance. The aim of the present study was to compare the effect of propofol and ketamine on respiratory mechanics after endotracheal intubation in children. METHODS: Forty pediatric patients were assigned randomly to two groups: propofol (n = 20) and ketamine (n = 20). Patients were anesthetized with propofol (2 mg/kg) or ketamine (2 mg/kg). All patients were paralyzed with rocuronium (0.8 mg/kg) and intubated and ventilated mechanically (ETCO2: 30-40 mmHg, tidal volume: 10 ml/kg, respiratory rate: 15-25 time/min). Peak inspiratory pressure (PIP), respiratory resistance (Rr), dynamic compliance (Cdyn) and expiratory tidal volume (Vte) measurements were recorded at five time points; 0.5 min after intubation without sevoflurane (baseline), following 2.5 min, 5 min, 7.5 min and 10 min of ventilation with 2% sevoflurane- 50% nitrous oxide. RESULTS: Rr at 0.5 min after intubation was 27.4 +/- 12.7 cmH2O/L/s in the propofol group, and 30.0 +/- 13.5 cmH2O/L/s in the ketamine group. Cdyn at 0.5 min after intubation was 28.0 +/- 9.9 ml/cmH2O in the propofol group, and 25.1 +/- 10.6 ml/cmH2O in the ketamine group. There was no significant difference in the response of PIP, Rr, Cdyn and Vte between two groups and within groups. CONCLUSIONS: We suggest that the effects of propofol and ketamine on respiratory mechanics were similar during anesthetic induction in children.
Airway Resistance ; Child* ; Compliance ; Humans ; Intubation ; Intubation, Intratracheal ; Ketamine* ; Nitrous Oxide ; Propofol* ; Respiratory Mechanics* ; Respiratory Rate ; Tidal Volume ; Ventilation

BACKGROUND: Accurate typing of Duffy blood group is important because anti-Duffy antibodies cause hemolytic transfusion reaction and hemolytic disease of the newborn. The aim of this study was to evaluate a new genotyping method using high resolution melting (HRM) analysis, a rapid and inexpensive approach for high-throughput Duffy genotyping. METHODS: A total of 20 unrelated Korean blood samples were obtained and an African-black sample was used for GATA control. Phenotyping was performed by hemagglutination (DiaMed AG, Switzerland). GATA and FYA/B PCR products were obtained by PCR-restriction fragment length polymorphism (RFLP) using Taq DNA polymerase (Promega, WI) and enzymes BanI and StyI (New England Biolab, UK). For HRM, PCR amplification was performed using LightCycler 480 ResoLight Dye (Roche, USA) and Lightcycer 480 (Roche, USA). RESULTS: Phenotyping and genotyping data using PCR-RFLP and HRM analysis were compared. Different types of HRM curves were obtained according to genotypes, FYA/FYA, FYB/FYB, and FYA/FYB, and to GATA mutations, homozygote FYB-33T (T/T), heterozygote FYB-33T/33C (T/C), and homozygote FYB-33C (C/C). Phenotypes 18 Fy(a+b-), 1 Fy(a+b+), 1 Fy(a-b+), and 1 Fy(a-b-) showed complete concordance with genotyping methods. Fy(a-b-) sample was found to be a FYB-33C homozygote by both genotyping methods. CONCLUSION: Phenotyping and genotyping showed concordant results and both genotyping methods using PCR-RFLP and HRM analysis showed good agreement in finding mutation in GATA and FY gene coding regions. HRM analysis is suitable and reliable for high-throughput screening for Duffy genotyping.
Antibodies ; Blood Group Antigens ; Blood Group Incompatibility ; Clinical Coding ; England ; Freezing ; Genotype ; Hemagglutination ; Heterozygote ; Homozygote ; Humans ; Infant, Newborn ; Mass Screening ; Phenotype ; Polymerase Chain Reaction ; Taq Polymerase