Hospital transfusion service should be directed toward the optimization of transfusion therapy, but in practice the hospital transfusions, especially of fresh frozen plasma(FFP), were practiced inappropriately against the real need. So we evaluated the usage pattern of fresh frozen plasma in the Capital Armed Forces General Hostal during the period of January through December in 1994. And then, from 1995, after education of the clinician upon the basis of the survey in 1994, we regulated the use of FFP, by adapting the transfusion control program. We compared the result of 1995 to those of 1994, including the total used FFP number, the usage pattem in various disease and the combined use with other blood components. The results were as follow. 1. About 50% of total FFP was used inappropriately at 1994, and the main misuse was done to the patients who were suffering from renal disease and bum. About 14% of FFP usage combined with the packed RBCs was also seemed to be inappropriate in 1994. 2. In 1995, with the transfusion control program, there was 72% fall in the total hospital's usage of FFP and the misused conditions such as bum and nephrotic syndrome were virtually corrected. We concluded that the education, guideline and regulation by the director of the transfusion service could remarkably correct the inappropriate use of FFP without any special costs.
Arm ; Education ; Humans ; Nephrotic Syndrome ; Plasma*

For the evaluation of the 51Cr labelled in-vivo crossmatching test as a transfusion safety test, We examined the viability of the thransfused autologous and heterologous 51Cr labelled red cell at 1 hour and 24 hour in 6 normal volunteers and 4 patients whose RBC had been stored in CPDA-1 media from 1 day to 30 day. In both autologous transfusion control group(n=3) and allogeneic transfusion control group(n=3), the in-vivo RBC survival rate were more than 70% at 1 hour and 24 hour compared to that of basal 3 minute result(percent counted as 100%), and the eluted free radioisotope activity was less than 5% compared to that of whole blood. The crossmatch incompatible patient group also satisfied the safe transfusion criteria. The mean labelling efficiency which was tested in three patients was more than 95% and also satisfactory to reliable test. We concluded that in-vivo crossmatching test using 51Cr radioisotope would give us valuable informations about transfusion safety, especially in serologically incompatible patients.
Healthy Volunteers ; Humans ; Survival Rate

PURPOSE: The purpose of this study is to investigate the relative surgical risk and problems in hip hemiarthroplasty for treatment of an unstable intertrochanteric fracture in elderly patients over 80 years old. MATERIALS AND METHODS: Between April 2005 and May 2010, 58 patients whose age was over 80 years were available for inclusion in this study. They were divided into two groups: group 1 included 30 patients with femoral neck fracture and group 2 included 28 patients with intertrochanteric fracture. No significant differences in average age, concomitant disease, and walking ability before development of fracture were noted between the two groups. The following factors, including interval from development of fracture to operation, operation time, amount of blood loss, start time of walking after operation, duration of hospital stay, complications, revision rate, and walking ability were compared between the two groups. RESULTS: Operation time was an average of 85.2 minutes in group 1 and 97.5 minutes in group 2(P=0.03). The amount of bleeding was an average of 483 cc in group 1 and 695 cc in group 2(P=0.006). Similar results for walking start and recovery of walking ability after operation were observed in the two groups. No significant differences were observed in duration of hospital stay, complications, and revision rate. While 25 patients in group 1(83.3%) showed restoration of walking ability after operation to the same level of walking before injury, 19 patients in group 2(67.8%) showed restoration of walking ability postoperatively. CONCLUSION: Even though patients in group 2 showed a longer operation time and a higher amount of blood loss, compared with those in group 1, patients in group 2 had similar surgical risk and complications, compared with those in group 1. Therefore, primary hip hemiarthropalsty could be a good treatment option for intertrochanteric fracture in elderly.
Aged ; Femoral Neck Fractures ; Femur Neck ; Hemiarthroplasty ; Hemorrhage ; Hip ; Hip Fractures ; Humans ; Length of Stay ; Walking

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

OBJECTIVES: To explore the role of apolipoprotein E in schizophrenia, we investigated apoli-poprotein E polymorphism in groups of patients with schizophrenia and normal controls. We also examined the relationship of clinical characteristics of schizophrenia to apolipoprotein E genotypes. METHODS: Samples were obtained from 101 schizophrenic patients and 96 controls in Korea and apolipoprotein E polymorphisms were analysed using polymerase chain reaction. RESULTS: The genotype and allele frequencies did not differ from those of controls. The clinical variables of schizophrenia, such as positive and negative groups by PANSS, subtypes by DSM-IV, family history were not associated with each genotypes. CONCLUSION: We could not find the association of apolipoprotein E in Korean schizophrenic patients and it could be suggested that apolipoprotein E isoforms might not play a main role in expression of schizophrenia.
Apolipoproteins* ; Diagnostic and Statistical Manual of Mental Disorders ; Gene Frequency ; Genotype ; Humans ; Korea ; Polymerase Chain Reaction ; Protein Isoforms ; Schizophrenia

Hormone replacement therapy combined with progestogens induces changes in effect of estrogen on serum lipid levels and it has been known that the changes depend on a type and dosage of progestogen. It is also known that progestational agent induces positive ch-ange in bone mineral density. To study the effects of progestogen on lipoprotein and bone metabolism, we administ- ered conjugated equine estrogen 0.625 mg alone to 50 postmenopausal women, in combinat- ion with medroxy- progesterone acetate 5 mg to 40 postmenopausal women. The data demonstrated a beneficial effect in lipoprotein profiles in both groups. Total cholesterol in two groups decreased from the baseline values, LDL-cholesterol decreased significantly by 4.8 % in group I and 16.2 % in group II(p < 0.05), HDL-cholesterol increa- sed significantly by 11.3 % in group I and 14.7 % in group II(p < 0.05), triglyceride incre- ased slightly in both groups. Bone mineral density of femur was maintained and BMD of vertebrae increased by 1.1 % in group I and 2.0 % in group II, but it is not statistically significant. The differences of changes between two groups were not statistically significa- nt. Our results suggest that medroxyprogesterone acetate have no adverse effect on HDL -cholesterol and have no additive effect on bone mineral density in hormone replacement therapy.
Bone Density* ; Cholesterol ; Estrogens* ; Female ; Femur ; Hormone Replacement Therapy ; Humans ; Lipoproteins ; Medroxyprogesterone Acetate ; Metabolism ; Progesterone ; Progestins ; Spine ; Triglycerides

BACKGROUND: Laryngoscopy and tracheal intubation for general anesthesia are potent stimuli to the cardiovascular system due to sympathetic stimulation. The aim of this study was to compare the hemodynamic responses with different administration routes of lidocaine on blood pressure and heart rate changes associated with tracheal intubation. METHODS: Sixty patients were randomly assigned to spray group (Group 1, n=20) received 10% lidocaine 1.5 mg/kg spray to intratracheally immediately before tracheal intubation, IV group (Group 2, n=20) received 2% lidocaine 1.5 mg/kg intravenously before 90 sec tracheal intubation and control group (Group 3, n=20). Anesthesia was induced with thiopental 5 mg/kg IV, vecuronium 0.1 mg/kg and 50% N2O-O2- 2vol % enflurane. After 5 minutes, tracheal intubation was performed. Mean arterial pressure and heart rate were measured at preintubation and immediately postintubation, 1, 3, 5 mins after tracheal intubation. RESULTS:The differences of mean arterial pressure which were measured at preintubation and immediately postintubation and 1 minute after intubation in group 1 were significantly lower than those in other group (p<0.05). The differences of heart rate which measured at preintubation and 1 minute after intubation were lower than those in group 3 (p<0.05). CONCLUSIONS: For the suppression of sympathetic stimulation following tracheal intubation, 10% lidocaine spray to the laryngotrachea is an effective method to suppress cardiovascular response.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Enflurane ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Laryngoscopy ; Lidocaine* ; Thiopental ; Vecuronium Bromide

PURPOSE: The purpose of this study was to review the relationship between physical activity and cardiovascular outcomes in the Korean elderly. METHODS: Experimental studies were located using PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed. The selected studies for analysis were 20 articles of cardiovascular outcomes (total cholesterol, triglyceride, high density lipoprotein (HDL), low density lipoprotein (LDL), blood pressure, and pulse rate) from 515 articles. RESULTS: One-group pretest-posttest design was the most common. The main physical activity was an aerobic exercise. Five of 14 studies reported a significant improvement of total cholesterol. Four of 14 studies found relationship between exercise and triglyceride. Eight of 12 studies reported a significant improvement of HDL, whereas 3 of 9 studies reported a significant improvement of LDL. In over 60% of selected studies, reported significant improvement of blood pressure. CONCLUSION: Based on the review, it suggests that regular physical activity of the elderly may improve cardiovascular outcomes.
Aged* ; Blood Pressure ; Cardiology ; Cholesterol ; Exercise ; Humans ; Lipoproteins ; Motor Activity* ; Triglycerides

PURPOSE: The purpose of this study was to review the effects of physical activity on musculoskeletal outcomes in older Koreans. METHODS: Experimental studies were retrieved from the search engines (PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed). The selected studies for analysis were 27 articles of musculoskeletal outcomes (gait, muscle strength, flexibility, balance, grip strength, endurance, body fat, and weight) from 515 articles. RESULTS: The most common type of physical activity was a resistance exercise. There were significant improvements in gait (71.4%), muscle strength (86.7%), flexibility (63.6%), balance (72.2%), grip strength (71.4%), endurance (71.4%), body fat (57.1%), and weight (28.6%). The activity programs that apply over 150 minutes a week showed greater improvement of 69.5% than 65.0% from those did not meet the guidelines totally. CONCLUSION: Based on the review, we conclude that regular physical activity in the elderly may improve the musculoskeletal outcomes. To be more effective programs, it is necessary to meet the guidelines of 150 minutes a week or 30 minutes of moderate-intensity activities on 5 days per week for the elderly.
Adipose Tissue ; Adult* ; Aged ; Gait ; Hand Strength ; Humans ; Motor Activity* ; Muscle Strength ; Musculoskeletal System ; Pliability ; Search Engine

PURPOSE: Following the first in 1990, the use of course evaluations(CE) by medical schools across the Republic of Korea has grown steadily since 1997. The purpose of this study was to investigate these CE programs and to make general recommendations for further implementation. METHODS: A questionnaire survey was conducted by mail. From June 20 to September 22, 2006, data was obtained from 38 of the 41(93%) medical schools in the country. Of those who responded, 27 schools also sent their CE forms as requested. RESULTS: There was little difference among the 38 medical schools in the main body, methods, frequency, grades, systems of evaluation, and types of survey. Evaluation criteria such as instructor effectiveness, course management efficiency, and student satisfaction showed high frequency, whereas issues concerning learning objectives and workload were less common. In contrast, the stated purposes of employing CE varied from school to school. While 92% of the respondents regarded improvement to the quality of instruction as the goal of their programs, 32% indicated that CE results also factored in administrative decisions concerning promotion, tenure, and salary increases. CONCLUSION: In addition to embracing the expanding role and influence of CE in Korean medical education, schools must proactively enact measures to enhance further implementation. First, evaluation criteria should be better formulated to increase the consistency, reliability, and validity of CE results. Next, to promote efficiency, the scheduling and methodology of CE administration should carefully consider the medical curriculum. Finally, professional attitudes should be fostered to recognize the value of CE as a tool for raising educational standards overall.
Curriculum ; Surveys and Questionnaires ; Education, Medical ; Humans ; Learning ; Postal Service ; Republic of Korea ; Salaries and Fringe Benefits ; Schools, Medical*