BACKGROUND: The aim of our study is to determine maximum surgical blood order schedule (MSBOS) in elective surgery through analyzing usage of blood products such as packed red cells and whole blood at Dankook University Hospital. We would like to establish the guidelines for effective utilization of blood products by introducing MSBOS to our hospital. METHODS: We calculated average amount of transfused blood for each elective surgery based on the discharge records of patients from January 1997 to December 1998 at Dankook University Hospital. Only those operations performed more than 5 times were included in this study. Average number of transfused units per patient of each operation was selected for MSBOS. RESULTS: For two years, the total number of surgery was 15,497 and the number of transfused operations was 1,682 (10.85%). Operation groups transfused below 10% was 77.3% of all 199 operation groups. The number of operation groups whose average of transfused blood was below 0.5 units was 80.3%. Type and screen (T&S) was recommended in 140 (70.4%) of all the operation groups. Of total groups MSBOS of 2 units was estimated in 4 groups (2.0%), of 3 in 14 groups (7.0%), 4 of 4 groups (2.0%), 5 of 2 groups (1.0%), 6 of 4 groups (2.0%), 7 of 7 groups (3.5%), and 8 in 2 groups (1.0%), respectively. CONCLUSION: We established MSBOS through the previous transfusion data of surgical operations over two years. To enforce MSBOS is needed for better medical services, which would decrease blood disuse and medical cost.
Appointments and Schedules* ; Humans

This study examines how acquired capability for suicide, negative urgency, and social support effectuate a suicide attempt. Sixty-three adults having visited an emergency room due to a suicide attempt were studied. The results can be summarized as follows. First, there were no significant sex differences in acquired capability for suicide, negative urgency, and social support. Second, the correlation among suicidal ideation, acquired capability for suicide, negative urgency, social support, and suicide attempts was examined. Results showed that suicide attempts were significantly and positively correlated with suicide ideation, acquired capability for suicide, and negative urgency. However, social support and suicide attempts did not significantly correlate. Third, results of hierarchical regression analysis indicated that acquired capability for suicide and negative urgency significantly predicted suicide attempts even when suicide ideation was controlled, but social support did not significantly explain attempts. In other words, study results imply that suicide attempts increase when acquired capability for suicide and negative urgency are high. Study results offer empirical data for understanding the intrinsic characteristics of individuals attempting suicide.

Resistant hypertension is defined as poorly controlled status of blood pressure despite of optimal use of three or more antihypertensive drugs of different classes, including diuretics. Although exact prevalence of resistant hypertension is not known, it has been reported to be 12.8% among patients treated with antihypertensive drugs. It is important to evaluate a possible secondary cause in patients with resistant hypertension. We report a case of resistant hypertension with renal artery segmental stenosis that was not revealed in renal Doppler study. Blood pressure of the patient was well controlled after renal balloon angioplasty.
Angioplasty, Balloon ; Antihypertensive Agents ; Blood Pressure ; Constriction, Pathologic ; Diuretics ; Humans ; Hypertension ; Prevalence ; Renal Artery

The adequacy of the urologist work force in Korea has never been investigated. This study investigated the geographic distribution of urologists in Korea. County level data from the National Health Insurance Service and National Statistical Office was analyzed in this ecological study. Urologist density was defined by the number of urologists per 100,000 individuals. National patterns of urologist density were mapped graphically at the county level using GIS software. To control the time sequence, regression analysis with fitted line plot was conducted. The difference of distribution of urologist density was analyzed by ANCOVA. Urologists density showed an uneven distribution according to county characteristics (metropolitan cities vs. nonmetropolitan cities vs. rural areas; mean square=102.329, P<0.001) and also according to year (mean square=9.747, P=0.048). Regression analysis between metropolitan and non-metropolitan cities showed significant difference in the change of urologists per year (P=0.019). Metropolitan cities vs. rural areas and non-metropolitan cities vs. rural areas showed no differences. Among the factors, the presence of training hospitals was the affecting factor for the uneven distribution of urologist density (P<0.001).Uneven distribution of urologists in Korea likely originated from the relatively low urologist density in rural areas. However, considering the time sequencing data from 2007 to 2012, there was a difference between the increase of urologist density in metropolitan and non-metropolitan cities.
Cities/statistics & numerical data ; Health Services Accessibility/*statistics & numerical data/trends ; Korea/epidemiology ; Physicians/*supply & distribution/trends ; Republic of Korea/epidemiology ; Rural Health Services/*manpower/statistics & numerical data/trends ; Rural Population/statistics & numerical data/trends ; Urban Health Services/*manpower/statistics & numerical data/trends ; Urology/*manpower/*statistics & numerical data/trends

Pylephlebitis, or suppurative thrombophlebitis of the portal venous system, is a rare condition occurring secondary to abdominal infections such as diverticulitis. Pylephlebitis can be diagnosed via ultrasonography or CT scan, and is characterized by the presence of a thrombus in the portal vein and bacteremia. However, the diagnosis may be delayed due to the vague nature of the clinical symptoms, causing morbidity and mortality due to pylephlebitis to remain high. Early diagnosis and immediate antibiotic therapy are important for favorable prognosis. Therefore, pylephlebitis should be considered in the differential diagnosis for cases of nonspecific abdominal pain and fever. We report a case of pylephlebitis secondary to diverticulitis, associated with Pseudomonas aeruginosa sepsis. Such cases have not been widely reported.
Abdominal Pain ; Bacteremia ; Diagnosis ; Diagnosis, Differential ; Diverticulitis* ; Early Diagnosis ; Fever ; Liver Abscess* ; Liver* ; Mortality ; Portal Vein ; Prognosis ; Pseudomonas aeruginosa* ; Pseudomonas* ; Sepsis* ; Thrombophlebitis ; Thrombosis ; Tomography, X-Ray Computed ; Ultrasonography

Intercoronary communication is a very rare congenital malformation, which differs from coronary collaterals in variable aspects. It is larger in diameter, extramural in location and more resembles normal mature arterial features histologically. There are no consensus for the definition of intercoronary communiations, but some reports have suggested their protective role against myocardial ischemia due to its dual blood supply system. We report the case of a 72 year-old male smoker who had chronic total occlusion at the proximal portion of right coronary artery, which was communicated with a normal left circumflex artery. Although the patient had chronic total occlusion and subsequent in stent restenosis, there were no presentations of acute coronary syndrome or myocardial infarction.
Acute Coronary Syndrome ; Arteries ; Consensus ; Coronary Occlusion ; Coronary Vessels ; Humans ; Male ; Myocardial Infarction ; Myocardial Ischemia ; Stents

OBJECTIVES: We examined the effects of INM 176 (K-1107) compared with placebo on the cognitive functions of 92 old aged subjects with cognitive impairment. METHODS: This was a prospective, 12 week, double-blind, placebo-controlled clinical trial. The elderly who achieved a score of less than 25 points on the K-MMSE or showed a high risk of Alzheimer's disease from the 7-Minute Neurocognitive Screening Battery were considered to have objective impairment and were selected as subjects for this study. The subjects were randomized to placebo or INM 176 group. The outcome measures were from the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog), the Instrumental Activities of Daily Living (IADL) and the Korean Geriatric Depression Scale (KGDS) and two kinds of computerized priming tests. After setting the total error score in the Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog) as the repeated measurement factor, an analysis of variance of the combined factor design was done between the placebo and INM 176 group. RESULTS: The interaction effect of time (pre- and post- trial) and group (placebo and INM 176 group) was significant in the analysis of the ADAS-cog's total error score. The INM 176 group's total error score in the ADAS-cog decreased significantly (p<0.01), whereas the placebo group showed a slight increase. The mean changes in IADL and GDS from baseline scores favored in the INM 176 group than in the placebo group. Outcome changes of ADAS-cog, IADL, KGDS scores during the 12 week clinical trail of INM 176 and placebo demonstrated favorable responses in the INM176 administered group. CONCLUSIONS: This is a preliminary clinical trial result of INM176 as a memory pill. Based on these results, INM176 may be a candidate molecule for the improvement of cognitive functions, including memory. Further clinical trial should demonstrate its efficacy.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Depression ; Humans ; Mass Screening ; Memory* ; Outcome Assessment (Health Care) ; Prospective Studies

PURPOSE: A number of countries have experienced an increase in pertussis during the past decade. In particular, there has been an increase in the incidence rate among adolescents and adults. To learn more about the current epidemiology of pertussis, we studied the prevalence and clinical characteristics of pertussis in children in Cheonan, South Korea. METHODS: We collected nasopharyngeal aspirates of 118 patients who were treated for respiratory symptoms at Dankook Univeristy Hospital between March 2008 and September 2009. We performed multiplex PCR for detection of Bordetella pertussis in those aspirates. RESULTS: Of the 118 patients, 10 (8%) were positive by PCR for B. pertussis. Six episodes occurred during the period July to September 2009. Nine of the 10 patients were less than 3 months old. Seven of them had not received DTaP vaccine. The mean duration of coughing before diagnosis was 10.9+/-5.2 days. Ten patients (100%) had paroxysmal cough and 8 (80%) had post-tussive vomiting. Only one patient had fever. One who had complications that include pneumonia, atelectasis and pneumomediastinum developed an absolute increase in leukocyte count (84,400/mm3). There was a statistically significant relation between vaccine being received and development of complications (P=0.033). CONCLUSION: We suspect that there was an epidemic of pertussis between July and September 2009. Further investigation by a pediatric or nationwide surveillance system is needed to monitor the changing epidemiology for pertussis.
Adolescent ; Adult ; Bordetella pertussis ; Child ; Cough ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Fever ; Humans ; Incidence ; Korea ; Leukocyte Count ; Mediastinal Emphysema ; Multiplex Polymerase Chain Reaction ; Organothiophosphorus Compounds ; Pneumonia ; Polymerase Chain Reaction ; Prevalence ; Pulmonary Atelectasis ; Republic of Korea ; Vomiting ; Whooping Cough