No abstract available.
Sarcoma, Endometrial Stromal*

BACKGROUND: This study was designed to examine the interactions between mivacurium and vecuronium when administered during a standardized technique. METHODS: Eighty patients (ASA physical status I or II) were randomly assigned to one of four groups (n=20). Their neuromuscular function was measured in response to ulnar nerve supramaximal square-wave TOF stimulation at 10-sec intervals. After the attainment of a stable baseline neuromuscular response, the patients were randomly assigned to receive a rapid iv bolus of either: (1) 3M group (n=20): mivacurium 0.21 mg/kg. Alone, or (2) 2M1V group (n=20): mivacurium 0.14 mg/kg plus vecuronium 0.05 mg/kg, or (3) 1M2V group (n=20): mivacurium 0.07 mg/kg plus vecuronium 0.10 mg/kg, or (4) 3V group (n=20): vecuronium 0.15 mg/kg alone. The onset time of the neuromuscular block, time of recovery of T1 to 25% and reblock time (the time from the reinjection of vecuronium at the time of recovery of T1 to 25% to the time of recovery of T1 to 25%: T25-25) were measured. The intubating condition was evaluated clinically with a scoring system. RESULTS: The onset of block in the 3M group was 33% slower than in the 3V group. The time durations until 25% recovery in the 2M1V, 1M2V and 3V groups were longer than in the 3M group, and the durations in the 1M2V and 3V groups were longer than in the 2M1V group. The T25-25 reblock times of the 2M1V, 1M2V and 3V groups were prolonged in comparison to that of the 3M group. There was no difference in intubating conditions between any of the groups. CONCLUSIONS: A combination of mivacurium with vecuronium provides rates of onset and duration of block which are more effective than an equivalent dose of mivacuriun alone as an additive reaction.
Anesthesia, General* ; Humans ; Neuromuscular Blockade* ; Ulnar Nerve ; Vecuronium Bromide*

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.
beta-Thalassemia* ; Thalassemia*

BACKGROUND: Detection methods for ABO antibody (Ab) titers vary across laboratories, and the results are different depending on the method used. We aimed to compare titer values using different detection methods for the measurement of ABO Ab titers. METHODS: For ABO Ab detection, pooled group A or B red blood cells (RBCs) were reacted with each of 20 sera from blood groups A, B, or O without dithiothreitol treatment. The room-temperature (RT) incubation technique and the indirect antiglobulin test (IAT) were used in the tube test and gel card test. Flow cytometry (FCM) was performed by using anti-IgM and anti-IgG Abs. RESULTS: Regardless of the blood groups tested, the FCM assay with anti-IgM showed the highest titer compared to the tube test and gel card test with RT incubation in both. The tube test with IAT showed a higher titer than the gel card test with IAT (Gel-IAT) or FCM with anti-IgG in blood group A and B, while Gel-IAT showed the highest titer relative to the other tests, only for the anti-A Ab in blood group O. CONCLUSIONS: There were significant differences in the titers depending on the detection method used, and each method showed a different detection capacity for each ABO Ab depending on the ABO blood group tested. Therefore, caution should be exercised in interpreting ABO Ab titer results, taking into consideration the detection method used and the blood group.
ABO Blood-Group System/*immunology ; Adult ; Aged ; Agglutination Tests/instrumentation/*standards ; Antibodies/*analysis ; Antibodies, Anti-Idiotypic/analysis ; Erythrocytes/chemistry/metabolism ; Female ; *Flow Cytometry ; Humans ; Male ; Middle Aged ; Temperature

BACKGROUND: Measurement of the ABO antibody (Ab) titer is important in ABO-incompatible transplantation. However, to the best of our knowledge, no standard protocol or external survey program to measure the ABO Ab titer has been established in Korea. We investigated the current status of ABO Ab titer measurements at various laboratories in Korea and the impact of the protocol provided to reduce interlaboratory variations in the methods and results of ABO Ab titers. METHODS: The Korean external quality assessment of blood bank laboratories sent external survey samples with a questionnaire to 68 laboratories across Korea for the measurement of ABO Ab titers in May 2012. After 6 months, a second set of survey samples were sent with a standard protocol to 53 of the previously surveyed laboratories. The protocol recommended incubation at room temperature only and use of the indirect antihuman globulin method for the tube test as well as and the column agglutination test (CAT). RESULTS: Several interlaboratory variations were observed in the results, technical procedures, and methods selected for measurement. We found that 80.4% laboratories hoped to change their protocol to the provisional one. Additionally, CAT showed significantly lower variation among laboratories (P=0.006) than the tube test. CONCLUSIONS: Our study provides baseline data regarding the current status of ABO Ab titer measurement in Korea. The standard protocol and external survey were helpful to standardize the technical procedures and select methods for ABO Ab titer measurement.
ABO Blood-Group System/*immunology ; Agglutination Tests/*standards ; Antibodies/*analysis ; Humans ; Immunoglobulin G/analysis ; Immunoglobulin M/analysis ; Laboratories/*standards ; Questionnaires ; Republic of Korea ; Temperature

BACKGROUND: There is significant inter-laboratory variation in the ABO antibody (Ab) titer levels of blood samples because a standardized method has not yet been developed. The aim of this study was to identify the best conditions for the preparation of the red blood cell (RBC) suspensions so as to aid the development of a standard ABO Ab titration method. METHODS: Serum samples from apparently healthy adults and RBCs from three different sources (residual EDTA blood from healthy adults, donor blood in citrate-phosphate-dextrose-adenine-1 [CPDA-1], and a commercially available RBC reagent) were used for Ab titrations. We measured the titers for each blood group under various conditions, including the time period of storage (days), the ratio of serum to RBC volume, and the RBC sources. The techniques for room temperature incubation and the indirect antiglobulin test were used for the tube and the gel card test. RESULTS: A storage period of 6 to 7 days significantly affected the Ab titers. Samples with 3% RBCs in a 1:1 serum to RBC volume ratio had significantly lower Ab titers than those with 2% RBCs in a 1:1 ratio or those with 3% RBCs in a 2:1 ratio. There were no significant differences in the Ab titers of RBCs from different sources. CONCLUSIONS: To reduce inter-laboratory variations in ABO Ab titrations, using RBC suspension within five days of storage and applying ratio of serum to RBC volume to 2:1 with 3% RBC in the tube test will be helpful when using home-made RBC suspension.
ABO Blood-Group System ; Adult ; Coombs Test ; Edetic Acid ; Erythrocytes* ; Humans ; Suspensions* ; Tissue Donors

BACKGROUND: Overnight transfusions have been associated with higher transfusion risk than transfusions during the day. The aim of the study was to evaluate the transfusion status at our hospital and to help provide plans for overnight transfusions. METHODS: All blood products, including red blood cell products (RBC), fresh frozen plasmas (FFP), and all platelet products (PLT) issued between January 2013 and December 2014 were included. Night1 (5 pm∼8 am) and Night2 (8 pm∼8 am) were defined as overnight, and all issued bloods (IB) were analyzed in accordance with the issued time, ordered medical departments, and the reason of transfusion. RESULTS: The total unit number of IB at Night1 (Night2) was 53,483 (38,224), and it consisted of 44.4% (31.7%) total IB; 53.2% (39.6%) FFP; 46.8% (33.4%) RBC; and 39.3% (27.6%) PLT. The IB ordered from the departments of trauma & acute care surgery and emergency medicine consisted of 40% IB. The 80.9% RBC, 53.1% FFP and 70.2% PLT could be considered as appropriate for overnight transfusion. CONCLUSION: Due to the characteristics of our hospital with many trauma patients, the percentage of IB during an overnight period in our hospital was higher than those in other countries, and the rate of appropriate reason for RBC transfusion was also higher. However, as inappropriate overnight transfusions may have been still performed, education for medical staffs and appropriate policies for overnight transfusion could be helpful in reducing inappropriate transfusion.
Blood Platelets ; Blood Transfusion ; Education ; Emergency Medicine ; Erythrocytes ; Humans ; Medical Staff ; Plasma ; Tertiary Care Centers*

Purpose: This was a pilot study to examine the clinical usefulness of the newly developed three-dimensional sweep mode extracorporeal shockwave treatment (ESWT) in patients with plantar fasciitis. Materials and Methods: Three-dimensional sweep mode ESWT was performed once a week for 5 weeks in patients with plantar fasciitis who showed no improvement with the conventional conservative treatment. A 100-mm visual analogue scale (VAS) reading for pain from walking and at rest after walking were collected before the treatment and 8 and 16 weeks after the initial treatment. In addition, the Foot and Ankle Outcome Score (FAOS) and EuroQol-5-dimension (EQ-5D) scores before and 16 weeks after the treatment were evaluated. Results: VAS for pain for walking improved from 50.60±8.38 to 19.80±15.61 at 8 weeks after the initial treatment (p=0.008) and 9.80±9.62 at 16 weeks after the treatment (p<0.001). VAS for pain at rest after walking improved from 36.60±19.55 to 11.80±12.95 at 8 weeks after the initial treatment (p=0.052) and 8.80±8.87 at 16 weeks after the treatment (p=0.024). Preoperative FAOS increased from an average of 74.80±9.73 before the treatment to an average of 81.00±8.86 at week 16 after the procedure (p=0.49) and compared to pre-treatment levels, there was a decrease of one level in the anxiety/depression domain of the EQ-5D, post-treatment. Conclusion The results of this preliminary study confirmed that the newly developed EWST with the smart forging sweep mode was effective in improving pain and function in plantar fasciitis.

No abstract available.
Morphine* ; Respiration, Artificial* ; Weaning*