Anti-E and anti-c is one of the clinical significant irregular antibodies developing a delayed hemolytic transfusion reaction and hemolytic disease of the newborn. Since anti-c occurs frequently with anti-E in immunized people whosoe cells are E-and c-, it has been recommended to select blood of the patient's own R1 phenotype for transfusion, even when the presence of anti-c cannot be demonstrated in his/her serum. To determine the utility of this approach, we reviewed the blood bank laboratory records of patients identified anti-E and anti-c in his/her serum in Severance hospital over a 12 year period (1985-1996). During the 12-year period of study, 53 patients were identified with anti-E and/or anti-c; 30(56.6%) patients had anti-E alone, 6(11.3%) had anti-c, and 17(32.1%) had both. Thirty eight of forty two patients whose Rh-hr phenotypes were tested were R1R1. Of these 38 R1R1 patients, 16 patients (42.1%) presented with anti-c concomitant with anti-E. Ouru study showed that the incidence of antni-c in R1R1 patients with anti-E is similar to that of studies reported in Caucasian groups. We highly suggest the transfusion protocol of prophylactic use of c negative blood for R1R1 patients with anti-E. Furthermore, because anti-c may be present in concentrations too low to be detected, the enzyme technique is recommended in parallel with standard serologic methods for the identification of irregular antibodies.
Antibodies ; Blood Banks ; Blood Group Incompatibility ; Humans ; Incidence ; Infant, Newborn ; Phenotype

PURPOSE: The purpose of study was to compare perceived nursing needs between patients having spinal surgery and the nurses caring for them. METHOD: The participants were from three general hospitals, 71 patients who were having spinal surgery and 63 nurses. Data were collected from September 18 to November 17, 2006. Frequencies, mean, and t-test with the SPSS PC 14.0 program were used to analyze the collected data. RESULTS: The score for perceived nursing needs during pre-op care was significantly different between the patients and nurses (t= -2.515, p= .013). The perceived nursing needs did not show significant differences in scores of perceived nursing needs at post-op or discharge. CONCLUSION: The results provide primary data to improve the quality of nursing care, plan, and implement appropriate nursing care for patients undergoing spinal surgery.
Hospitals, General ; Humans ; Nursing Care ; Spine

Although rare, agranulocytosis is the most serious, potentially fatal side effect of antithyroid drug. We experienced a 13-year-old girl who developed methimazole-induced agranulocytosis at 1 month after the initiation of treatment. Her granulocyte count recovered after discontinuation of methimazole and treatment with broad spectrum-antibiotics, G-CSF, and methylprednisolone. After recovery from agranulocytosis she was treated with radioiodine ablation therapy. Early detection and proper management of antithyroid drug-induced agranulocytosis is very important.
Adolescent ; Agranulocytosis* ; Female ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Humans ; Methimazole ; Methylprednisolone*

PURPOSE: This study was conducted to evaluate the effect of a one-session spouse-support enhancement childbirth education on childbirth self-efficacy and perception of childbirth experience. METHODS: The design of this study was a nonequivalent control group pretest-posttest experiment. The participants in the study were 31 couples in the experimental group and 30 in the control group. The experimental couples were provided with one session on spouse-support enhancement childbirth education the night before delivery. Data were collected at two hours after delivery using the Childbirth Self-Efficacy Inventory (CBSEI) and perception of childbirth experience scale. Data were analyzed using PASW statistics 18 program. Frequencies, percentage, mean, chi2 test, t-test were used for data analysis. RESULTS: Childbirth self-efficacy significantly increased in the experimental group as compared to the control group, but there was no significant difference in perception of childbirth experience in the experimental group compared to the control group. CONCLUSION: The results suggest that a one-session childbirth education has beneficial effects on enhancing childbirth self-efficacy in pregnant couples. A one-session spouse-support enhancement childbirth education is recommended as an effective nursing intervention to promote couple's childbirth self-efficacy and it is also recommended that modifications of program to promote women's childbirth experience should be considered.
Adaptation, Psychological ; Adult ; Female ; Humans ; Male ; Parturition/psychology ; Patient Education as Topic ; Pregnant Women/*psychology ; *Self Efficacy ; Spouses/*psychology

PURPOSE: The aim of this study is to evaluate the clinical and radiologic outcomes of supramalleolar tibial osteotomy for medial compartment ankle osteoarthritis (OA) and to verify the efficacy of the supramalleolar osteotomy. MATERIALS AND METHODS: This study is based on 9 ankles of the medial compartment ankle OA treated with supramalleolar tibial osteotomy from August 2007 to June 2011 with at least 1 year follow-up. As for the functional evaluation, visual analogue scale (VAS) pain scores and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were evaluated. On radiographs, tibial anterior surface (TAS) angles, tibial lateral surface angles were measured. The severity of ankle OA was classified by the Takaura staging system. RESULTS: The mean VAS pain scores improved to 0.6 and AOFAS scores improved to 89.3. Radiographically, TAS angle increased to 93.5degrees postoperatively. Seven ankles showed improvement of the ankle arthritis grading from IIIa to II according to Takakura's staging. CONCLUSION: Supramalleolar tibial osteotomy for patients with medial compartment varus ankle OA showed satisfactory clinical and radiological outcome. We confirmed that the procedure is recommendable for medial compartment varus ankle OA especially for Takakura stage IIIa.
Animals ; Ankle ; Arthritis ; Follow-Up Studies ; Foot ; Humans ; Osteoarthritis ; Osteotomy

Pontine hemorrhage is characterized by high mortality and morbidity. We report a case of pontine hemorrhage treated by extraventricular drainage (EVD) of cerebrospinal fluid (CSF) and control of intracranial pressure (ICP) at the neuro-intensive care unit (NICU). The patient's ICP was well controlled, but hyperthermia with tachycardia developed 8 hours after admission, and the patient expired with sudden cardiac arrest. A literature review revealed that high fever (>39degrees C) developing within 24 hours after onset of hemorrhage with tachycardia (>110 beat/min) is a clinical indicator for high probability of death. Therefore, it is important that not only ICP and neurological changes but also vital signs, especially body temperature and heart rate, be monitored in pontine hemorrhage patients.
Body Temperature ; Death, Sudden, Cardiac ; Drainage ; Fatal Outcome ; Fever ; Heart Rate ; Hemorrhage ; Humans ; Intracranial Pressure ; Tachycardia ; Vital Signs

Total body irradiation (TBI) is included in the conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT), with unique advantages such as uniform distribution over the whole body and decreased exposure to cytotoxic chemotherapeutic agents. For individuals who lack matched sibling or matched unrelated donors, the use of haploidentical donors has been increasing despite challenges such as graft rejection and graft-versus-host disease (GVHD). Although a limited number of studies have been performed to assess the clinical role of TBI in haploidentical HSCT, TBI-based conditioning showed comparable results in terms of survival outcomes, rate of relapse, and GVHD in diverse hematologic malignancies such as leukemia, lymphoma, and multiple myeloma. Advances in supportive care, along with recent technical improvements such as restriction of maximum tolerated dose, appropriate fractionation, and organ shielding, help to overcome diverse adverse events related to TBI. Post-transplantation cyclophosphamide was used in most studies to reduce the risk of GVHD. Additionally, it was found that post-transplantation rituximab may improve outcomes in TBI-based haploidentical HSCT, especially in patients with B-cell lymphoma. Along with the advances of techniques and strategies, the expansion of age restriction would be another important issue for TBI-based haploidentical HSCT considering the current tendency toward increasing age limitation and lack of matched donors. This review article summarizes the current use and future perspectives of TBI in haploidentical HSCT.

Total body irradiation (TBI) is included in the conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT), with unique advantages such as uniform distribution over the whole body and decreased exposure to cytotoxic chemotherapeutic agents. For individuals who lack matched sibling or matched unrelated donors, the use of haploidentical donors has been increasing despite challenges such as graft rejection and graft-versus-host disease (GVHD). Although a limited number of studies have been performed to assess the clinical role of TBI in haploidentical HSCT, TBI-based conditioning showed comparable results in terms of survival outcomes, rate of relapse, and GVHD in diverse hematologic malignancies such as leukemia, lymphoma, and multiple myeloma. Advances in supportive care, along with recent technical improvements such as restriction of maximum tolerated dose, appropriate fractionation, and organ shielding, help to overcome diverse adverse events related to TBI. Post-transplantation cyclophosphamide was used in most studies to reduce the risk of GVHD. Additionally, it was found that post-transplantation rituximab may improve outcomes in TBI-based haploidentical HSCT, especially in patients with B-cell lymphoma. Along with the advances of techniques and strategies, the expansion of age restriction would be another important issue for TBI-based haploidentical HSCT considering the current tendency toward increasing age limitation and lack of matched donors. This review article summarizes the current use and future perspectives of TBI in haploidentical HSCT.

In cases where pulmonary tuberculosis (PTB) is not microbiologically diagnosed via sputum specimens, bronchoscopy has been the conventional method to enhance diagnostic rates. Although the additional benefit of bronchoscopy in diagnosing PTB is well-known, its overall effectiveness remains suboptimal. This review introduces several strategies for improving PTB diagnosis via bronchoscopy. First, it discusses how bronchoalveolar lavage or an increased number of bronchial washings can increase specimen abundance. Second, it explores how thin or ultrathin bronchoscopes can achieve specimen acquisition closer to tuberculosis (TB) lesions. Third, it highlights the importance of conducting more sensitive TB-polymerase chain reaction tests on bronchoscopic specimens, including the Xpert MTB/RIF assay and the Xpert MTB/RIF Ultra assay. Finally, it surveys the implementation of endobronchial ultrasound with a guide sheath for tuberculomas, collection of post-bronchoscopy sputum, and reduced use of lidocaine for local anesthesia. A strategic combination of these approaches may enhance the diagnostic rates in PTB patients undergoing bronchoscopy.

No abstract available.
Bone Marrow* ; Chimerism* ; Hematologic Neoplasms* ; Recurrence*