No abstract available.
Hemophilia A* ; Humans

No abstract available.
Adult* ; Humans ; Thrombocytopenia*

BACKGROUND: In sepsis, large scale inflammatory responses can cause extensive collateral damage to the vasculature, because both coagulation and fibrinolysis are activated unevenly. Thrombin-activatable fibrinolysis inhibitor (TAFI) plays a role in modulating fibrinolysis. Since TAFI can be activated by both thrombin and plasmin, it is thought to be affected in sepsis. Hence, activated and inactivated TAFI (TAFIa/ai) may be used to monitor changes in sepsis. METHODS: TAFIa/ai-specific in-house ELISA can detect only the TAFIa/ai form, because the ELISA capture agent is potato tuber carboxypeptidase inhibitor (PTCI), which has selective affinity towards only the TAFIa and TAFIai isoforms. TAFIa/ai levels in plasma from 25 patients with sepsis and 19 healthy volunteers were quantitated with the in-house ELISA. RESULTS: We observed increased TAFIa/ai levels in samples from patients with sepsis (48.7+/-9.3 ng/mL) than in samples from healthy individuals (10.5+/-5.9 ng/mL). In contrast, no difference in total TAFI concentration was obtained between sepsis patients and healthy controls. The results suggest that TAFI zymogen was activated and that TAFIa/ai accumulated in sepsis. CONCLUSION: The detection of TAFIa/ai in plasma could provide a useful and simple diagnostic tool for sepsis. Uneven activation of both coagulation and fibrinolysis in sepsis could be caused by the activation of TAFI zymogen and elevation of TAFIa/ai. TAFIa/ai could be a novel marker to monitor sepsis and other blood-related disturbances.
Carboxypeptidase U ; Enzyme-Linked Immunosorbent Assay ; Fibrinolysin ; Fibrinolysis ; Humans ; Organothiophosphorus Compounds ; Plasma ; Protein Isoforms ; Sepsis ; Solanum tuberosum ; Thrombin

No abstract available.
B-Lymphocytes* ; Lymphoma, B-Cell*

We report a case of multiple myeloma showing marked differences in serum Immunoglobulin G (IgG) levels between serum protein electrophoresis and turbidimetry. A 47-yr old man was admitted to our hospital due to severe back pain and diagnosed as having IgG-kappa type multiple myeloma. Serum protein level was 14.4 g/dL at the time of diagnosis. Serum IgG level was 8.5 g/dL by serum protein electrophoresis, but 11.6 g/dL by turbidimetry. The patient's clinical conditions had improved after receiving VAD (vincristine, adriamycin, dexamethasone) and VTD (vincristine, thalidomide, dexamethasone) chemotherapy and there were no differences in IgG levels between electrophoresis and turbidimetry when serum IgG levels were less than 3.0 g/dL. According to this, we considered that both protein electrophoresis and turbidimetry should be needed to quantify serum immunoglobulins for diagnosis and follow-up of the patients with monoclonal gammopathy.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Electrophoresis, Agar Gel ; Humans ; Immunoglobulin G/*blood ; Immunoglobulin kappa-Chains/blood ; Male ; Middle Aged ; Multiple Myeloma/*diagnosis ; Nephelometry and Turbidimetry ; Paraproteinemias/drug therapy ; Time Factors

BACKBROUND: The over-preparation of blood for elective surgery causes some problems such as returning of blood, inefficient task and loss of reagent. Even though "Type & Screen" method helps solve such problems, we need to make a great effort to inform clinician of it. In Severance hospital, 1986 MSBOS had been established for the first time and revised in 1991. Recently, as various side effects of transfusion have been known and operation technique developed, blood usage is being decreased. Therefore, we try to revise maximal surgical blood order schedule(MSBOS) investigating RBC utilization for elective surgery in Severance hospital, 1999. METHODS: We investigated RBC utilization for elective surgery of the adult patient and, pre-op hemoglobin level, number of transfused patients, mean blood amount of transfused patients and mean blood amount of all operated patient referring to anesthesiologic record and blood delivery sheet in Severance hospital during 6 months from January through June 1999. RESULTS: The blood utilization of the period has been significantly decreased, compared with the previous reports(Korean J Blood Transfusion 1991;2:183-90) except in cardiovascular surgery. CONCLUSIONS: We could revise the guidelines for ordering blood on the basis of above results. Afterthis, MSBOS should be reestablished at regular intervals to improve blood utility.
Adult ; Blood Transfusion ; Humans

This case study reports a rare fibrinogen variant, gamma Met310Thr mutation, for the first time in Korea. The case shows a point mutation from T to C in the 1,007th nucleotide of the FGG gene. This report describes a variant fibrinogen, hereinafter called "fibrinogen Yecheon", using the name after the town where the patient was living at the time of diagnosis. Fibrinogen Yecheon has a de novo heterozygous point mutation of FGG resulting in gamma Met310Thr and subsequent extra N-glycosylation at gamma Asn308. Extra N-glycosylated fibrinogen is considered a main inhibitor of normal fibrinogen activity.
Base Sequence ; *Blood Coagulation Disorders, Inherited/genetics/physiopathology ; DNA Mutational Analysis ; Fibrinogens, Abnormal/*genetics ; Humans ; Korea ; Male ; Methionine/*genetics ; Molecular Sequence Data ; *Point Mutation ; Threonine/*genetics ; Young Adult

BACKGROUND: Blood supply in Korea has been unstable in more than a year because transfusion-related infection was repeated in patients receiving blood that the Korean Red Cross Blood Center (KRCBC) had supplied. The purpose of this study is to contribute to stable and efficient blood supply in our country by analysis of present status of hospital blood banks as blood donation center and their satisfaction levels with the KRCBC. METHODS: From July to August 2004, we performed questionnaire survey in 129 hospital blood banks that the KRCBC issued donor card in 2003. Among them, 73 hospitals replied and we analyzed them. RESULTS: Fifty-one (69.8%) among 73 hospital blood banks collected less than 100 cases of blood donation in 2003 and 16 of them collected no blood component. Satisfaction level with KRCBC was only 1.8 in hospitals less than 300 beds. Improvement in the delivery of blood components and blood testing of donated blood were in highest need among all areas of services supplied by KRCBC. Hospitals more than 1,000 beds answered that they would not transfer the collection service to KRCBC no matter how NAT be performed in all donated blood because of the directed and autologous donation of their hospitals. CONCLUSION: Satisfaction level of Hospital blood banks in Korea with blood services of KRCBC was rated below average, especially in hospitals less than 300 beds. It is important that the government should be the subject of national blood services and suggest appropriate schemes such as national audit program through close cooperation with the KRCBC and hospitals.
Blood Banks* ; Blood Donors* ; Hematologic Tests ; Humans ; Korea ; Red Cross* ; Tissue and Organ Procurement ; Surveys and Questionnaires

BACKGROUND: We established a bloodless center at Soonchunhyang University Hospital (SCH) in 1996 and have provided medical and surgical care for Jehovah's Witness patients. In this study, we evaluated their outcomes to provide the basis of bloodless medicine and surgery in Korea. METHODS: A retropective review of the medical records of 757 Jehovah's Witness patients admitted in the SCH Bloodless Center from December 1996 to July 2003 was performed. RESULTS: Among 757 patients, 19 (2.5%) expired during treatment and 4 of them died of cardiopul-monary dysfunction secondary to anemia. As alternatives to blood transfusion, 85 (11.2%) patients were treated with iron, 81 (10.7%) with erythropoietin, 49 (6.5%) with aprotinin, 31 (4.1%) with hemodilution and 28 (3.7%) with cell saver. Four hundreds fifteen (54.8%) of 757 patients underwent surgery. The most frequently involved cinical department was Obstetric/Gynecology (23.8%). The ratio of female and the percentage of cases treated with alternatives to blood transfusion were higher in surgery group than non-surgery group patients.(Chi-square test, P<0.01) CONCLUSIONS: Most Jehovah's Witness patients were treated successfully in our bloodless center with various alternatives to blood transfusion, such as erythropoietin, intraoperative autotransfusion, acute normovolemic hemodilution etc. Collaboration and good communication among surgeons, anesthesiologists, hematologists and blood bank physicians are very important to provide qualified medical or surgical treatment to the patients who have a religious objection to receiving blood or blood-related products.
Anemia ; Aprotinin ; Blood Banks ; Blood Transfusion ; Blood Transfusion, Autologous ; Cooperative Behavior ; Erythropoietin ; Female ; Hemodilution ; Humans ; Iron ; Korea ; Medical Records