No abstract available.
Adult* ; Humans ; Thrombocytopenia*

No abstract available.
Hemophilia A* ; Humans

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

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

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

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: 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

BACKGROUND: Among the multitude of tests developed for the diagnosis of hepatitis C virus (HCV) infection, the enzyme immunoassay and the chemiluminescence immunoassays (CLIA) are the most commonly used. The OraQuick HCV Rapid Antibody Test is also popular because it can detect HCV antibodies from blood or saliva within 20 minutes. In this study, we compared the performances of the OraQuick HCV Rapid Antibody Test and CLIA in the diagnosis of HCV infection. METHODS: We tested 150 serum samples from Soonchunhyang University Seoul Hospital for HCV between November 2012 and January 2013 using CLIA (ADVIA Centaur) as well as the OraQuick test. The data from both tests were compared to the results of HCV real-time PCR (COBAS AmpliPrep/COBAS TaqMan HCV test kit). RESULTS: In the PCR analysis, 59 of the 150 samples (39.3%) tested positive and 91 (60.7%) tested negative for HCV RNA. All these samples also tested positive when screened by CLIA. However, only 57 of 59 samples tested positive with the OraQuick test. Among the 91 samples found to be HCV-negative in the PCR analysis, 50 tested negative in both CLIA and the OraQuick tests. However, a discrepancy was noted among the remaining 41 samples that tested HCV-negative in the PCR analysis; 21 of these samples tested positive in both CLIA and the OraQuick tests, but the remaining 20 tested positive only in CLIA. CONCLUSIONS: Although the OraQuick test showed a marginally lower sensitivity for HCV detection than CLIA, we conclude that it is still beneficial because it is rapid and can be performed using blood and saliva samples. Our findings suggest that the OraQuick test could be an important diagnostic tool for screening HCV infection.
Diagnosis ; Hepacivirus* ; Hepatitis C Antibodies ; Hepatitis C* ; Hepatitis* ; Immunoassay ; Immunoenzyme Techniques ; Luminescence ; Mass Screening* ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; RNA ; Saliva ; Seoul