Backgroud: To evaluate the appropriateness of the requests of the emergency transfusions, 3 year experiences in the use of the immediate-spin crossmatched blood(ISMB) for emergency transfusions in tertiary hospital were reviewed. METHODS: Low-isotonic salt solution was used as a cell suspension and crossmatchings were continued including antiglobulin phase after issuing of the ISMB. The number of cases, the issuing time, sex, age, reasons for emergency transfusions and vital signs of the patients were retrospectively reviewed. Only cases of massive transfusions and classes III and IV according to the Advanced Trauma Life Support(ATLS) classification were considered appropriate. RESULTS: 1. The total number of emergency transfusions were 614 and 0.53 cases per day. The average age of the patients was 44.7+/-17.8 and male to female ratio was 2:1. And 357 cases(58.2%) were performed during off hours when the hospital was not fully staffed. 2. Six hundred thirteen cases(99.8%) were transfused with compatible blood. However, one case(0.2%) was found to have anti-E antibody during the emergency transfusion. 3. Massive transfusion was performed only in 32% of the total cases and the reasons of emergency transfusions in remaining cases were upper gastrointestinal bleeding(53%), trauma(19.2%) and obstetrical problems(16.8%). 4. Of the total 519 cases reviewed, 392 cases(75.5%) were considered appropriately, and 127 cases(24.5%) were considered inappropriately selected for emergency transfusions. CONCLUSIONS: One fourth of emergency transfusions was found to be inappropriate. We believe that the use of ISMB for emergency transfusions should be carefully requested by physicians and educational programs for the use of ISMB is clearly indicated for emergency transfusion management.
Classification ; Emergencies* ; Female ; Humans ; Male ; Retrospective Studies ; Tertiary Care Centers ; Vital Signs

The purpose of this study was to investigate setting and thermal expansion of dental soldering investments. In order to compare expansion rates and to investigate the effect of water/powder ratio on expansion, setting and thermal expansion of four dental soldering investments were measured under three different water/powder ratio conditions: standard, 20% decreased and 20% increased. Setting expansion of investments was measured by use of dialgauge method. Each measurement was started two minutes later from the beginning of spatulation and recorded every one minute for one hour. Thermal expansion of cylindrical test specimens, 10mm diameter, 50mm length, was recorded in a Thermodilatometer at heating rate of 10degrees C per minute from 25degrees C to 700degrees C. The results of this study were obtained as follows: 1. Setting expansion rates under the standard water/power ratio condition were 0.198% in Speed-E, 0.090% in Deguvest, 0.080% in CM and Hi-temp. Setting expansion of Speed-E was significantly different from those of CM, Deguvest and Hi-temp, and setting expansion of Deguvest was significantly different from those of CM and Hi-temp(p<.05). 2. Under the decreased water/powder ratio condition, there was significant increase in setting expansion of 4 dental soldering investments(p<.05). 3. There were no significant differences in setting expansions of investments except Hi-temp between standard and increased water/powder ratio condition(p<.05). 4. Thermal expansion rates under the standard water/powder ratio condition were 1.923% in Deguvest, 1.629% in Speed-E, 1.619% in Hi-temp and 1.580% in CM. No significant difference in thermal expansions under the standard water/powder ratio condition existed only between Speed-E and Hi-temp(p<.05). 5. Under the decreased water/powder ratio condition, there was significant increase in thermal expansion of CM and Deguvest but decrease in thermal expansion of Speed-E(p<.05). 6. Under the increased water/powder ratio condition, there was significant decrease in thermal expansion of CM, Deguvest and Speed-E but decrease in thermal expansion of Hi-temp(p<.05).
Dental Soldering* ; Heating ; Hot Temperature ; Investments*

Intracranial lipomas located in the cerebellopontine angle are extremely rare. These tumors are maldevelopmental lesions which can cause slowly progessive neurological symptoms. The clinical management of these tumours differs significantly from other lesions in this region. A 45 year old man presented with a 3-month history of vertigo and tinnitus in the left ear. In T1-weighted magnetic resonance imaging, the lesion was hyperintense and did not enhance after application of gadolinium. The patient was treated with medical therapy with good response. We present a review of the literature, with particular regard to management. Conservative treatment is recommended and limited surgery is usually indicated if the patients suffer from disabling neurological symptoms and signs e.g., vertigo, nausea, trigeminal neuralgia, facial weakness or facial spasm.
Cerebellopontine Angle ; Ear ; Gadolinium ; Humans ; Lipoma* ; Magnetic Resonance Imaging ; Middle Aged ; Nausea ; Spasm ; Tinnitus ; Trigeminal Neuralgia ; Vertigo

BACKGROUND: It has been reported that the cytokine released from the white blood cells (WBC) in the stored platelet concentrates may induce febrile nonhemolytic transfusion reactions. Few studies, however, have examined the effects of cytokine on platelet activation. METHODS: The platelets from healthy donors were incubated with interleukin (IL) at the final concentration of IL-8 0.5 ng/mL, 3 ng/mL, 5 ng/mL, 10 ng/mL, 1000 ng/mL, and IL-6 0.1 ng/mL, 0.5 ng/mL, 1 ng/mL, 5 ng/mL, respectively. The activated platelets were stained with monoclonal antibodies of PAC-1 and CD62, and were analyzed by flow cytometry. RESULTS: The ranges of mean percent of PAC-1 and CD62 expressions on platelets were 61.1-71.4% and 9.0-12.5% by incubating with IL-8, and 69.0-73.4% and 13.0-13.9% with IL-6, respectively. There were no significant differences of PAC-1 and CD62 expressions on platelets among the various concentrations of IL-8 nor IL-6. In 0.5 ng/mL concentration, the mean percentage of CD62 expressions on platelets by incubating with IL-6 (13.8%) were greater than that of IL-8 (9.0%). CONCLUSION: During the period of the storage of platelet concentrates, the IL-6 and IL-8 secreted by WBC can activate platelets and thus the suppression of the cytokine secretion may be important for increasing post-transfusional survival of platelets.
Antibodies, Monoclonal ; Blood Group Incompatibility ; Blood Platelets* ; Flow Cytometry ; Humans ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Leukocytes ; Platelet Activation* ; Tissue Donors

BACKGROUND: More attention is given to oxidative hypothesis which causes atherosclerosis to be recognized as inflammatory response. The relationship between serum ferritin which catalyzes lipid peroxidation and high sensitivity C-reactive protein which reflects vascular inflammation was investigated among adults in a health promotion center. METHODS: The study group consisted of 297 men and women (men 86, women 211) who visited the health promotion center of a hospital in Seoul to have a health checkup from October 1, 2004 to April 1, 2005. These subjects answered the questionnares and were measured in the following; blood tests, brachial-ankle pulse wave velocity and several anthropometric measurements. Statistical analysis was performed on 111 subjects after exclusion of those subjects who were taking antihypertensive agents or antidiabetic agents, and who had acute inflammatory diseases, acute liver diseases, anemia, and who had a WBC > or =11,000x10(3)/mm3 or a serum ferritin > or =200 ug/L or a ABI (Ankle Brachial Index) <0.9. RESULTS: The average serum ferritin concentration of men against women was 132.57+/-43.12 ng/ml to 78.23+/-38.10 ng/ml which means that men have about 1.7 times as high concentration than women (P<0.001). Serum ferritin was significantly correlated with high sensitivity C-reactive protein (r=0.332). Even in multiple stepwise regression analysis, there was a independent relationship between serum ferritin and high sensitivity C-reactive protein (beta=0.138, P=0.010). When we analyzed with distinction of sex, this relationship in women was constant (beta=0.131, P=0.031), but serum ferritin in men just showed the trend of correlation with BMI (beta=9.510, P=0.059). CONCLUSION: There is a significant relationship between the increase of serum ferritin and high sensitivity C-reactive protein in healthy women; furthermore, studies in men need to be confirmed.
Acute Disease ; Adult ; Anemia ; Antihypertensive Agents ; Atherosclerosis ; C-Reactive Protein ; Female ; Ferritins ; Health Promotion ; Hematologic Tests ; Humans ; Hypoglycemic Agents ; Inflammation ; Lipid Peroxidation ; Liver Diseases ; Male ; Oxidative Stress ; Pulse Wave Analysis

BACKGROUND/OBJECTIVES: The purpose of this study was to investigate the association between socioeconomic status and chewing discomfort and identify the role of food insecurity in the association's causal pathway in a representative sample of Korean elders.MATERIALS/METHODS: We conducted cross-sectional analyses of the Korea National Health and Nutrition Examination Survey (2013–2015) data for elders aged ≥ 65 years.Socioeconomic status indicators used included household income and education level.Chewing discomfort was assessed according to the self-reported presence of chewing problems. Food security was surveyed using a questionnaire based on the US Household Food Security Survey Module. RESULTS: The odds ratios of chewing discomfort in the 1st and 2nd income quartiles were 1.55 (95% confidence interval [CI], 1.15–2.10) and 1.40 (95% CI, 1.03–1.90), respectively, compared to participants in the highest income quartile. Participants with the lowest education level were 1.89 (95% CI, 1.30–2.75) times more likely to have chewing discomfort than those without chewing discomfort. After including food security in the final model, the logistic coefficients were attenuated in the income and education quartiles. CONCLUSIONS Low socioeconomic status was associated with chewing discomfort. In addition, the results confirm that food insecurity can mediate the association between socioeconomic inequalities and chewing discomfort among the elderly.

BACKGROUND: Tuberculosis is still one of the major public health problems in Korea. The patient's compliance with anti-tuberculosis therapy is the most important matter in managing tuberculosis. Research, particularly on this issue, is needed. Therefore, we analyzed the factors associated with compliance of pulmonary tuberculosis patients using the Health Belief Model. METHODS: One hundred and 47 patients who visited the outpatient Department of Family Medicine in Asan Medical Center from January 1995 to December 1998, and who were diagnosed as having pulmonary tuberculosis and treated with anti-tuberculosis drugs were chosen through chart reviews. Questions were given by telephone with questionnaire based on Health Belief Model. RESULTS: One hundred and two patients out of the total 147 participated in the study. The group was divided into two: 79 patients as a compliance group, and 23 as a non-compliance group. Recognition of their diagnosis, recognition of the duration of taking anti-tuberculosis drugs, disturbance of daily living with taking the drugs, efficacy expectations were statistically significant factors between the two groups. CONCLUSIONS: Higher the knowledge about their diagnosis as having tuberculosis, higher their knowledge about the durations of having to take the anti-tuberculosis drugs, less disturbance they had experieced on their daily living, and higher their expectation for the efficacies of taking the drugs resulted in higher compliance with anti-tuberculosis medication.
Chungcheongnam-do ; Compliance* ; Diagnosis ; Humans ; Korea ; Outpatients ; Public Health ; Telephone ; Tuberculosis ; Tuberculosis, Pulmonary* ; Surveys and Questionnaires

BACKGROUND: There is a need to prepare an adequate blood supply because of the imbalance between the blood supply and demand and the advent of an aging society. This paper presents the basic data for the blood supply and demand through an estimation of the blood donation and blood usage over the next ten years. METHODS: Data analysis was carried out using time-series methods. The data for the monthly blood donation from the Korean Red Cross from 1992 to 2004 was used to estimate the blood donation, and data of the blood supply from the Korean Red Cross and hospitals from 2000 to 2004 for the estimation of the blood supply for transfusion. In order to overcome the limits of the time-series methods, one prospect excluding the data from the year 2004 and the other prospect including the data from the year 2004 were analyzed simultaneously. RESULTS: According to the analysis performed with data from the year 2004 excluded, blood donation rate is expected to decrease to 2.5% in 2015 and the total blood demand (1,435,903 units), which is composed of RBC and single donor platelet, is expected to exceed the total blood donation (1,408,244 donors) by 2015. According to the analysis performed with the data from the year 2004 included, the blood donation rate is expected to decrease to 1.3% in 2015 and the total blood demand (1,760,219 units) is expected to exceed the total blood donation (1,639,042 donors) in 2009. CONCLUSION: A shortage of blood supply is expected to occur during the next ten years. In order to eliminate this blood shortage, a national data management system for blood collection and usage will be needed. In addition, adequate donor resources as well as a monitoring system will be needed to improve the efficiency of blood usage.
Aging ; Blood Donors ; Blood Platelets ; Humans ; Red Cross ; Statistics as Topic ; Tissue Donors

OBJECTIVES: To evaluate the oncologic and functional results of larynx-preserving partial pharyngectomy (LPP) via lateral pharyngotomy approach as a primary treatment for small (T1 or T2) hypopharyngeal squamous cell carcinoma (HPSCC). METHODS: We performed a retrospective review of 23 patients who underwent LPP through lateral pharyngotomy approach for small HPSCC at the our department between January 1991 and June 2007. Fourteen (61%) patients had adjuvant postoperative radiotherapy. RESULTS: The 2-years and 5-years disease specific survival rate was 77% and 61%, respectively. Nine patients (39%) had tumor recurrence. The most common pattern of recurrence was isolated distant failure (n=4, 44%) followed by local (n=2, 22%) and loco-regional (n=3, 34%) recurrence. The ultimate cure rate of the primary tumor was 87% (20 of 23). Twenty-two of the 23 patients (95%) could be decannulated, tolerate an oral diet, and had acceptable postoperative phonatory function. CONCLUSION: LPP via lateral pharyngotomy approach appears to be a feasible procedure for selected small HPSCC patients in terms of both oncologic and functional outcomes.
Carcinoma, Squamous Cell ; Diet ; Humans ; Hypopharyngeal Neoplasms ; Pharyngectomy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate

OBJECTIVES: To evaluate the oncologic and functional results of larynx-preserving partial pharyngectomy (LPP) via lateral pharyngotomy approach as a primary treatment for small (T1 or T2) hypopharyngeal squamous cell carcinoma (HPSCC). METHODS: We performed a retrospective review of 23 patients who underwent LPP through lateral pharyngotomy approach for small HPSCC at the our department between January 1991 and June 2007. Fourteen (61%) patients had adjuvant postoperative radiotherapy. RESULTS: The 2-years and 5-years disease specific survival rate was 77% and 61%, respectively. Nine patients (39%) had tumor recurrence. The most common pattern of recurrence was isolated distant failure (n=4, 44%) followed by local (n=2, 22%) and loco-regional (n=3, 34%) recurrence. The ultimate cure rate of the primary tumor was 87% (20 of 23). Twenty-two of the 23 patients (95%) could be decannulated, tolerate an oral diet, and had acceptable postoperative phonatory function. CONCLUSION: LPP via lateral pharyngotomy approach appears to be a feasible procedure for selected small HPSCC patients in terms of both oncologic and functional outcomes.
Carcinoma, Squamous Cell ; Diet ; Humans ; Hypopharyngeal Neoplasms ; Pharyngectomy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate