Blood utilization review has recently been used to minimize inappropriate transfusion, reduce post transfusion infections and improve the quality of transfusion practices. Ajou University Hospital is a 906 bed tertiary care teaching institution. Since March, 1995, the concurrent review of blood transfusion requests using institutional blood transfusion criteria has been initiated. To evaluate the effectiveness of the transfusion review, the units of blood components transfused per patient(total number of units of blood components transfused/total number of patients discharged) and inappropriate transfusion ratio of blood components(total number of units of blood components inappropriately transfused/total number of units of blood components transfused) were compared during the concurrent review for 9 months and pre-concurrent review for 9 months, respectively. The possible savings of blood components realized by the review were also extrapolated. The results were as follows : 1. The unit transfused per patient for pre-review and during review were 0.675 (9,080/ 13,422) and 0.654(12,123/18,546) for packed RBC(PRBC); 0.417 (5,602/ 13,422) and 0.296 (5,444/18,546) for fresh frozen plasma(FFP); 0.372(5,007/13,422) and 0.424(7,868/18,546) for platelet con-centrates(PC), respectively. 2. The inappropriate transfusion ratio of blood components for pre-review and during review were 0.039 and 0.009 for PRBC; 0.321 and 0.064 for FFP; 0.143 and 0.008 for PC, respectively. These differences were statistically significant(p=0.000). 3. The PRBC and FFP anticipated to have been saved by this review was 519 units and 2,992 units annually, respectively. 4. However, 2,621 units of PC were used additionaly during this review due to increased number of oncology patients and better hemostatic therapy practiced during the same period. In conclusion, the concurrent review of transfusion requests was very effective tool to educate residents in clinical departments the transfusion medicine and improve utilization of blood and its components.
Blood Platelets ; Blood Transfusion* ; Concurrent Review* ; Humans ; Income ; Tertiary Healthcare ; Transfusion Medicine ; Utilization Review

No abstract available.

Paragangliomas of the mediastinum are rare neoplasms. We report a case of a unsuspected mediastinal paraganglioma in 55-year-old man. The mediastnal tumor was accidentally discovered on a chest roentgenogram and there was no history of hypertension, sweating, flushing and headache. Surgical resection was difficult with bleeding and fluctuation of arterial blood pressure reaching up to 190/130 mmHg with tachycardia. The blood pressure was controlled with nitroglycerine and tachycardia controlled with beta-blocker. After tumor resection, hypotension was treated with dopamine and blood transfusion. Postoperative recovery was satisfactory and the patient discharged after 20 days. The diagnosis of aorticosympathetic paraganglioma was established by histologic examination.
Arterial Pressure ; Blood Pressure ; Blood Transfusion ; Diagnosis ; Dopamine ; Flushing ; Headache ; Hemorrhage ; Humans ; Hypertension ; Hypotension ; Mediastinum ; Middle Aged ; Nitroglycerin ; Paraganglioma* ; Sweat ; Sweating ; Tachycardia ; Thorax

Aniridia is a relatively rare congenital anomaly and its incidence is about 1:100, 000.Main features of aniridia include congenitally partial or nearly complete absence of the iris and hypoplasia of optic disc and fovea. It is almost bilateral and occurred as an autosomal dominant trait.However, some patients develop both sporadic nonfamilial aniridia and Wilms 'tumor, and another group of patients is transmitted as an autosomal recessive trait. We observed aniridia in two generations, as mother and two daughters. They had cataract, nystagmus, neovascularization of corneal margin and pannus formation, as well as aniridia.We also found hypoplasia of optic disc and fovea in mother. We have operated on mother with phacoemulsified lens aspiration and posterior chamber IOL implantation in both eyes consecutively.The postoperative visual acuity following lens extraction improved, but was not corrected. In addition, intraocular pressure decreased.
Aniridia* ; Cataract ; Family Characteristics ; Humans ; Incidence ; Intraocular Pressure ; Iris ; Mothers ; Nuclear Family ; Visual Acuity

PURPOSE: The globe luxation is a rare phenomenon in which there is a forward displacement of the eye ball so that the eye lids spasmodically close behind it. In Korea, no case has been reported. The authors experienced a case of globe luxation by laceration of the conjunctiva with trauma. METHODS: The authors experienced a case of globe luxation in 64-year-old male who had crushed with infantile marry-go-round handle and complained proptosis and ocular pain. Ocular examination revealed best corrected visual acuity of right eye 0.1, IOP 44mmHg, conjunctival hyperemia and laceration, extraocular muscle limitation in all direction. Exophthalmometer shows right eye 23mm, left eye 19mm. Orbital CT yielded proptosis and globe luxation without avulsion of internal and external rectus muscle and optic nerve. RESULTS: After the lateral canthotomy, we successfully treated with the corticosteroid therapy without visual impairment or eyeball movement disorder. we report a case of globe luxation with the review of literature.
Conjunctiva ; Exophthalmos ; Humans ; Hyperemia ; Korea ; Lacerations ; Male ; Middle Aged ; Movement Disorders ; Optic Nerve ; Orbit ; Vision Disorders ; Visual Acuity

BACKGROUND: In the Republic of Korea, there had been no reports about indigenous malaria cases since 1984 until a vivax malaria case was detected in 1993. Thereafter fram 1993 to 1996, 486 malaria cases were reported. Most of the patients were soldiers in the northern militarized zone. However, since 1997, several patients with malaria were detected in Kang Hwa where there had previously been no report of malaria cases. It is our intent to report the 16 cases diagrnosed in Kang Hwa Community Hospital from January 1, 1997 to August 10, 1998. METHODS: Medical records of the malaria cases from January 1, 1997, to August 10, 1998 in Kang Hwa Community Haspital were reviewed. All of the patients had no histories of traveling abroad, drug abuse or blood transfusion. They were all civilians. Laboratory studies including blood cell count, routine chemistry and platelet-associated IgG(PAIgG) and abdominal sanography were taken. RESULTS: All of the patients were diagnosed with malaria by blood smears. Common symptams were fever(100%), headache(94%), rigors(81%), myaJgia(56%), nausea or vomiting(44%), alternate day fever (25%), left flank pain(19%), diarrhea(13%), and abdominal pain(13%). Splenomegaly was detected in 92% of cases by sonography. Laboratory findings included leukopenia(37.5%), anemia(37.5%) and thrombocytopenia(81.3%). Platelet-associated IgG was elevated in 1 of 5 thrombocytopenic patients who had had the laboratory study performed. All recovered withaut complications. CONCLUSIONS: Cases of indigenous malaria have been progressively increasing in the Republic of Korea. Fortunately, patients responded well to treatment, but continued interest will be required in the future.
Blood Cell Count ; Blood Transfusion ; Chemistry ; Fever ; Hospitals, Community ; Humans ; Immunoglobulin G ; Malaria ; Malaria, Vivax ; Medical Records ; Military Personnel ; Nausea ; Republic of Korea ; Splenomegaly ; Substance-Related Disorders ; Thrombocytopenia

BACKGROUND: Patients with chest pain are common among outpatients. Several researches shows that chest pain patients can suffer from psychiatric illnesses such as hypochondriasis, depression, anxiety, somatization, panic disorder and so on. This study aims to examine the pschogenic symptoms in patients with noncardiac chest pain METHODS: In this study, the 98 people who have undergone treadmill test for chest pain during the three months from June 1st to September 30 of 1998 were selected, and the 98 patients were asked to respond to the prepared questionnaire and SCL-MPD(symptom check list-minor psychiatric disorders) before they underwent treadmill test. And then, they were classified into two groups. One group consisted of patients with noncardiac chest,pain, and the other group of patients with cardiac chest pain. These two groups were compared in 10 measures, and the compared results were analyzed by t-test. RESULTS: Among the 25 patients with cardiac chest pain, 15 patients were males and 10 patients (38%) were females, and among the 44 patients with noncardiac chest pain, 31 patients (70%) were males, 13 patients (30%) were females. The average age was 47 years old. The average age in patients with noncardiac chest pain was 48, and the 46 for those patients with cardiac chest pain . In the statistical analysis between the patients with cardiac chest pain and those with noncardiac chest pain, significant difference(p<0.005) was shown in the measures such as somatization, depression, phobic anxiety, obsessive-compulsive, neurasthenic, hypochondriacal, anxiety, anger-hostility, interpersonal sensitivity. CONCLUSIONS: As in the analysis the patients with noncardiac chest pain showed significant difference in the symptom check list-minor psychiatric disorder compared to those with cardiac chest pain. We conclude that primary care physician should take more interest in evaluating psychiatric symptoms in patients with noncardiac chest pain.
Anxiety ; Chest Pain* ; Depression ; Exercise Test ; Female ; Humans ; Hypochondriasis ; Male ; Middle Aged ; Outpatients ; Panic Disorder ; Physicians, Primary Care ; Thorax* ; Surveys and Questionnaires

Crossed renal ectopia is an unusual congenital anomaly, probably produced by abnormal development of the ureteral bud. The deformity itself produces no symptoms and the clinical presentation generally is for obstruction and infection. The pediatric patients present most often with multiple congenital anomalies, especially of the skeletal system. We report the two cases of crossed renal ectopia with fusion with review of literatures.
Congenital Abnormalities ; Humans ; Ureter

BACKGROUND: The purpose of this study was to investigate the relationship between 7 health habits and health-related quality of life using the SF-36 questionnaires. METHODS: The subjects for this study were 550 workers in Seongnam City, Kyonggi Province, Korea. Data were collected by using constructed questionnaires from 11 September 2004 to 25 September 2004. Statistical analyses were conducted using SPSS. RESULTS: There were positive relationships of favorable health habits as indicated by Alameda 7 to health-related quality of life. After controlling for the effects of confounding cofactors that included age, sex, diseases, and other health habits, multiple regression analysis indicated as follows. 1) The item of 'eating breakfast everyday' were significantly related to the grade of social function (SF) and bodily pain (BP). 2) The item of 'sleeping for 7~8 hours a day' were significantly related to all domains of the SF-36 except physical function (PF). 3) The item of 'normal Body Mass Index' were significantly related to the grade of Role limitations-emotional (RE). 4. The item of 'regular physical exercise' were significantly related to the grade of general health (GH), physical function (PF), Vitality (VT), and mental health (MH). Other health habits like not snacking between meals, never smoking, and low alcohol consumption were not associated with any of the SF-36 profiles. CONCLUSION: There were positive relationships of favorable health habits to health-related quality of life. It is important to have favorable health habits for good health-related quality of life.
Alcohol Drinking ; Breakfast ; Gyeonggi-do ; Korea ; Meals ; Mental Health ; Quality of Life* ; Smoke ; Smoking ; Snacks

The present study was conducted to examine metabolic risk factors and total antioxidant capacity (TAC) of Korean females living in Seoul and to investigate the relationship between the metabolic risk factors and serum TAC. A total of 353 females aged between 20 and 64 participated in the study. Obesity indicators, blood pressure, serum lipid profile and fasting blood glucose were measured as metabolic risk factors. Ferric reducing antioxidant power (FRAP) assay was employed to determine serum TAC of subjects. Obesity indicators such as body mass index, waist circumference and waist-hip ratio were significantly higher in the participants aged > or = 50 y (older group) than in the participants aged 20-49 y (younger group) (p < 0.001). Blood pressure, serum total cholesterol (TC), riglyceride (TG) and fasting blood glucose were also significantly higher in the older group than in the younger group (p < 0.001), demonstrating significant positive correlations between age and MS risk factors. The association between FRAP and MS risk factors were also investigated. FRAP values showed significant positive correlations with age (p = 0.001), serum TG (p = 0.002) and TC (p = 0.03). A tendency of positive association between FRAP and waist circumference was observed without any significant difference (p = 0.06). Increased serum FRAP with central obesity and serum lipids may be interpreted as results of activation of antioxidant defense system against oxidative stress induced by metabolic syndrome (MS) constituent factors. However, to verify the function of FRAP as a potential biomarker of susceptibility to MS various contributors to the plasma antioxidant capacity and their biological relevance related to MS should be elucidated further.
Aged ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Fasting ; Female ; Humans ; Obesity ; Obesity, Abdominal ; Oxidative Stress ; Plasma ; Risk Factors ; Waist Circumference ; Waist-Hip Ratio