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

The results of ABO blood typing in 64-year-old patient with chronic renal and heart failure were positive with anti-B, delayed and weak positive with anti-A in the slide method for the cell typing, mixed-field agglutiniation by light microscopy in the tube method for the cell typing, and also was negative in anti-A, lectin and positive in anti-H, therefore blood typing of this patient was confirmed to A3B.
Blood Grouping and Crossmatching ; Heart Failure ; Humans ; Microscopy ; Middle Aged

BACKGROUND: There is no comprehensive report on the donor reaction rate among blood donors in South Korea. We attempted to analyze the patterns and rates of immediate blood donor reactions and the current status of the reporting system in our country. METHODS: Immediate donor reaction rate was defined as the number of donor reaction cases in 10,000 donations during or immediately after donation. We retrospectively analyzed the 4,835,499 donations collected in 2 yr (2008 and 2009) at the Korean Red Cross Blood Center. The data presented are the average data of the 2 yr. RESULTS: The overall donor reaction rate was 8.7. The rate for subcutaneous bleeding, vasovagal reaction, and nerve injury was 4.1, 4.0, and 0.1, respectively. For citrate reaction, which occurred among apheresis donations, the donor reaction rate was 0.4. The overall reaction rates among male and female donors were 6.0 and 16.2, respectively. The rates were highest in teenagers (12.0) and lowest in those in their forties (4.3). The most frequent reaction in male donors was subcutaneous bleeding (3.3); that in female donors was vasovagal reaction (8.9). CONCLUSIONS: The donor reaction rate of the study was lower than that of other countries or that of domestic prospective studies by a local blood center. These data suggested that the reporting system for blood donor reactions in Korean donors is not active, and that national standards and the continuing education of blood-collection personnel regarding donor reactions should be established to ensure reliable data collection.
Adolescent ; Blood Component Removal ; Blood Donors ; Citric Acid ; Data Collection ; Dietary Sucrose ; Education, Continuing ; Female ; Hemorrhage ; Humans ; Male ; Red Cross ; Republic of Korea ; Retrospective Studies ; Tissue Donors

No abstract available.
Classification* ; Dermatoglyphics* ; Yersinia*

BACKGROUND: Transfusion is a choice of treatment and should be used in order to maintain patients' lives and health. In order to supply safe blood, the quality improvements of hospital blood collection centers should be periodically monitored. To establish systematic surveillance of blood management system, we would like to suggest proper program. METHODS: Twenty-nine hospital small scale blood centers, collects less than 100 units of blood collection per year, were evaluated. Qualified were selected among blood bank specialists who were eligible to simultaneously perform inspections and consultations, and who had attended inspectors' workshop. RESULTS: Among twenty-five blood collection centers, four blood collection centers were closed prior to inspections. Among them, two blood collection centers were evaluated as inadequate. Among adequate centers, some questionnaires were evaluated as "not applicable" mainly for reasons pertaining to personnel and facilities, such as blood component preparation rooms and/or center administrators. CONCLUSION: A checklist for an inspection program should be reviewed continuously. Additionally, detailed guidelines for inspection should be standardized prior to commencing of subsequent year's inspection program. Finally, guidelines for inspection should be established for every questionnaire.
Blood Banks ; Checklist ; Quality Improvement ; Referral and Consultation ; Specialization ; Surveys and Questionnaires

Authors found a case of anti-Yka antibody in a 66-year-old female patient with acute peritonitis due to colon cancer perforation. Although anti-Yka antibody has no clinical significance, its high-titer, low-avidity (HTLA) characteristics with weak and variable reactivity to Yk(a+) RBC in the indirect antiglobulin test can cause confusion and difficulties in identifying coexisting clinically significant antibodies. Titration studies could be used to determine such reactions due to HTLA antibodies. Since anti-Yka antibody has not been shown to cause significant destruction of transfused Yk(a+) RBC, Yk(a+) units can be safely transfused to patients with anti-Yka antibody unless clinically significant antibodies coexist in their sera. This is the first case report of anti-Yka antibody as an high-titer, low-avidity antibody in Korea.
Aged ; Antibodies ; Blood Transfusion ; Colonic Neoplasms ; Coombs Test ; Female ; Humans ; Korea ; Peritonitis

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

BACKGROUND: Because ABO reverse typing reagents approved by the Ministry of Food and Drug Safety (MFDS) for manual typing are rare in Korea, 3% DiaCell ABO A₁ red blood cell (RBC) reagents (DiaCell A₁, BioRad, DiaMed, Cressier, Switzerland) and DiaCell ABO B RBC reagents (DiaCell B) for a manual technique were compared with already approved RBC reagents for the acquisition of an import permit. METHODS: Residual plasmas or sera were collected after routine ABO grouping or other tests. The reverse typing tests were performed by a manual tube technique with DiaCell A₁& B as the test reagents and 0.8% ID-DiaCell ABO A₁& B RBC reagents, ID-Card for NaCl, and an IH-1000 autoanalyzer from the same manufacturer of DiaCell A₁& B as the control reagents. Agreements, clinical sensitivities and clinical specificities between test and control reagents were calculated. RESULTS: Comparison tests were performed in 1000 samples, and agreements were 99.9% for DiaCell A₁ and 100.0% for DiaCell B. Clinical sensitivities and clinical specificities were 99.9% and 100.0% for DiaCell A₁ and all 100.0% for DiaCell B, respectively. CONCLUSION: Because the evaluation results of DiaCell A₁ and B were all satisfied with more than 99% as the evaluation criteria of MFDS, they were concluded to be suitable for use as ABO reverse typing reagents for manual typing. The results of this study are also expected to be useful in the design of clinical trials for approval of future in vitro medical devices.
Erythrocytes* ; In Vitro Techniques ; Indicators and Reagents* ; Korea ; Plasma

In recent years pulmonary function teste have had a wide application in clinical pulmonary diseases. By combining a number of different pulmonary function tests, abnormality present in a particular pa tient can be defined. This narrows the list of possible diagnosis and allows to determine accurately the degree of impairment and assess the pesponse to therapy. To assess the pulmonary function in a patient and label as abnormal, it becomes important to define the range of expected values for a normal population. These normal'predicted values'vary according to sex and prowth, i.e., age, height, and weight, particularly in children. In addition, race and geography have been consistently shown to bc an important determinant of lung function. In order to obtain normal perdicted values of pulmonary function tests in Korean school-aged children, we performed spirometry-based pulmonary function tests on the normal healthy 2022 children, age from 6 through 15, and analyzed the data, with the parameters such as sex, age, height, weight, and body surface area. We calculated each of their simple and complex linear and logarithmic regression equations setting the predicted values. The results are as follows: 1) Predicted values of pulmonary function test items were generally higher in boys than those of girls. 2) A correlation coefficient to the parameters examined was the highest in FEV1, then those of FVC, FEF25,PEFR, FEF50, MMEF, AND FEF75 follow in order. 3) Of the parameters examined, height had the highest correlation coefficient consistently in all pulmonary function test items. 4) As compared with the inland and overseas data, some differences were observed.
Body Surface Area ; Child* ; Continental Population Groups ; Diagnosis ; Female ; Geography ; Humans ; Lung ; Lung Diseases ; Respiratory Function Tests*

BACKGROUND: This study was performed to develop a dietary self-efficacy questionnaire and to determine how dietary self-efficacy is related to selected biochemical markers and health-related quality of life in hemodialysis patients. METHODS: Participants included 172 patients who had been participating in a dialysis program for at least 6 months at two teaching hospitals. A questionnaire was used to assess socio-demographic factors, dialysis-related factors, dietary self-efficacy, and kidney disease quality of life (KDQOL). Serum levels of potassium and phosphorus and interdialytic weight gain were also measured. RESULTS: The internal reliability of dietary self-efficacy was 0.944 (Cronbach's alpha). Principal component analysis resulted in two factors, situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice. The correlation analysis showed a significant association between situational self-efficacy of compliance with dietary guidelines and serum potassium and KIDQOL. The average scores of situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice in the participants were 3.52+/-0.72 and 3.61+/-0.71 respectively. Multiple linear regression analysis showed that the situational self-efficacy of compliance with dietary guidelines was significantly associated with serum potassium level and KDQOL and self-efficacy of food choice was significantly associated with KDQOL. CONCLUSIONS: Based on our results, the developed dietary self-efficacy questionnaire may be a suitable survey tool for hemodialysis patients, which can play a role in predicting clinical indicators of patient and health-related quality of life. We recommend further research into clarifying whether the positive effects of increased dietary self-efficacy is maintained in long-term dialysis patients.
Biomarkers ; Compliance ; Dialysis ; Diet ; Hospitals, Teaching ; Humans ; Kidney Diseases ; Linear Models ; Phosphorus ; Potassium ; Principal Component Analysis ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Weight Gain