Hospital transfusion service should be directed toward the optimization of transfusion therapy, but in practice the hospital transfusions, especially of fresh frozen plasma(FFP), were practiced inappropriately against the real need. So we evaluated the usage pattern of fresh frozen plasma in the Capital Armed Forces General Hostal during the period of January through December in 1994. And then, from 1995, after education of the clinician upon the basis of the survey in 1994, we regulated the use of FFP, by adapting the transfusion control program. We compared the result of 1995 to those of 1994, including the total used FFP number, the usage pattem in various disease and the combined use with other blood components. The results were as follow. 1. About 50% of total FFP was used inappropriately at 1994, and the main misuse was done to the patients who were suffering from renal disease and bum. About 14% of FFP usage combined with the packed RBCs was also seemed to be inappropriate in 1994. 2. In 1995, with the transfusion control program, there was 72% fall in the total hospital's usage of FFP and the misused conditions such as bum and nephrotic syndrome were virtually corrected. We concluded that the education, guideline and regulation by the director of the transfusion service could remarkably correct the inappropriate use of FFP without any special costs.
Arm ; Education ; Humans ; Nephrotic Syndrome ; Plasma*

For the evaluation of the 51Cr labelled in-vivo crossmatching test as a transfusion safety test, We examined the viability of the thransfused autologous and heterologous 51Cr labelled red cell at 1 hour and 24 hour in 6 normal volunteers and 4 patients whose RBC had been stored in CPDA-1 media from 1 day to 30 day. In both autologous transfusion control group(n=3) and allogeneic transfusion control group(n=3), the in-vivo RBC survival rate were more than 70% at 1 hour and 24 hour compared to that of basal 3 minute result(percent counted as 100%), and the eluted free radioisotope activity was less than 5% compared to that of whole blood. The crossmatch incompatible patient group also satisfied the safe transfusion criteria. The mean labelling efficiency which was tested in three patients was more than 95% and also satisfactory to reliable test. We concluded that in-vivo crossmatching test using 51Cr radioisotope would give us valuable informations about transfusion safety, especially in serologically incompatible patients.
Healthy Volunteers ; Humans ; Survival Rate

PURPOSE: The purpose of this study is to investigate the relative surgical risk and problems in hip hemiarthroplasty for treatment of an unstable intertrochanteric fracture in elderly patients over 80 years old. MATERIALS AND METHODS: Between April 2005 and May 2010, 58 patients whose age was over 80 years were available for inclusion in this study. They were divided into two groups: group 1 included 30 patients with femoral neck fracture and group 2 included 28 patients with intertrochanteric fracture. No significant differences in average age, concomitant disease, and walking ability before development of fracture were noted between the two groups. The following factors, including interval from development of fracture to operation, operation time, amount of blood loss, start time of walking after operation, duration of hospital stay, complications, revision rate, and walking ability were compared between the two groups. RESULTS: Operation time was an average of 85.2 minutes in group 1 and 97.5 minutes in group 2(P=0.03). The amount of bleeding was an average of 483 cc in group 1 and 695 cc in group 2(P=0.006). Similar results for walking start and recovery of walking ability after operation were observed in the two groups. No significant differences were observed in duration of hospital stay, complications, and revision rate. While 25 patients in group 1(83.3%) showed restoration of walking ability after operation to the same level of walking before injury, 19 patients in group 2(67.8%) showed restoration of walking ability postoperatively. CONCLUSION: Even though patients in group 2 showed a longer operation time and a higher amount of blood loss, compared with those in group 1, patients in group 2 had similar surgical risk and complications, compared with those in group 1. Therefore, primary hip hemiarthropalsty could be a good treatment option for intertrochanteric fracture in elderly.
Aged ; Femoral Neck Fractures ; Femur Neck ; Hemiarthroplasty ; Hemorrhage ; Hip ; Hip Fractures ; Humans ; Length of Stay ; Walking

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

PURPOSE: Most students choose the same option to questions in course evaluation surveys. Identical answers to each question render the results unreliable. The purpose of this study was to analyze the trend of medical student' consistent responses to course evaluations. METHODS: The data of this study were the results of a course evaluation over 3 years (from 2006 to 2008) at the School of Medicine at A University. RESULTS: The proportion of students who replied with the same answers to each question was below 20%. This result was consistent in freshmen, sophomores, and junior students. Using a 5-point Likert scale, more than 40% of the students gave 5 points consistently. CONCLUSION: We conclude that student' responses to evaluations do not have a significant impact on the reliability of course evaluations at Medical School at A University. These results differ significantly from those of previous research. Hence, future studies are required to analyze course evaluations in medical schools using diverse aspects.
Humans ; Schools, Medical

BACKGROUND: There has been rapid increase in demand for fresh frozen plasma and its derivatives in Korea. It may be due to active therapy by the clinicians especially hematologic and coagulopathy areas. So, now, the plasma is lack of supply of full demand. So, We studied the concurrent collection procedure of plasma during a plateletpheresis for the purpose of plasma supply. METHODS: Over three month period from January 1996 to March 1996, we introduced a program of concurrent collection of plasma (CCP) during plateletpheresis at Korea University Guro Hospital, in which the additional plasma are collected for preparation of FFP. Donors were enrolled in our 62 volunteer plateletpheresis. The 31 volunteers (group I) were done plateletphersis only, another volunteers (group II) were done CCP. We compared the platelet concentrate volume, to the characteristics of donor's condition and the adverse reaction during plateletpheresis between two groups. RESULTS: Before the plateletpheresis, there were no differences in the age, weight, height, pre-platelet count between the two groups. Also there were no adverse reactions through the procedure, such as perioral paresthesia, hypotension, hyperventilataion, chills, nausea and vomiting. The mean platelet count per unit did not show significant differences between two groups. In group 1, the mean platelet concentrate volume was 300 mL, yield was 4.5 x 1011 and group II, the volume was 315 mL, the yield was 5.1 x 1011 and the fresh plasma volume was 223 mL. CONCLUSION: We have experienced the concurrent collection procedure of plasma during a plateletpheresis from 31 volunteers without main adverse reactions.
Blood Platelets ; Chills ; Humans ; Hypotension ; Korea ; Nausea ; Paresthesia ; Plasma ; Plasma Volume ; Platelet Count ; Plateletpheresis ; Tissue Donors ; Volunteers ; Vomiting

PURPOSE: Following the first in 1990, the use of course evaluations(CE) by medical schools across the Republic of Korea has grown steadily since 1997. The purpose of this study was to investigate these CE programs and to make general recommendations for further implementation. METHODS: A questionnaire survey was conducted by mail. From June 20 to September 22, 2006, data was obtained from 38 of the 41(93%) medical schools in the country. Of those who responded, 27 schools also sent their CE forms as requested. RESULTS: There was little difference among the 38 medical schools in the main body, methods, frequency, grades, systems of evaluation, and types of survey. Evaluation criteria such as instructor effectiveness, course management efficiency, and student satisfaction showed high frequency, whereas issues concerning learning objectives and workload were less common. In contrast, the stated purposes of employing CE varied from school to school. While 92% of the respondents regarded improvement to the quality of instruction as the goal of their programs, 32% indicated that CE results also factored in administrative decisions concerning promotion, tenure, and salary increases. CONCLUSION: In addition to embracing the expanding role and influence of CE in Korean medical education, schools must proactively enact measures to enhance further implementation. First, evaluation criteria should be better formulated to increase the consistency, reliability, and validity of CE results. Next, to promote efficiency, the scheduling and methodology of CE administration should carefully consider the medical curriculum. Finally, professional attitudes should be fostered to recognize the value of CE as a tool for raising educational standards overall.
Curriculum ; Surveys and Questionnaires ; Education, Medical ; Humans ; Learning ; Postal Service ; Republic of Korea ; Salaries and Fringe Benefits ; Schools, Medical*

PURPOSE: The purpose of this study was to review the relationship between physical activity and cardiovascular outcomes in the Korean elderly. METHODS: Experimental studies were located using PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed. The selected studies for analysis were 20 articles of cardiovascular outcomes (total cholesterol, triglyceride, high density lipoprotein (HDL), low density lipoprotein (LDL), blood pressure, and pulse rate) from 515 articles. RESULTS: One-group pretest-posttest design was the most common. The main physical activity was an aerobic exercise. Five of 14 studies reported a significant improvement of total cholesterol. Four of 14 studies found relationship between exercise and triglyceride. Eight of 12 studies reported a significant improvement of HDL, whereas 3 of 9 studies reported a significant improvement of LDL. In over 60% of selected studies, reported significant improvement of blood pressure. CONCLUSION: Based on the review, it suggests that regular physical activity of the elderly may improve cardiovascular outcomes.
Aged* ; Blood Pressure ; Cardiology ; Cholesterol ; Exercise ; Humans ; Lipoproteins ; Motor Activity* ; Triglycerides

PURPOSE: The purpose of this study was to review the effects of physical activity on musculoskeletal outcomes in older Koreans. METHODS: Experimental studies were retrieved from the search engines (PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed). The selected studies for analysis were 27 articles of musculoskeletal outcomes (gait, muscle strength, flexibility, balance, grip strength, endurance, body fat, and weight) from 515 articles. RESULTS: The most common type of physical activity was a resistance exercise. There were significant improvements in gait (71.4%), muscle strength (86.7%), flexibility (63.6%), balance (72.2%), grip strength (71.4%), endurance (71.4%), body fat (57.1%), and weight (28.6%). The activity programs that apply over 150 minutes a week showed greater improvement of 69.5% than 65.0% from those did not meet the guidelines totally. CONCLUSION: Based on the review, we conclude that regular physical activity in the elderly may improve the musculoskeletal outcomes. To be more effective programs, it is necessary to meet the guidelines of 150 minutes a week or 30 minutes of moderate-intensity activities on 5 days per week for the elderly.
Adipose Tissue ; Adult* ; Aged ; Gait ; Hand Strength ; Humans ; Motor Activity* ; Muscle Strength ; Musculoskeletal System ; Pliability ; Search Engine

Hormone replacement therapy combined with progestogens induces changes in effect of estrogen on serum lipid levels and it has been known that the changes depend on a type and dosage of progestogen. It is also known that progestational agent induces positive ch-ange in bone mineral density. To study the effects of progestogen on lipoprotein and bone metabolism, we administ- ered conjugated equine estrogen 0.625 mg alone to 50 postmenopausal women, in combinat- ion with medroxy- progesterone acetate 5 mg to 40 postmenopausal women. The data demonstrated a beneficial effect in lipoprotein profiles in both groups. Total cholesterol in two groups decreased from the baseline values, LDL-cholesterol decreased significantly by 4.8 % in group I and 16.2 % in group II(p < 0.05), HDL-cholesterol increa- sed significantly by 11.3 % in group I and 14.7 % in group II(p < 0.05), triglyceride incre- ased slightly in both groups. Bone mineral density of femur was maintained and BMD of vertebrae increased by 1.1 % in group I and 2.0 % in group II, but it is not statistically significant. The differences of changes between two groups were not statistically significa- nt. Our results suggest that medroxyprogesterone acetate have no adverse effect on HDL -cholesterol and have no additive effect on bone mineral density in hormone replacement therapy.
Bone Density* ; Cholesterol ; Estrogens* ; Female ; Femur ; Hormone Replacement Therapy ; Humans ; Lipoproteins ; Medroxyprogesterone Acetate ; Metabolism ; Progesterone ; Progestins ; Spine ; Triglycerides