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 hyperimmunoglobulin E syndrome is a primary immunodificiency disorder characterized by recurrent staphylococcal infections and markedly elevated serum IgE level. Clinical features are coarse face and severe infections of the skin-furunculosis or chronically pruritic dermatitis and sinopulmonary tract infection from infancy by coagulase positive Staphylococcus aureus, or Candida albicans etc. The patients's serum IgE level is elevated but the basic immunologic pathogenesis not fully understood. We have experienced a case of hyperimmunoglobulin E syndrome in a 26/12-year-old who had suffered from recurrent staphylococcal pneumonias and abscesses and chronically pruritic dermatitis from 1 month of age with elevated serum IgE level. A brief review of the related literature is presented.
Abscess ; Candida albicans ; Coagulase ; Dermatitis ; Immunoglobulin E ; Pneumonia, Staphylococcal ; Staphylococcal Infections ; Staphylococcus aureus

No abstract available.
Hemochromatosis* ; Spleen*

Purpose: This study examined whether various lower extremity exercises using a Swiss ball in the standing position could improve balance, muscle strength, gait, and fall efficacy in stroke patients. Methods: Twenty-one stroke patients were randomly divided into three groups, each with seven participants. For four weeks, experimental group 1 performed various lower extremity exercises using a Swiss ball, while experimental group 2 executed the same exercises without a Swiss ball, and the control group underwent general physical therapy. The subjects’ knee extensor muscle strength, balance, gait, and fall efficacy were evaluated before and after the intervention using portable muscle strength measurement, the Berg Balance Scale (BBS), G-walk, and the Korean Falls Efficacy Scale (K-FES). Results: Knee extensor strength increased significantly in all three groups after the intervention; in particular, a significant increase was seen in experimental groups 1 and 2 compared to the control group. Moreover, all three groups had significantly better BBS scores and higher cadence after the intervention; notably, experimental group 1 had better scores and increased cadence than the control group.Additionally, gait speed was significantly increased in the experimental group 1 than in the control group. The step length of the non-affected leg was also significantly higher in the same group. The K-FES score improved significantly in all three groups, but there was no significant difference between the groups. Conclusion This study suggests that lower extremity exercises with or without a Swiss ball could be effective interventions to improve muscle strength, balance, gait, and fall efficacy in stroke patients.

Purpose: This study examined whether various lower extremity exercises using a Swiss ball in the standing position could improve balance, muscle strength, gait, and fall efficacy in stroke patients. Methods: Twenty-one stroke patients were randomly divided into three groups, each with seven participants. For four weeks, experimental group 1 performed various lower extremity exercises using a Swiss ball, while experimental group 2 executed the same exercises without a Swiss ball, and the control group underwent general physical therapy. The subjects’ knee extensor muscle strength, balance, gait, and fall efficacy were evaluated before and after the intervention using portable muscle strength measurement, the Berg Balance Scale (BBS), G-walk, and the Korean Falls Efficacy Scale (K-FES). Results: Knee extensor strength increased significantly in all three groups after the intervention; in particular, a significant increase was seen in experimental groups 1 and 2 compared to the control group. Moreover, all three groups had significantly better BBS scores and higher cadence after the intervention; notably, experimental group 1 had better scores and increased cadence than the control group.Additionally, gait speed was significantly increased in the experimental group 1 than in the control group. The step length of the non-affected leg was also significantly higher in the same group. The K-FES score improved significantly in all three groups, but there was no significant difference between the groups. Conclusion This study suggests that lower extremity exercises with or without a Swiss ball could be effective interventions to improve muscle strength, balance, gait, and fall efficacy in stroke patients.

No abstract available.
Anaphylaxis* ; Aprotinin* ; Thoracic Surgery*

Propylthiouracil(PTU) is one of lupus-inducing drugs, though rarely reported. We report a case of PTU-induced lupus, with the review of of previous literatures. Lupus-like symptoms in a 28year-old female patient, who had been suffering from relapsed Graves' disease, were presented during PTU therapy. The results of antinuclear antibody and anti-histone antibody were positive. After symptomatic reatment and discontinuation of PTU, all of the symptoms and the abnormalities in laboratory tests disappeared, which suggested drug-induced lupus.
Antibodies, Antinuclear ; Female ; Graves Disease ; Humans ; Propylthiouracil

Purpose: To investigate the effects of simultaneous soft and hard tissue augmentation and the addition of polydeoxyribonucleotide (PDRN) on regenerative outcomes. Materials and Methods: In five mongrel dogs, chronic ridge defects were established in both mandibles. Six implants were placed in the mandible, producing buccal dehiscence defects. The implants were randomly allocated to one of the following groups: 1) control: no treatment; 2) GBR: guided bone regeneration (GBR) only; 3) GBR/PDRN: GBR+PDRN application to bone substitute particles; 4) GBR/CTG: GBR+connective tissue grafting (CTG);5) GBR/VCMX: GBR+soft tissue augmentation using volume stable collagen matrix (VCMX); and 6) group GBR/VCMX/ PDRN: GBR+VCMX soaked with PDRN. The healing abutments were connected to the implants to provide additional room for tissue regeneration. Submerged healing was achieved. The animals were euthanized after four months. Histological and histomorphometric analyses were then performed. Results: Healing abutments were gradually exposed during the healing period. Histologically, minimal new bone formation was observed in the dehiscence defects. No specific differences were found between the groups regarding collagen fiber orientation and density in the augmented area. No traces of CTG or VCMX were detected. Histomorphometrically, the mean tissue thickness was greater in the control group than in the other groups above the implant shoulder (IS). Below the IS level, the CTG and PDRN groups exhibited more favorable tissue thickness than the other groups. Conclusion Failure of submerged healing after tissue augmentation deteriorated the tissue contour. PDRN appears to have a positive effect on soft tissues.

Achondroplasia is a rare disease and characterized by the combination of short extremities with an enlarged head and a trunk approximating normal size. We had experienced 4 cases of achondroplasia; they all showed stunted growth, short arms and legs, prominent forehead, flattening of the bridge of the nose and moderate degree of kyphcsis and one case was associated with hydrocephalus. X-ray showed the thickness of the bones and their irregular epiphyseal ends such as cupping, flaring and spurs. Intelligence seemed to be normal except one case. We had seen those patients at the age of 8 months, 6 months and 1year, 7months and 2 years, confirming achodroplasia by clinical, X-ray survey and biochemical study. Review of the references concerning achondroplasia was made briefly.
Achondroplasia* ; Arm ; Extremities ; Forehead ; Head ; Humans ; Hydrocephalus ; Intelligence ; Leg ; Nose ; Rare Diseases

No abstract available.