Anaphylactic transfusion reaction is caused by deficiency of certain protein(s) in the recipient. We report on the experience of platelet count recovery using washed platelets for transfusion in a patient who developed an anaphylactic transfusion reaction. A 50-year old male diagnosed with angioimmunoblastic T-cell lymphoma was treated with chemotherapy followed by autologous hematopoietic stem cell transplantation. Immediately after starting transfusion of apheresis platelets, he began sweating and complained of visual impairment, chest discomfort, and abdominal pain. Both systolic and diastolic blood pressures and oxygen saturation monitored by pulse oximetry were decreased. Platelet transfusion was discontinued immediately and hydrocortisone was administered, and the symptoms and signs were resolved within two hours. Laboratory test using post-transfusion blood showed no apparent evidence of hemolysis. Platelet washing procedure using normal saline three times was newly set to prevent anaphylactic reaction in the patient. Transfusions of washed platelets were performed 20 times for 60 days, and the patient showed no anaphylactic reaction during this period. He showed no evidence of immunoglobulin A, haptoglobin, C3, or C4 deficiencies. We confirmed that washed platelet transfusion is highly effective for prevention of anaphylactic transfusion reaction.
Abdominal Pain ; Anaphylaxis ; Blood Component Removal ; Blood Group Incompatibility* ; Blood Platelets* ; Drug Therapy ; Haptoglobins ; Hematopoietic Stem Cell Transplantation ; Hemolysis ; Humans ; Hydrocortisone ; Immunoglobulin A ; Lymphoma, T-Cell ; Male ; Oximetry ; Oxygen ; Platelet Count ; Platelet Transfusion* ; Sweat ; Sweating ; Thorax ; Vision Disorders

This study was undertaken to investigate mineral changes in weathered scalp hair after burial. EDX (energy dispersive X-ray spectroscopy) analysis was performed to measure the presence of minerals on the hair surface. Twelve scalp hairs, buried for 5-40 years, were chosen from deceased individuals buried in tombs in Soha-Ri, Kyonggi-Do, and other regions in Korea. Three normal hairs were used as the control group. EDX data showed that carbon, oxygen, and sulfur were detected in hair collected from all three burial grounds. In contrast, calcium was only detected in hair collected from tombs in Soha-ri. The amounts of calcium and sulfur were found to decrease with time for hair collected from tombs in Soha-ri. Similar results were observed with sodium for hair collected from other regions. These results show region specific mineral detection and a decrease in the concentration of minerals with time. Consequently, it is suggested that changes in minerals concentration in weathered hair could be used as basic data in the field of forensic medicine.
Burial ; Calcium ; Carbon ; Forensic Medicine ; Forensic Sciences ; Hair ; Humans ; Korea ; Minerals ; Oxygen ; Scalp ; Sodium ; Spectrometry, X-Ray Emission ; Sulfur ; Weather

This study was undertaken to investigate the morphological changes of scalp hair according to weathering after burial and to offer basic data for forensic science. To examine the effect of weathering degree, the 51 human scalp hairs buried after death were taken from deceased individuals in tombs in Korea. The morphological changes in weathering hair shafts of the scalp were investigated using the transmission electron microscopes (TEM). There were little morphological differences of weathering depending on the burial period. The weathering changes includes detachment of cuticle layer, aggregation of macrofibril and hollow formation in the cortex according to the burial period. These results could provide basic data to the field of forensic medicine.
Burial ; Electrons ; Forensic Medicine ; Forensic Sciences ; Hair ; Humans ; Korea ; Scalp ; Weather

This study was undertaken to investigate the morphological changes of scalp hair according to weathering after burial and to offer basic data for forensic science. To examine the effect of weathering degree, the 51 human scalp hairs buried after death were taken from deceased individuals in tombs in Korea. The morphological changes in weathering hair shafts of the scalp were investigated using the transmission electron microscopes (TEM). There were little morphological differences of weathering depending on the burial period. The weathering changes includes detachment of cuticle layer, aggregation of macrofibril and hollow formation in the cortex according to the burial period. These results could provide basic data to the field of forensic medicine.
Burial ; Electrons ; Forensic Medicine ; Forensic Sciences ; Hair ; Humans ; Korea ; Scalp ; Weather

BACKGROUND: Accurate measurement of blood glucose concentrations is essential for defining diabetes, and the minimization of ex vivo glycolysis has been recommended. Recent guidelines advocate two kinds of methods for sample collection and processing: either the sodium fluoride (NaF) method or immediate refrigeration using a serum separation tube (SST). We investigated the difference between the two methods in measuring subsequent glucose concentrations using blood specimens from participants recruited for the fourth Korean National Health and Nutrition Examination Survey. METHODS: Paired venous blood samples were collected in an SST and a NaF tube from 1,103 men and women. SST serum was separated within 30 min, including standing for 15 min, and then refrigerated. The NaF samples were refrigerated, but not separated until immediately before analysis. We compared the blood glucose concentrations between the SST (SST glucose) and NaF (NaF glucose) methods. RESULTS: The mean SST glucose was significantly higher than NaF glucose (99.0 mg/dL vs 96.5 mg/dL, P<0.05). NaF glucose showed a negative mean bias of 2.6 mg/dL vs SST glucose but showed high correlation (R=0.9899). There was no significant correlation between the bias of blood glucose concentrations by two methods and the storage time of NaF glucose. CONCLUSIONS: The negative bias associated with the use of NaF tubes may significantly affect the prevalence of diabetes. Serum separation and refrigeration within 30 min after venous sampling is recommended over NaF method, not only to minimize the preanalytical impact on detecting diabetes but also to reduce sample volume and number of tubes.
Blood Glucose/*analysis ; Blood Specimen Collection/*methods ; Diabetes Mellitus/diagnosis ; Female ; Glycolysis/*drug effects ; Humans ; Male ; Nutrition Surveys ; Republic of Korea ; Sodium Fluoride/*pharmacology ; Specimen Handling

BACKGROUND: Observation on the hemodialysis treatment; whether there are any different effects on mortality rate, side effects, or effectiveness of the treatment depending on patients' age. METHODS: Chronic renal failure patients who started hemodialysis treatment between 2002 and 2003 were separated in two groups, 33 patients of 60 and older and 76 patients under 60. We investigated mortality rate difference, A-V shunt re-operation, and total protein and albumin level. Also, comparing and analyzing the urea reduction ratio, we examined whether effectiveness is different depending on the patients' age. RESULTS: The 3 year survivor rate of patients who initially started hemodialysis treatment over 60 was 66.7%, and that of the patients under 60 resulted as 73.1%. The average total protein lefel for over 60 was 6.48g/dL and for under 60 was 6.80g/dL, and albumin for over 60 was 3.15g/dL and under 60 was 3.46g/dL. We identified that the patients who repeated shunt operation in over 60 group was 4(12%) and in under 60 group was 4(5.2%). Effectiveness of the treatment, Urea Reduction Ratio(URR), for both groups was 71%. CONCLUSION: The 3 year survivor rate of patients who initially started hemodialysis treatment over 60 was lower than the control group, but considering the remaining life expectancy, it seems to be no significant difference between the groups; and the treatment effectiveness was same in both groups.
Humans ; Kidney Failure, Chronic ; Life Expectancy ; Prognosis ; Renal Dialysis ; Survivors ; Treatment Outcome ; Urea

BACKGROUND: Recently, many Korean people travel abroad where malaria is prevalent. However, in Korea, relatively little is known about compliance of chemoprophylaxis against malaria. This study was performed to determine the factors influencing compliance of chemoprophylaxis against malaria in Korean travelers. MATERIALS AND METHODS: Face to face interview, telephone interview and e-mail correspondence were performed to 241 people who were prescribed with atovaquone-proguanil at the international travelers' clinic of National Medical Center between February 2007 and October 2007. RESULTS: Total of 55 people out of 235 reported one or more events of adverse reactions after chemoprophylaxis (total 76 events). However, in 38 adverse events the link between chemoprophylaxis and adverse events were very weak. Compliance of malaria chemoprophylaxis with atovaquone-proguanil was 53.9% in the study group. The predictive factors for non-compliance were package tour, travel of business affair and young age group. Conclusions: Compliance of malaria chemoprophylaxis in Korea travelers was low compared with Dutch and French studies. More efforts to increase compliance are needed, especially in travelers on package tour, business travel and people under age 40.
Aluminum Hydroxide ; Atovaquone ; Carbonates ; Chemoprevention ; Commerce ; Compliance ; Drug Combinations ; Electronic Mail ; Humans ; Interviews as Topic ; Korea ; Malaria ; Proguanil

BACKGROUND: Recently, many Korean people travel abroad where malaria is prevalent. However, in Korea, relatively little is known about compliance of chemoprophylaxis against malaria. This study was performed to determine the factors influencing compliance of chemoprophylaxis against malaria in Korean travelers. MATERIALS AND METHODS: Face to face interview, telephone interview and e-mail correspondence were performed to 241 people who were prescribed with atovaquone-proguanil at the international travelers' clinic of National Medical Center between February 2007 and October 2007. RESULTS: Total of 55 people out of 235 reported one or more events of adverse reactions after chemoprophylaxis (total 76 events). However, in 38 adverse events the link between chemoprophylaxis and adverse events were very weak. Compliance of malaria chemoprophylaxis with atovaquone-proguanil was 53.9% in the study group. The predictive factors for non-compliance were package tour, travel of business affair and young age group. Conclusions: Compliance of malaria chemoprophylaxis in Korea travelers was low compared with Dutch and French studies. More efforts to increase compliance are needed, especially in travelers on package tour, business travel and people under age 40.
Aluminum Hydroxide ; Atovaquone ; Carbonates ; Chemoprevention ; Commerce ; Compliance ; Drug Combinations ; Electronic Mail ; Humans ; Interviews as Topic ; Korea ; Malaria ; Proguanil

BACKGROUND: A questionnaire survey was performed to perceive the problem of the current medical insurance reimbursement system for laboratory tests referred to independent medical laboratories; then, we intended to find a way to improve the reimbursement system. METHODS: Questionnaires were distributed to 220 independent medical laboratories and 700 laboratory physicians from July through October 2005. Frequency analysis was used to analyse the replies from 109 respondents to 25 questionnaire items regarding the current medical insurance reimbursement system for referral tests, problems with the system, and suggestions for the improvement of the system. RESULTS: Among the 109 respondents to this survey, 49 (45.8%) considered the current reimbursement system to be unsatisfactory, while only 16 (15.0%) answered satisfactory. The problem was that the referral clinics-not the laboratories that performed the tests--would first receive their reimbursement for the laboratory tests from Health Insurance Review Agency (HIRA) and then give a portion of the laboratory test fees to the independent medical laboratories after the deduction of administrative fees. They (62.5% of the respondents) would prefer a separated reimbursement system by which the referral clinic-as well as the independent medical laboratory-would receive their reimbursement directly from HIRA through an Electronic Data Interchange (EDI) system. In this new system, 34% of the respondents expected the quality of the laboratory tests to be improved; however, 41.6% answered that the income of the referral clinic is expected to decrease. CONCLUSIONS: For the improvement of the medical insurance reimbursement system, the administrative fee for the referral clinic and the test fee for the independent medical laboratory should be reimbursed directly to the respective organizations. These changes could be made possible with the proper analysis of medical costs and the development of an effective EDI reimbursement system.
Clinical Laboratory Techniques/*economics ; Female ; Humans ; *Insurance, Health, Reimbursement ; Korea ; Laboratories, Hospital/economics ; Male ; Questionnaires

Systemic manifestation of tuberculosis is common, but tuberculous biliary obstruction of the pancreas and a colon adenocarcinoma with combined colonic tuberculosis is an uncommon disorder. We encountered a case of the above condition in 63-year-old male that was admitted to our hospital because of fever, diffuse abdominal pain and rigidity. Abdominal computed tomography showed biliary and pancreatic duct dilatation with left colonic wall thickening and surrounding peritoneal infiltration. Emergency segmental resection of the descending colon with intraoperative T-tube choledochostomy was performed due to the colon mass and biliary obstruction. A colonofiberoscopy was performed for low abdominal pain and hematochezia at 12 days after surgery. It showed multiple colonic ulcerations with a partial stricture. A colonic biopsy showed granulomatous inflammation with acid-fast bacilli. The cause of the biliary obstruction was also revealed as pancreatic tuberculosis by an intraoperative pancreatic and mesenteric biopsy. The patient improved after antituberculous treatment and the patient has been in good health until the last outpatient follow-up visit.
Abdominal Pain ; Adenocarcinoma* ; Biopsy ; Choledochostomy ; Colitis* ; Colon* ; Colon, Descending ; Colonic Neoplasms ; Constriction, Pathologic ; Dilatation ; Emergencies ; Fever ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Humans ; Inflammation ; Male ; Middle Aged ; Outpatients ; Pancreas ; Pancreatic Ducts ; Tuberculosis* ; Ulcer