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Analysis of Massive Transfusion Blood Product Use in a Tertiary Care Hospital (일개 3차 의료기관의 대량수혈 혈액 사용 분석)

  • Lim, Young Ae;Jung, Kyoungwon;Lee, John Cook-Jong
    • The Korean Journal of Blood Transfusion
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    • v.29 no.3
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    • pp.253-261
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    • 2018
  • Background: A massive blood transfusion (MT) requires significant efforts by the Blood Bank. This study examined blood product use in MT and emergency O Rh Positive red cells (O RBCs) available directly for emergency patients from the Trauma Center in Ajou University Hospital. Methods: MT was defined as a transfusion of 10 or more RBCs within 24 hours. The extracted data for the total RBCs, fresh frozen plasma (FFP), platelets (PLTs, single donor platelets (SDP) and random platelet concentrates (PC)) issued from Blood Bank between March 2016 and November 2017 from Hospital Information System were reviewed. SDP was considered equivalent to 6 units of PC. Results: A total of 345 MTs, and 6233/53268 (11.7%) RBCs, 4717/19376 (24.3%) FFP, and 4473/94166 (4.8%) PLTs were used in MT (P<0.001). For the RBC products in MT and non-MT transfusions, 28.0% and 34.1% were group A; 27.1% and 26.0% were group B; 37.3% and 29.7% were group O, and 7.5% and 10.2% were group AB (P<0.001). The ratios of RBC:FFP:PLT use were 1:0.76:0.72 in MT and 1:0.31:1.91 in non-MT (P<0.001). A total of 461 O RBCs were used in 36.2% (125/345) of MT cases and the number of O RBCs transfused per patient ranged from 1 to 18. Conclusion: RBCs with the O blood group are most used for MT. Ongoing education of clinicians to minimize the overuse of emergency O RBCs in MT is required. A procedure to have thawed plasma readily available in MT appears to be of importance because FFP was used frequently in MT.

Analysis of Reentry Test for the Donors Showing Reactivity or Grey Zone in a HBV Surface Antigen Assay by a Chemiluminescent Immunoassay (화학발광면역법에 의한 HBV 항원선별검사에서 양성 및 Grey Zone 결과를 보인 헌혈자의 헌혈 보류 해제 검사 결과 분석)

  • Shin, Sunmi;Kang, Jungwon;Lee, Kyeong Rak;Shin, Geon Sik;Kang, Jae-won;Seo, Young Ik;Min, Hyukki
    • The Korean Journal of Blood Transfusion
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    • v.29 no.3
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    • pp.301-309
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    • 2018
  • Background: If donors who were deferred due to the reactivity or grey zone in HBV surface antigen (HBsAg) assay want to donate blood again, they need to pass reentry tests. On the other hand, approximately half of the donors who are subject to the reentry tests cannot be reentered. This study examined the association between the sample to cutoff (S/Co) value of the HBsAg assay and the final results of the reentry test. Methods: This study analyzed the S/Co values of the HBsAg assay and the final results of the reentry tests for the 3,947 donors from January 2008 to December 2017 using the database of Blood Information Management System of the Korean Red Cross. Results: 1,767 donors (44.8%) were not reentered among 3,947 deferred donors. Among 1,585 donors showing ${\geq}10$ of the S/Co value in the HBsAg screening test, 1,542 donors (97.3%) were not reentered. The additional reentry tests were performed on 120 donors who were not reentered in the first reentry test; 98 donors (81.7%) were still not reentered. Overall, 4.6% of the donors showing a grey zone in the HBsAg assay were not reentered. Conclusion: The reentry test needs to be restricted for the deferred donors showing a more than 10 S/Co value. The application of the grey zone of current HBsAg assay will need to be continued to enhance the HBV-related blood safety.

Archival Appraisal of Public Records Regarding Urban Planning in Japanese Colonial Period (조선총독부 공문서의 기록학적 평가 -조선총독부 도시계획 관련 공문서군을 중심으로-)

  • Lee, Seung Il
    • The Korean Journal of Archival Studies
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    • no.12
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    • pp.179-235
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    • 2005
  • In this article, the task of evaluating the official documents that were created and issued by the Joseon Governor General office during the Japanese occupation period, with new perspectives based upon the Macro-Appraisal approaches developed by the Canadian scholars and personnel, will be attempted. Recently, the Canadian people and the authorities have been showing a tendency of evaluating the meaning and importance of a particular document with perspectives considering the historical situation and background conditions that gave birth to that document to be a more important factor, even than considering the quality and condition of that very document. Such approach requires the archivists to determine whether they should preserve a certain document or not based upon the meaning, functions and status of the entity that produced the document or the meaning of the documentation practice itself, rather than the actual document. With regard to the task of evaluating the official documents created and issued by the Joseon Governor General office and involved the city plans devised by the office back then, this author established total of 4 primary tasks that would prove crucial in the process of determining whether or not a particular theme, or event, or an ideology should be selected and documents involving those themes, events and ideologies should be preserved as important sources of information regarding the Korean history of the Japanese occupation period. Those four tasks are as follow: First, the archivists should study the current and past trends of historical researches. The archivists, who are usually not in the position of having comprehensive access to historical details, must consult the historians' studies and also the trends mirrored in such studies, in their efforts of selecting important historical events and themes. Second, the archivists should determine the level of importance of the officials who worked inside the Joseon Governor General office as they were the entities that produced the very documents. It is only natural to assume that the level of importance of a particular document must have been determined by the level of importance(in terms of official functions) of the official who authorized the document and ordered it to be released. Third, the archivists should be made well aware of the inner structure and official functions of the Joseon Governor General office, so that they can have more appropriate analyses. Fourth, in order to collect historically important documents that involved the Koreans(the Joseon people), the archivists should analyze not only the functions of the Joseon Governor General office in general but also certain areas of the Office's business in which the Japanese officials and the Koreans would have interacted with each other. The act of analyzing the documents only based upon their respective levels of apparent importance might lead the archivists to miss certain documents that reflected the Koreans' situation or were related to the general interest of the Korean people. This kind of evaluation should provide data that are required in appraising how well the Joseon Governor General office's function of devising city plans were documented back then, and how well they are preserved today, utilizing a comparative study involving the Joseon Governor General office's own evaluations of its documentations and the current status of documents that are in custody of the National Archive. The task would also end up proposing a specialized strategy of collecting data and documents that is direly needed in establishing a well-designed comprehensive archives. We should establish a plan regarding certain documents that were documented by the Joseon Governor General office but do not remain today, and devise a task model for the job of primary collecting that would take place in the future.

Situations and Challenges of ODA for Sustainability of Asian Cultural Heritage (아시아 문화유산의 지속가능성을 위한 ODA 현황과 과제)

  • Yu, Jae Eun
    • Korean Journal of Heritage: History & Science
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    • v.49 no.3
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    • pp.270-285
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    • 2016
  • Various opinions and discussions have been actively in progress which are connected with cultural heritage since 'Sustainable Development Goals, SDGs' was announced by UN Sustainable Development Summit 2015 as Post-2015 Development Agenda. Apart from SDGs, conservation of cultural heritage itself stands on the basis of sustainability that originality, characteristic, diversity of cultural heritage should be permanently preserved. From that point of view, it is necessary to understand practical ODA for cultural heritage, far from theoretical approaches and policies. This paper is intended to look into the domestic and overseas situation related to ODA of Asian cultural heritage and the mentioned problems, future plans and challenges. First, the background and concepts about ODA were described and then ODA projects which have been carried out by Japan and China as typical ODA countries for Southeast Asia were introduced. ODA of cultural heritage in Korea has relatively recently started for restoration work for historic sites of Laos and Cambodia and its scale and performance do not come to much yet. Therefore, to develop ODA of cultural heritage, there are suggestions as in the followings. First, it is necessary to have a long-term master plan of ODA projects for sustainability of cultural heritage. Second, based on the view from the long-term perspective, the selection and focus for ODA partner countries should be considered, avoiding short-term projects aiming at a number of countries. Not widespread existing projects by other countries, but the model of Korean ODA for cultural heritage only Korea can conduct should be prepared. The next thing is connection with sustainability, and ultimately the conservation of cultural heritage should result in benefit to the natives by giving an impetus to economy as well as fostering tourism of local areas. To accomplish that connection, educational training and building capacity are suggested as the most suitable alternatives. Cultural heritage of each country reflects its indigenous originality and characteristics, therefore, the restoration work should be conducted by people in each country as the best way. From this point of view, ACPCS held by National Research Institute of Cultural Heritage will take a role of a specialized training program in Korean way. Lastly, establishment of a control tower for ODA in Korea is necessary. JCIC(Japan Consortium for International Cooperation in Cultural Heritage), which was set up in Japan for sharing information, establishment of cooperation system and prevention of overlapped projects will be an example we can take into consideration.

Design of Cloud-Based Data Analysis System for Culture Medium Management in Smart Greenhouses (스마트온실 배양액 관리를 위한 클라우드 기반 데이터 분석시스템 설계)

  • Heo, Jeong-Wook;Park, Kyeong-Hun;Lee, Jae-Su;Hong, Seung-Gil;Lee, Gong-In;Baek, Jeong-Hyun
    • Korean Journal of Environmental Agriculture
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    • v.37 no.4
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    • pp.251-259
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    • 2018
  • BACKGROUND: Various culture media have been used for hydroponic cultures of horticultural plants under the smart greenhouses with natural and artificial light types. Management of the culture medium for the control of medium amounts and/or necessary components absorbed by plants during the cultivation period is performed with ICT (Information and Communication Technology) and/or IoT (Internet of Things) in a smart farm system. This study was conducted to develop the cloud-based data analysis system for effective management of culture medium applying to hydroponic culture and plant growth in smart greenhouses. METHODS AND RESULTS: Conventional inorganic Yamazaki and organic media derived from agricultural byproducts such as a immature fruit, leaf, or stem were used for hydroponic culture media. Component changes of the solutions according to the growth stage were monitored and plant growth was observed. Red and green lettuce seedlings (Lactuca sativa L.) which developed 2~3 true leaves were considered as plant materials. The seedlings were hydroponically grown in the smart greenhouse with fluorescent and light-emitting diodes (LEDs) lights of $150{\mu}mol/m^2/s$ light intensity for 35 days. Growth data of the seedlings were classified and stored to develop the relational database in the virtual machine which was generated from an open stack cloud system on the base of growth parameter. Relation of the plant growth and nutrient absorption pattern of 9 inorganic components inside the media during the cultivation period was investigated. The stored data associated with component changes and growth parameters were visualized on the web through the web framework and Node JS. CONCLUSION: Time-series changes of inorganic components in the culture media were observed. The increases of the unfolded leaves or fresh weight of the seedlings were mainly dependent on the macroelements such as a $NO_3-N$, and affected by the different inorganic and organic media. Though the data analysis system was developed, actual measurement data were offered by using the user smart device, and analysis and comparison of the data were visualized graphically in time series based on the cloud database. Agricultural management in data visualization and/or plant growth can be implemented by the data analysis system under whole agricultural sites regardless of various culture environmental changes.

A Study on the Necessity Verification of Convex Probe Disinfection (Convex Probe 소독 필요성 검증에 관한 연구)

  • Choi, Kwan-Yong;Yoo, Se-jong;Lee, Jun-ho;Hong, Sung-Yong
    • Journal of the Korean Society of Radiology
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    • v.13 no.2
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    • pp.193-200
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    • 2019
  • The study was conducted surveying ultrasound room workers on hospital infection awareness in Daejeon and Choong-chunng region. The contamination of ultrasonic probes used in clinical trials was measured using ATP, and the results were verified after using 70% alcohol sterilization. It was measured on the group's general characteristics and the specific categories such as academic background, job type, having professional certificate and infection education. After the examination, the gel removal and method, disinfection status of the probe and variable correlation analysis were performed to analyze the recognition of the ultrasonic probe disinfection. After examination in ultrasound room, it was found that towels were used the most for cleaning, and the gel container was not replaced for more than three months. After 70% alcohol disinfection, ATP contamination was reduced from $1055.4{\pm}944.2$ to $133.5{\pm}93.2$ and the result was analyzed to be statistically significant.(${\rho}<0.01$) The found bacteria were CNS, Gram positive bacillus, and Micrococcus specs. In order to solve this problem, 70% alcohol sterilization was applied and the bacteria were not detected after the treatment. The research shows that regular training on infection control and efforts to prevent infection are necessary, and that 70% alcohol is effective in disinfect the bacteria. Therefore, the medical institution should provide active hospital infection control education to improve the awareness of hospital infection among workers and contribute to the prevention of patient infection. It is also understood that proper use of the results of this study will help prevent infection by means of ultrasonic probes.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea

  • Kim, Chul;Sung, Jidong;Lee, Jong Hwa;Kim, Won-Seok;Lee, Goo Joo;Jee, Sungju;Jung, Il-Young;Rah, Ueon Woo;Kim, Byung Ok;Choi, Kyoung Hyo;Kwon, Bum Sun;Yoo, Seung Don;Bang, Heui Je;Shin, Hyung-Ik;Kim, Yong Wook;Jung, Heeyoune;Kim, Eung Ju;Lee, Jung Hwan;Jung, In Hyun;Jung, Jae-Seung;Lee, Jong-Young;Han, Jae-Young;Han, Eun Young;Won, Yu Hui;Han, Woosik;Baek, Sora;Joa, Kyung-Lim;Lee, Sook Joung;Kim, Ae Ryoung;Lee, So Young;Kim, Jihee;Choi, Hee Eun;Lee, Byeong-Ju;Kim, Soon
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.248-329
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    • 2019
  • Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Psychological Characteristics of Living Liver Transplantation Donors using MMPI-2 Profiles (MMPI-2를 이용한 생체 간 공여자들의 심리적 특성에 대한 연구)

  • Lee, Jin Hyeok;Choi, Tae Young;Yoon, Seoyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.42-49
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    • 2019
  • Objectives : Living donor liver transplantation (LDLT) is a life-saving therapy for patients with terminal liver disease. Many studies have focused on recipients rather than donors. The aim of this study was to assess the emotional status and personality characteristics of LDLT donors. Methods : We evaluated 218 subjects (126 male, 92 female) who visited Daegu Catholic University Medical Center from August 2012 to July 2018. A retrospective review of their preoperative psychological evaluation was done. We investigated epidemiological data and the Minnesota Multiphasic Personality Inventory-2 questionnaire. Subanalysis was done depending on whether subjects actually underwent surgery, relationship with the recipient, and their gender. Results : Mean age of subjects was $32.19{\pm}10.91years$. 187 subjects received LDLT surgery (actual donors) while 31 subjects didn't (potential donors). Donor-recipient relationship included husband-wife, parent-children, brother-sister etc. Subjects had statistical significance on validity scale L, F, K and all clinical scales compared to the control group. Potential donors had significant difference in F(b), F(p), K, S, Pa, AGGR, PSYC, DISC and NEGE scales compared to actual donors. F, D and NEGE scales were found to be predictive for actual donation. Subanalysis on donor-recipient relationship and gender also showed significant difference in certain scales. Conclusions : Under-reporting of psychological problems should be considered when evaluating living-liver donors. Information about the donor's overall psychosocial background, mental status and donation process should also be acquired.

A Study on the Sketch of Trikaya Banner Painting in the Suta-sa Temple (수타사 삼신불괘불도(三身佛掛佛圖) 초본(草本) 연구)

  • Kim, Chang Kyun
    • Korean Journal of Heritage: History & Science
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    • v.42 no.4
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    • pp.112-131
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    • 2009
  • The Trikaya Banner Painting in the Suta-sa Temple at Hongcheon-gun, Gangwon-do draws attention as it was painted not on flax but on paper, and used the water color painting technique on the sketch rather than the deep color painting technique, which is most common in Buddhist paintings created during the Chosun Dynasty. Nevertheless, there is not any information on the creation of the Trikaya Banner Painting in the painting record on the painting, in Sutasasajeok(壽陀寺史蹟), or in Sutasagogirok(壽陀寺古記錄), so it is uncertain when the painting was created. Furthermore, because it was not drawn by the deep color painting technique, it has been difficult to compare it with other banner paintings. For these reasons, the Trikaya Banner Painting has been studied little except brief introduction. In recent preservation treatment that removed multiple-layered paper from the back of the painting, however, an inked inscription written on Korean paper 118cm high and 87.5cm wide was discovered on the back. It is a kind of placard notifying a number of acts prohibited in order to follow Buddha's teachings correctly, and was found to have been written on April 15, 1690. The inked inscription is a very valuable material for estimating the creation date of the Suta-sa Trikaya Banner Painting, and provides crucial clues for approaching the contents and nature of the painting more precisely. When the image, form, and style of the Suta-sa Trikaya Banner Painting were examined and its creation date was estimated based on the inked inscription, first, the painting is presumed to have been created in around 1690 as suggested by 'the placard' attached on the back instead of a painting record. Second, the painting is highly likely to be the first standing Trikaya banner painting showing the basic icons of Trikaya banner paintings in the Chosun Dynasty since the Trikaya Banner Painting in the Gap-sa Temple in Gongju (1650). Furthermore, considering the shape of the Trikaya in the painting, screen composition, background treatment, solemn and affectionate facial expression, harmonious and adequate body proportion, etc., the painting is believed to have had a considerable influence not only on Trikaya banner paintings of similar style in the 18thcentury but also on deep-color Trikaya banner paintings in the 19thcentury. Third, although the Suta-sa Trikaya Banner Painting is not acompleted work but a sketch, it exhibits the typical water color painting technique in which the strokes are clearly visible. Thus, it is considered highly valuable in understanding and analyzing stroke styles and in studying the history of Buddhist paintings. As there are not many extant banner paintings of the same style in form and expression technique as the Suta-sa Temple Trikaya Banner Painting, this study could not make thorough comparative analysis of the work, but still it is meaningful in that it laid the ground for research on standing Trikaya banner paintings in the 18thand 19thcenturies in the Chosun Dynasty.

An Overview of Surgical Treatment of Thymic Epithelial Tumors in Korea: A Retrospective Multicenter Analysis

  • Lee, Jun Oh;Lee, Geun Dong;Kim, Hyeong Ryul;Kim, Dong Kwan;Park, Seung-Il;Cho, Jong Ho;Kim, Hong Kwan;Choi, Yong Soo;Kim, Jhingook;Shim, Young Mog;Park, Samina;Park, In Kyu;Kang, Chang Hyun;Kim, Young Tae;Park, Seong Yong;Lee, Chang Young;Lee, Jin Gu;Kim, Dae Joon;Paik, Hyo Chae;the Korean Association for Research on the Thymus,
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.126-142
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    • 2022
  • Background: Thymic epithelial tumors (TETs) are rare, and information regarding their surgical outcomes and prognostic factors has rapidly changed in the past few decades. We analyzed surgical treatment practices for TETs and outcomes in terms of overall survival (OS) and freedom from recurrence (FFR) during a 13-year period in Korea. Methods: In total, 1,298 patients with surgically resected TETs between 2000 and 2013 were enrolled retrospectively. OS and FFR were calculated using the Kaplan-Meier method and evaluated with the log-rank test. Prognostic factors for OS and FFR were analyzed with multivariable Cox regression. Results: A total of 1,098 patients were diagnosed with thymoma, and 200 patients were diagnosed with thymic carcinoma. Over the study period, the total number of patients with surgically treated TETs and the proportion of patients who underwent minimally invasive thymic surgery (MITS) increased annually. The 5-year and 10-year survival rates of surgically treated TETs were 91.0% and 82.1%, respectively. The 5-year and 10-year recurrence rates were 86.3% and 80.0%, respectively. The outcomes of surgically treated TETs improved over time. Multivariable Cox hazards analysis for OS, age, tumor size, and Masaoka-Koga stage were independent predictors of prognosis. The World Health Organization classification and tumor-node-metastasis (TNM) staging were also related to the prognosis of TETs. Conclusion: Surgical treatment of TETs achieved a good prognosis with a recent increase in MITS. The M-K stage was the most important prognostic factor for OS and FFR. The new TNM stage could also be an effective predictor of the outcomes of TETs.