• 한국보건간호학회지
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• 제19권1호
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• pp.41-52
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• 2005

This study was designed to provide a base for nursing intervention to help apheresis blood-donors to perform health promotion behavior effectively by surveying their health promotion behavior and by analyzing the critical factors. The study subjects were 468 participants in platelet donation at a university hospital apheresis unit in Seoul. The data for this study were collected between May and June. 2002. by questionnaire. Data were analyzed by t-test, ANOVA. Scheffe test, Pearson correlation coefficient. and stepwise multiple regression. The results were as follows. 1. The degree of performance of health promotion behavior of the subjects was a total average score of $152.9\pm21.5$ points and a mean score of 2.7 points. The highest score was 'I have a good relationship with others' in the factor of self-actualization and interpersonal support. The lowest score was 'I have my blood pressure checked regularly' in the factor of health responsibility. 2. Considering the classification according to the subjects' general characteristics. the health promotion behavior score was significantly higher for soldiers than high school students, for religious believers than atheists. and for high class economic status than mid and low class economic status. Also the health promotion behavior score was higher for those who had made more than five blood donations than those who had made zero or one donation. and for those who had made more than four blood donations than for those who had made less than four blood donations in the previous times of apheresis blood donation. The score was also higher for those not having a relationship with recipient than those having a relationship. 3. The self-efficacy related to donation. general self-efficacy and self-esteem had a significant correlation with the performance in health promotion behavior. 4. The critical factors that influenced the health promotion behavior were explained by $35.6\%$ of the general self-efficacy and by $40.2\%$ of the total of self-efficacy related to donation, and previous times of apheresis blood donation. The health promotion behavior score of apheresis blood-donors differed according to job, religion, economic status, previous times of whole blood donation, previous times of apheresis blood donation, and relationship with recipient. The health promotion behavior and self-efficacy related to donation, general self-efficacy, and self-esteem showed significant positive correlation with one another. The general self-efficacy, self-efficacy related to donation, and previous times of apheresis blood donation appeared to be the significant predictive factors of health promotion behavior. Therefore, from these study results, it is necessary to establish more effective and organized nursing intervention strategies for the health promotion behavior of apheresis blood-donors.

• 한국보건간호학회지
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• 제17권1호
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• pp.122-131
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• 2003

This study was designed to provide the base of nursing intervention that could help apheresis blood-donors to promote self-efficacy effectively by analyzing critical factors that influence on this. The subjects recruited for the research were 468 persons who participated in platelet donation at a university hospital apheresis unit in Seoul. The data for this study were collected between May and June, 2002 using questionnaires. Data were analyzed by t-test, ANOVA, Scheffe test, and stepwise multiple regression. The results were as follows. 1. The mean self-efficacy score on the questions related to blood donation was $32.9\pm5.1$, indicating that blood donors have above the mean level of self-efficacy related to blood donation. 2. The self-efficacy score was significantly higher for the group of persons who have more than 5 times of experiences in blood donation than others who have only one experience. 3. The critical factors that influence self-efficacy related to donation were the marital status, educational level. and previous experiences of whole blood donation, while the critical factor that influence on general self-efficacy was previous experiences of whole blood donation. Therefore, it is necessary to establish more effective and organized nursing intervention strategies that can promote the self-efficacy of apheresis blood-donors.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권1호
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• pp.39-44
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• 2020

Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

• Journal of Microbiology and Biotechnology
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• 제21권6호
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• pp.659-664
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• 2011

Staphylococcus aureus (SA) bacteremia is associated with high mortality, and often results in metastatic infections. The methicillin-resistant SA (MRSA) is an urgent health care issue, as nosocomial infections with these bacteria represent limited treatment alternatives. Samples of whole blood containing challenge inoculums of SA and MRSA strains were passed through columns packed with surfaceheparinized polyethylene beads. The bound bacteria were eluted and quantitatively determined by culturing and by real-time PCR. Significant amounts of both SA and MRSA adhered to the heparinized beads (more than 65% of inoculated bacteria). After rinsing with buffer at high ionic strength, viable bacteria or bacterial DNA were eluted from the columns, indicating that the binding was specific. The conclusions that can be made from these experiments are that, as earlier reported in the literature, the high affinity of SA to heparin is retained in whole blood, and MRSA in whole blood binds to heparin with similar or higher affinity than SA. It should be possible to lower the amount of SA and/or MRSA from the blood of infected patients to levels that could be taken care of by the immune system. In previous studies, we have shown that passing blood from septic patients over beads coated with end-point-attached, biologically active heparin is a useful technique for regulating the levels of heparinbinding cytokine. These findings in combination with the present findings indicate the possibility of creating an apheresis technology for treatment of sepsis caused by SA and/or MRSA.

• 한국보건간호학회지
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• 제17권2호
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• pp.333-341
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• 2003

This study was designed to provide basic strategies of nursing intervention in order to keep and obtain healthy, responsible and regular donors by investigating and analyzing relationships of health promotion behavior. self-efficacy and self-esteem of blood-donors. The subjects collected for the research were four hundred and sixty-eight individuals who participated in platelet donation at a university hospital apheresis unit in Seoul. The data for this study were collected between May and June, 2002 using questionnaires. The results were as follows. 1. The proportion of subjects who have not had previous experience of whole blood-donation was $13.7\%$, while the proportion of subjects who have had two times previous experiences was $16.2\%$ and over five times was $30.6\%$. 2. Mean score of health promotion behavior was 2.7 (range 1-4), self-efficacy was 3.8 (range 1-5) and self-esteem was 3.3 (range 1-4), which showed higher than middle. 3. There was positive significant relationship between the number of blood-donation and health promotion behavior as well as the number of blood donation and self-efficacy. 4. Positive significant relationship existed between the number of whole blood-donation and the number of apheresis blood-donation. Therefore, to increase recurrence of blood-donation. it is necessary to establish more effective and organized nursing intervention strategies that can promote the health promotion behavior, self-efficacy and self-esteem of blood-donors.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.81-88
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• 2017

Purpose: The American Society for Apheresis provides clinical guidelines for therapeutic apheresis in adults, but there are no guidelines for children. This study aimed to analyze the effect of therapeutic plasma exchange (TPE) in pediatric patients with various kidney diseases in Korea. Methods: We retrospectively reviewed the data of 16 children (up to 18 years of age) who were admitted to Severance Children's Hospital with refractory kidney disease. All patients received TPE between 1994 and 2016. Clinical and laboratory characteristics such as age, weight, sex, change in blood urea nitrogen (BUN), and creatinine level before and after TPE, and complications after TPE were analyzed. Results: The mean age and weight of the 16 patients at the time of TPE was $11.3{\pm}4.0$ years and $34.6{\pm}17.5$ kg, respectively. The BUN level was 35.4 mg/dL before TPE and significantly decreased to 21.5 mg/dL (P=0.025) at 1 week and 20.5 mg/dL (P= 0.01) at 1 month after TPE. The creatinine level significantly decreased from 1.20 mg/dL before TPE to 0.90 mg/dL (P=0.02) at 1 week after TPE. Four complications (hypovolemia, anemia, hypocalcemia, and thrombocytopenia) were reported, but were not fatal. Conclusion: Our findings suggest that TPE is an effective therapeutic modality in children with refractory kidney disease and can be indicated for the treatment of various kidney diseases.

• 생명과학회지
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• 제24권9호
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• pp.1030-1038
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• 2014

혈소판제제는 출혈질환이나 혈소판의 기능장애 치료를 위해 사용되고 있다. 혈소판성분채집술은 혈액성분채집기를 사용하여 혈소판 성분을 채집하는 방법으로, 성분채집혈소판의 질 평가에는 다양한 지표들이 이용되고 있다. 채집된 혈소판의 생산성은 채집효율(collection efficiency)과 채집률(collection rates)로 평가되고 보관된 혈소판의 질은 in vitro 상에서 시각적 외양, 대사활성도, 양, 혈소판 수, 백혈구 수, 미세입자(microparticles), 그리고 다양한 혈소판 활성 표지자들로 평가된다. 혈소판 활성 표지자들은 여러 연구분야에서도 이용되고 있다. 수혈된 후의 혈소판의 질은 교정증가치(corrected count increment)와 혈소판회복퍼센트(percentage platelet recovery)로 평가된다. 본 논문은 혈소판성분채집술의 채집과정, 사용되는 장비, 성분채집혈소판의 질, 전반적인 효율성, 그리고 질평가 지표들에 대한 리뷰(review)와 함께 다른 혈액성분채집기 간의 기능의 차이점을 비교하였고, 또한 혈소판성분채집술은 구연산염 항응고제에 의한 부작용을 일으킬 수는 있지만 전혈 헌혈시에 실신의 전구증상이나 실신을 일으킬 위험이 있는 헌혈자들에게는 더 안전한 방법임을 보여주고 있다.

• The Korean Journal of Medicine
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• 제93권6호
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• pp.518-524
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• 2018

Hypertriglyceridemia a major cause of acute pancreatitis, accounting for up to 10% of all cases. The pathophysiological mechanism of hypertriglyceridemia-induced acute pancreatitis (HTGP) is presumed to involve the hydrolysis of triglycerides by pancreatic lipase resulting in an excess of free fatty acids and elevated chylomicrons, which are thought to increase plasma viscosity and induce ischemia and inflammation in pancreatic tissue. Although the clinical course of HTGP is similar to other forms of acute pancreatitis, the clinical severity and associated complications are significantly higher in patients with HTGP. Therefore, an accurate diagnosis is essential for treatment and prevention of disease recurrence. At present, there are no approved guidelines for the management of HTGP. Different treatment modalities such as apheresis/plasmapheresis, insulin, heparin, fibric acids, and omega-3 fatty acids have been successfully implemented to reduce serum triglycerides. Following acute phase management, lifestyle modifications including dietary adjustments and drug therapy are important for the long-term management of HTGP and the prevention of relapse. Additional studies are required to produce generalized and efficient treatment guidelines for HTGP.

• Childhood Kidney Diseases
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• 제26권1호
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• pp.25-30
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• 2022

Dyslipidemia in nephrotic syndrome (NS) is often characterized by marked increases in the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, and other lipoproteins, such as very low-density lipoprotein, intermediate-density lipoprotein, and lipoprotein(a). It has been suggested that impaired catabolism of lipoproteins and cholesterol is mainly due to decreased lipoprotein lipase and hepatic lipase activity, and increased biosynthesis of lipoproteins in the liver. The management strategies for dyslipidemia in patients with NS consist of lifestyle modification, lipid-lowering agents represented by statins, second-line agents such as fibrates and bile acid sequestrants, and lipid apheresis. Compared with dyslipidemia in adult NS patients, whose risks of atherosclerotic disease and progressive renal injury are considered high, clinical data on dyslipidemia in pediatric NS patients are limited. Therefore, it is necessary to pay more attention to the evaluation and management of dyslipidemia in pediatric patients with NS in clinical practice.

• 한국보건간호학회지
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• 제14권1호
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• pp.172-181
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• 2000

This study was designed to evaluate the degree of the anxiety and discomfort experienced by first-time donors in platelet donation. The subject of this study was 309 first-time platelet donors visiting apheresis unit of St. Mary hospital in Seoul. The data was collected from Questionnaire during period of 28 April to 10 September 1999. The statistical methods used were t-test. ANOVA and stepwise multiple regression. The results were as follows. 1. The most common group were 21-30 years of age and soldier of job. 2. The mean scores of the platelet donor's anxiety was $1.60\pm0.32$. 3. The mean scores of platelet donor's discomfort was $1.72\pm0.44$. 4. The variables influencing anxiety were the physical condition. the level of education and donation experience. 5. The variables influencing discomfort were the job. diet before donation and physical condition. As the result above. the student group of the first time platelet donor experienced highest anxiety. It is important to assess the physical condition and diet before donation for more comfortable platelet donation. Furthermore. the developments of nursing interventions are required to reduce anxiety and discomfort of platelet donors.